Percutaneous MR-Guided Cryoablation of Low-Flow Vascular Malformation: Technical Feasibility, Safety and Clinical Efficacy

Autrusseau, Pierre-Alexis; Cazzato, Roberto Luigi; Marini, Pierre De; Dalili, Danoob; Koch, Guillaume; Boatta, Emanuele; Garnon, Julien; Gangi, Afshin

doi:10.1007/s00270-020-02455-z

Cited by 20 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5), OB, 81 ABC (►Fig. 6), primary bone tumors, neuromata and AVMs, 82,83 and chondroblastoma. 84 • Malignant: Skeletal metastasis (particularly osteoblastic and sclerotic; ►Fig.…”

Section: Cryoablation Techniquementioning

confidence: 99%

Interventional Techniques for Bone and Musculoskeletal Soft Tissue Tumors: Current Practices and Future Directions - Part I. Ablation

Dalili

Isaac

Bazzocchi

et al. 2020

Semin Musculoskelet Radiol

Self Cite

View full text Add to dashboard Cite

Musculoskeletal (MSK) image-guided oncologic intervention is an established field within radiology. Numerous studies have described its clinical benefits, safety, cost effectiveness, patient satisfaction, and improved quality of life, thereby establishing image-guided oncologic intervention as a preferred pathway in treating patients presenting with specific benign MSK tumors. But there is a paradigm shift on the horizon because these techniques may also support established pillars (surgery, systemic treatment, radiotherapy) in the treatment of malignant MSK tumors. Unlike benign tumors, where they are used as primary therapy lines with curative intent, such interventions can be selected for malignant tumors as adjuvant treatment in painful or unstable bone or soft tissue lesions or as more palliative therapy strategies. Using examples from our clinical practices, we elaborate on the benefits of applying a multidisciplinary approach (traditionally involving MSK radiologists, oncologists, orthopaedic surgeons, microbiologists, pathologists, physiotherapists, and pain management experts), ideally within a sarcoma treatment center to deliver a patient-specific therapy plan and illustrate methods to assess the benefits of this model of care.In this article, we review the current repertoire of ablation techniques, demonstrate why such procedures offer value-based alternatives to conventional treatments of specific tumors, and reflect on future directions. Additionally, we review the advantages and limitations of each technique and offer guidance to improve outcomes.

show abstract

“…5), OB, 81 ABC (►Fig. 6), primary bone tumors, neuromata and AVMs, 82,83 and chondroblastoma. 84 • Malignant: Skeletal metastasis (particularly osteoblastic and sclerotic; ►Fig.…”

Section: Cryoablation Techniquementioning

confidence: 99%

Interventional Techniques for Bone and Musculoskeletal Soft Tissue Tumors: Current Practices and Future Directions - Part I. Ablation

Dalili

Isaac

Bazzocchi

et al. 2020

Semin Musculoskelet Radiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…At a mean follow-up time of 548 days, 67% (6/9) patients reported complete resolution of pain without recurrence after single session. The remaining 3 patients underwent further cryoablation treatments, after which they reported complete resolution of symptoms at post-procedure follow-up (range 25–153 days) ( 30 ). Koepsel et al reported another experience treating 5 foot LFVM patients with MR-guided cryoablation in a 1.5 T Philips Ingenia system (Philips Healthcare, Andover, MA, USA) with IceRod cryoprobes (Galil Medical/Boston Scientific, Marlborough, MA).…”

Section: Cryoablationmentioning

confidence: 99%

Magnetic resonance – guided treatment of low-flow vascular malformations and the technologies to potentiate adoption

Bailey,

Herrera,

Neumeister

et al. 2024

Front. Med.

View full text Add to dashboard Cite

Vascular malformations are congenital, non-neoplastic lesions that arise secondary to defects in angiogenesis. Vascular malformations are divided into high-flow (arteriovenous malformation) and low-flow (venous malformations and lymphatic malformations). Magnetic resonance imaging (MRI) is the standard for pre-and post-intervention assessments, while ultrasound (US), X-ray fluoroscopy and computed tomography (CT) are used for intra-procedural guidance. Sclerotherapy, an image-guided therapy that involves the injection of a sclerosant directly into the malformation, is typically the first-line therapy for treating low-flow vascular malformations. Sclerotherapy induces endothelial damage and necrosis/fibrosis with eventual involution of the malformation. Image-guided thermal therapies involve freezing or heating target tissue to induce cell death and necrosis. MRI is an alternative for intra-procedural guidance and monitoring during the treatment of vascular malformations. MR can provide dynamic, multiplanar imaging that delineates surrounding critical structures such as nerves and vasculature. Multiple studies have demonstrated that MR-guided treatment of vascular malformations is safe and effective. This review will detail (1) the use of MR for the classification and diagnosis of vascular malformations, (2) the current literature surrounding MR-guided treatment of vascular malformations, (3) a series of cases of MR-guided sclerotherapy and thermal ablation for the treatment of vascular malformations, and (4) a discussion of technologies that may potentiate interventional MRI adoption including high intensity focused ultrasound and guided laser ablation.

show abstract

“…The newest cone-beam CT units have incorporated artificial intelligence capabilities including deep learning algorithms that allow guidance of bone access cannulas without requiring fluoroscopy, markedly reducing radiation dose. 31 MRI guidance has also emerged, allowing target identification in soft tissue lesions while avoiding ionizing radiation, 32 , 33 although its usage is limited by costs and availability.…”

Section: Imaging Guidancementioning

confidence: 99%

Cementoplasty to cryoablation: review and current status

Tan,

Yan,

Sheikh

et al. 2023

BJR|Open

View full text Add to dashboard Cite

Recent advances in percutaneous image-guided techniques have empowered interventional radiologists with diverse treatment options for the management of musculoskeletal lesions. Of note, there is growing utility for cementoplasty procedures, with indications ranging from stabilisation of bone metastases to treatment of painful vertebral compression fractures. Likewise, cryoablation has emerged as a viable adjunct in the treatment of both primary and secondary bone and soft tissue neoplasms. These treatment options have been progressively incorporated into the multi-disciplinary approach to holistic care of patients, alongside conventional radiotherapy, systemic therapy, surgery and analgesia. This review article serves to outline the indications, technical considerations, latest developments and evidence for the burgeoning role of cementoplasty and cryoablation in the musculoskeletal system, with an emphasis on pain palliation and tumour control.

show abstract

Percutaneous MR-Guided Cryoablation of Low-Flow Vascular Malformation: Technical Feasibility, Safety and Clinical Efficacy

Cited by 20 publications

References 17 publications

Interventional Techniques for Bone and Musculoskeletal Soft Tissue Tumors: Current Practices and Future Directions - Part I. Ablation

Interventional Techniques for Bone and Musculoskeletal Soft Tissue Tumors: Current Practices and Future Directions - Part I. Ablation

Magnetic resonance – guided treatment of low-flow vascular malformations and the technologies to potentiate adoption

Cementoplasty to cryoablation: review and current status

Contact Info

Product

Resources

About