Combination acetabular radiofrequency ablation and cementoplasty using a navigational radiofrequency ablation device and ultrahigh viscosity cement: technical note

Abstract

Palliative percutaneous acetabular radiofrequency ablation and cementoplasty can be feasibly performed from an anterior approach using a navigational ablation probe and ultrahigh viscosity cement instilled under CT-fluoroscopic guidance.

CT fluoroscopy-guided percutaneous osteoplasty with or without radiofrequency ablation in the treatment of painful extraspinal and spinal bone metastases: technical outcome and complications in 29 patients

“…Some interventional units employ a combination of a computed tomography (CT) scanner and a mobile C-arm, allowing for exact needle positioning using CT image to view the cross-sectional area of the osteolysis and adjacent soft tissues, and C-arm fluoroscopy to view needle inclination and cement extravasation (10,21). Other authors stated successful needle placement, or the combination of needle placement for thermal ablation and consecutive cementoplasty under conventional sequential CT (12,28), CT fluoroscopy (9,29), or conebeam CT guidance (25).…”

Percutaneous Ablation in Painful Bone Tumors

“…1 More recently, navigational bipolar RFA probes with built-in thermocouples have become available that allow real-time monitoring of ablation zone size by measuring the temperatures along the periphery of the ablation zone during the procedure. [2][3][4] The navigating tip of the probe can be articulated in different orientations through the same entry site that is beneficial for accessing lesions in challenging locations as well as achieving larger overlapping ablation zones. [2][3][4] Choice of the RF probe depends in large part on the volume of tissue to be ablated and the proximity to vital structures.…”

“…[2][3][4] The navigating tip of the probe can be articulated in different orientations through the same entry site that is beneficial for accessing lesions in challenging locations as well as achieving larger overlapping ablation zones. [2][3][4] Choice of the RF probe depends in large part on the volume of tissue to be ablated and the proximity to vital structures. 1 Limitations of RFA include nonvisualization of the ablation margin with computed tomography (CT), pain associated with the procedure, and, frequently, increased pain during the immediate posttreatment period.…”

“…Over the past several years, investigators have demonstrated the safety and efficacy of RFA for the management of patients with painful appendicular osseous metastatic disease to achieve pain palliation and/or local tumor control often combined with cementoplasty for pathologic fracture stabilization or prevention 3,4,[20][21][22][23] In a multicenter clinical trial, 22 43 patients with painful osteolytic osseous metastases were treated with RFA, and 95% of patients had clinically significant improved pain with decreased opioid usage following the procedure. There were three complications including one skin burn at the grounding pad site, one acetabular fracture, and one transient bowel/bladder incontinence following a sacral RFA.…”

“…65 An advantage of RFA is the commercial availability of a probe with an articulated distal segment that can be curved into multiple portions of the tumor from a single approach. [2][3][4] Cryoablation is a good choice for larger tumors with complex geometries because multiple cryoprobes can be strategically arranged to produce a contiguous ice ball with a tailored configuration. 49,51,52 Thermal protec-tion measures (described in the next section) should be used when the planned ablation zone is in close proximity to structures at risk of ablation-induced injury including the peripheral nerves, skin, and vital torso soft tissues such as the bowel.…”