The Use of Radiofrequency Ablation in the Treatment of Musculoskeletal Tumors

Volkmer, Dustin; Sichlau, Michael J.; Rapp, Timothy

doi:10.5435/00124635-200912000-00002

Cited by 33 publications

(35 citation statements)

References 36 publications

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“…Soft tissue and skin burns are also well-known complications with an overall reported complication rate less than 10%. 10,15,[27][28][29] Two minor skin burns occurred in our study following RFA of tibial lesions. We used to irrigate the entry site with saline for all superficial lesions to avoid this complication and we found this technique very beneficial.…”

Section: Discussionmentioning

confidence: 93%

Radiofrequency ablation of osteoid osteoma using tissue impedance as a parameter of osteonecrosis

Al-Omari¹,

Ata

Al-Muqbel³

et al. 2012

J Med Imag Rad Onc

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Introduction: The aim of this study is to assess the safety and the efficacy of radiofrequency ablation (RFA) of osteoid osteoma with Soloist monopolar electrode using tissue impedance, rather than temperature, as an indicator of osteonecrosis. Methods: The medical records and imaging studies of 30 patients (males 18, females 12) who underwent RFA of osteoid osteoma at our institution were reviewed. The mean age of the patients was 15.3 years (range 5-34 years) and the mean duration of follow up was 26.9 months (range 3-52 months). The lesions were located in the femur (n = 6, 53%), tibia (n = 8, 27%), hand (n = 3, 10%), foot (n = 2, 6%) and humerus (n = 1, 3%). The procedure was performed with general anaesthesia under CT guidance. The nidus was accessed with 11-gauge bone biopsy needle and then the stylet was removed and replaced by monopolar 16.5G radiofrequency probe with a 9-mm active tip through the coaxial axis. Power delivery via the radiofrequency generator was started at 2 W and increased gradually until the end point of 450-500 W reached and 'Roll-Off' achieved indicating coagulation necrosis of the target lesion. Results: The procedure was technically successful in all patients. The mean procedure time was 72 min and the mean RFA time was 12.7 min. The clinical success rate was 93%. In one patient, the procedure was abandoned due to immature Roll-Off despite all measures. In one patient (3%), recurrence occurred 39 months after the procedure. No major complications were encountered. Two minor skin burns occurred that were resolved with conservative measures. Conclusion: RFA of osteoid osteoma using Soloist monopolar electrode is a safe and effective treatment. Tissue impedance could be used as an alternative to temperature to indicate osteonecrosis of osteoid osteoma during RFA.

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Section: Discussionmentioning

confidence: 93%

Radiofrequency ablation of osteoid osteoma using tissue impedance as a parameter of osteonecrosis

Al-Omari¹,

Ata

Al-Muqbel³

et al. 2012

J Med Imag Rad Onc

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“…Focal ablative therapies, including cryoablation, radiofrequency ablation, and microwave ablation, lead to cellular necrosis and architectural tissue destruction by thermal effects on tumor cells [24–26]. Although often associated with lower morbidity compared to extensive open surgery, these therapies can cause complications related to thermal damage of surrounding tissues, including skin necrosis [27, 28]. Acute myonecrosis can also occur, and has been reported to affect the diaphragm after radiofrequency ablation of hepatocellular carcinoma at the dome [29].…”

Section: Discussionmentioning

confidence: 99%

Acute myonecrosis on MRI: etiologies in an oncological cohort and assessment of interobserver variability

et al. 2016

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Objective To determine etiologies of myonecrosis in oncology patients and to assess interobserver variability in interpreting its MRI features. Materials and Methods Pathology records in our tertiary cancer hospital were searched for proven myonecrosis, and MRIs of affected regions in those patients were identified. MRI reports that suggested myonecrosis also were identified. Each MRI was reviewed independently by two of six readers to assess anatomic site, size, and signal intensities of muscle changes, and presence of the previously reported stipple sign (enhancing foci within a region defined by rim enhancement). The stipple sign was assessed again, weeks after a training session. Cohen kappa and percent agreement were calculated. Medical records were reviewed for contemporaneous causes of myonecrosis. Results MRI reports in 73 patients suggested the diagnosis of myonecrosis; pathologic proof was available in another two. Myonecrosis was frequently associated with radiotherapy (n=34 (45%) patients)); less frequent causes included intraoperative immobilization, trauma, therapeutic embolization, ablation therapy, exercise, and diabetes. Myonecrosis usually involved lower extremity, pelvis, and upper extremity; mean size was 13.0 cm. Stipple sign was observed in 55–95% of patients at first assessment (k=0.09–0.42; 60–80% agreement) and 55–100% at second (k=0.0–0.58; 72–90% agreement). Enhancement surrounded myonecrosis in 55–100% patients (k=0.03 – 0.32; 58–70% agreement). Conclusion Myonecrosis in oncology patients usually occurred after radiotherapy, and less commonly after intraoperative immobilization, trauma, therapeutic embolization, ablation therapy, exercise, or diabetes. Although interobserver variability for MRI features of myonecrosis exists (even after focused training), a combination of findings facilitates diagnosis and conservative management.

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“…Dasatinib Src kinase inhibitor Single arm, chemotherapy-naive patient CRPC II, completed [9] Single arm, combined with docetaxel, in metastatic CRPC I/II, completed [11] Randomized, placebo-controlled docetaxel versus docetaxel dasatinib in chemotherapy-naive metastatic CRPC III, ongoing respectively. In another Phase I/II study [12], dasatinib demonstrated efficacy in combination with docetaxel, with a 50% PSA response rate, 40% partial soft-tissue response rate and 28% reduction in bony metastases.…”

Section: Refmentioning

confidence: 99%

Advances in Bone Metastasis Management

Picci

Ruggieri

2012

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The Use of Radiofrequency Ablation in the Treatment of Musculoskeletal Tumors

Cited by 33 publications

References 36 publications

Radiofrequency ablation of osteoid osteoma using tissue impedance as a parameter of osteonecrosis

Radiofrequency ablation of osteoid osteoma using tissue impedance as a parameter of osteonecrosis

Acute myonecrosis on MRI: etiologies in an oncological cohort and assessment of interobserver variability

Advances in Bone Metastasis Management

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