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Saline-Infused Bipolar Radiofrequency Ablation of High-Risk Spinal and Paraspinal Neoplasms

Xavier Buy1, Antonio Basile1,2, Guillame Bierry1, Juan Cupelli1 and Afshin Gangi1

1 Department of Radiology B, University Hospital of Strasbourg, Strasbourg, France.
2 Department of Radiology, Ospedale Ferrarotto, via Citelli, Catania 94125, Italy.


Figure 1
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  		Fig. 1A —49-year-old man with renal cell carcinoma of left kidney who was referred for palliative treatment of refractory painful metastasis in L3. Axial CT scans show soft-tissue mass involving vertebral body, posterior wall, and ipsilateral pedicle (A) and same mass with two infused 18-gauge radiofrequency needles inserted (B).

 

Figure 2
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  		Fig. 1B —49-year-old man with renal cell carcinoma of left kidney who was referred for palliative treatment of refractory painful metastasis in L3. Axial CT scans show soft-tissue mass involving vertebral body, posterior wall, and ipsilateral pedicle (A) and same mass with two infused 18-gauge radiofrequency needles inserted (B).

 

Figure 3
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  		Fig. 1C —49-year-old man with renal cell carcinoma of left kidney who was referred for palliative treatment of refractory painful metastasis in L3. Posttreatment CT control scan shows air bubbles within treated lesion, a sign of necrosis.

 

Figure 4
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  		Fig. 2A —65-year-old man who previously underwent surgery for prostatic cancer and was referred with paresthesia for palliative treatment of refractory painful metastasis in T10. CT scan shows extensive involvement of either vertebral body or pedicles, with right paravertebral mass involving posterior arc of ipsilateral rib.

 

Figure 5
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  		Fig. 2B —65-year-old man who previously underwent surgery for prostatic cancer and was referred with paresthesia for palliative treatment of refractory painful metastasis in T10. CT scan shows two infused 18-gauge radiofrequency needles that were inserted into paravertebral mass under CT and fluoroscopic guidance.

 

Figure 6
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  		Fig. 2C —65-year-old man who previously underwent surgery for prostatic cancer and was referred with paresthesia for palliative treatment of refractory painful metastasis in T10. CT scan shows 10-gauge vertebroplasty needle that was placed into vertebral body between contralateral rib and pedicle under CT and fluoroscopic guidance, and 18-gauge radiofrequency needle that was inserted through the 10-gauge needle (arrow).

 

Figure 7
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  		Fig. 2D —65-year-old man who previously underwent surgery for prostatic cancer and was referred with paresthesia for palliative treatment of refractory painful metastasis in T10. CT and fluoroscopic control image after radiofrequency plus vertebroplasty shows oval paraspinal necrotic area, with cement in vertebral body.

 

Figure 8
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  		Fig. 3A —52-year-old man with history of prostatic carcinoma previously treated by surgery who was referred for palliative treatment of refractory painful metastasis in T10. CT scan shows left paraspinal soft-tissue lesion, with involvement of ipsilateral pedicle and posterior arc of ipsilateral rib.

 

Figure 9
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  		Fig. 3B —52-year-old man with history of prostatic carcinoma previously treated by surgery who was referred for palliative treatment of refractory painful metastasis in T10. CT scan shows two infused 18-gauge radiofrequency needles that were inserted through posterior approach with patient prone.

 

Figure 10
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  		Fig. 3C —52-year-old man with history of prostatic carcinoma previously treated by surgery who was referred for palliative treatment of refractory painful metastasis in T10. Posttreatment CT control scan shows air bubbles within treated lesion, a sign of necrosis.

 

Figure 11
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  		Fig. 3D —52-year-old man with history of prostatic carcinoma previously treated by surgery who was referred for palliative treatment of refractory painful metastasis in T10. MR follow-up image shows round-shaped hypointense area corresponding to ablated tissue.

 

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