Enhanced Precision and Safety in Thermal Ablation: O-Arm Cone Beam Computed Tomography with Magnetic Resonance Imaging Fusion for Spinal Column Tumor Targeting

Abstract

Spinal metastatic tumors are common and often cause debilitating symptoms. Image-guided percutaneous thermal ablation (IPTA) has gained significant recognition in managing spinal column tumors due to its exceptional precision and effectiveness. Conventional guidance modalities, including computed tomography, fluoroscopy, and ultrasound, have been important in targeting spinal column tumors while minimizing harm to adjacent critical structures. This study presents a novel approach utilizing a fusion of cone beam computed tomography with magnetic resonance imaging to guide percutaneous thermal ablation for four patients with secondary spinal column tumors. The visual analog scale (VAS) evaluated the procedure effectiveness during an 18-month follow-up. Percutaneous vertebroplasty was performed in two cases, and a thermostat was used during all procedures. Imaging was performed using the Stealth Station navigation system Spine 8 (SSS8) and a 1.5T MRI machine. The fusion of CBCT with MRI allowed for precise tumor localization and guidance for thermal ablation. Initial results indicate successful tumor ablation and symptom reduction, emphasizing the potential of CBCT–MRI fusion in spinal column tumor management. This innovative approach is promising in optimizing therapy for secondary spinal column tumors. Further studies are necessary to validate its efficacy and applicability.

Evaluating Imaging Techniques for Diagnosing and Drainage Guidance of Psoas Muscle Abscess: A Systematic Review

“…Integrating an O-arm scan with MRI intraoperatively, combined with the navigation system, has already proven to be beneficial in managing various liver, kidney, and spinal column tumors, leveraging the distinct advantages of CT and MRI during surgical procedures [ 25 , 26 ]. Utilizing MRI’s detailed soft tissue visualization alongside the precise anatomical detail provided by CT ensures highly accurate targeting and the adequate drainage of abscesses.…”

“…The focus on imaging-guided PD reflects a critical step toward optimizing PMA management. However, we believe there is still space for improvement in guiding the PD process using fusion techniques (CT and MRI), especially since it has proven its efficacy in different percutaneous interventions, such as diagnosing and ablating different spinal column tumors or their management [ 25 , 26 ].…”