Thermoablation of Bone Tumors

Abstract

The aim of this article is to review the significance of percutaneous thermal ablation in the treatment of bone tumors. We describe available ablation techniques as well as advantages and disadvantages in specific settings. In detail, radiofrequency ablation (RFA), microwave ablation (MWA), laser ablation, high intensity focused ultrasound (HIFU) and cryoablation are presented. In the second part of this review curative and palliative indications for the treatment of benign and malignant bone tumors are discussed. This includes especially RFA, laser or cryoablation for the treatment of osteoid osteoma, as well as the palliative treatment of painful bone metastases, for example, by means of MWA or MR-guided HIFU.

Key Points:

• The various thermoablative techniques demonstrate specific advantages and disadvantages.

• Radiofrequency ablation is the evidence-based method of choice for treating osteoid osteoma.

• Laser ablation is primarily suited for the treatment of small lesions of the hands and feet.

• The intrinsically analgesic effect of cryoablation is advantageous when treating painful lesions.

• Palliative treatment of painful bone metastases can for example be performed using MWA or MR-guided HIFU, by itself or combined with cementoplasty.

Citation Format:

• Ringe KI, Panzica M, von Falck C. Thermoablation of Bone Tumors. Fortschr Röntgenstr 2016; 188: 539 – 550

Zusammenfassung

In der vorliegenden Übersichtsarbeit wird der Stellenwert der perkutanen Thermoablation bei der Behandlung von Knochentumoren dargelegt. Zunächst werden technische Grundlagen der unterschiedlichen Verfahren beschrieben, sowie Vor- und Nachteile der einzelnen Methoden aufgezeigt. Im Detail wird dabei auf die Radiofrequenzablation (RFA), die Mikrowellenablation (MWA), die Laserablation, den hochintensiven fokussierten Ultraschall (HIFU) sowie die Kryoablation eingegangen. Im zweiten Abschnitt werden kurative und palliative Indikationen zur Behandlung benigner und maligner Knochenläsionen diskutiert. Hierzu zählen insbesondere die RFA, Laser- oder Kryoablation zur Behandlung des Osteoidosteoms, sowie die palliative Behandlung schmerzhafter Knochenmetastasen beispielsweise mittels MWA oder MR-gesteuertem HIFU.

Key words

bones - laser - RFA - MWA - cryoablation - HIFU

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