Semin intervent Radiol 2014; 31(02): 167-179
DOI: 10.1055/s-0034-1373791
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bone and Soft Tissue Ablation

Ryan C.B. Foster
1   Department of Radiology, Hospital for Special Surgery, New York, New York
,
Joseph M. Stavas
2   Department of Radiology, the University of North Carolina, Chapel Hill, North Carolina
› Author Affiliations
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Publication History

Publication Date:
21 May 2014 (online)

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Abstract

Bone and soft tissue tumor ablation has reached widespread acceptance in the locoregional treatment of various benign and malignant musculoskeletal (MSK) lesions. Many principles of ablation learned elsewhere in the body are easily adapted to the MSK system, particularly the various technical aspects of probe/antenna design, tumoricidal effects, selection of image guidance, and methods to reduce complications. Despite the common use of thermal and chemical ablation procedures in bone and soft tissues, there are few large clinical series that show longitudinal benefit and cost-effectiveness compared with conventional methods, namely, surgery, external beam radiation, and chemotherapy. Percutaneous radiofrequency ablation of osteoid osteomas has been evaluated the most and is considered a first-line treatment choice for many lesions. Palliation of painful metastatic bone disease with thermal ablation is considered safe and has been shown to reduce pain and analgesic use while improving quality of life for cancer patients. Procedure-related complications are rare and are typically easily managed. Similar to all interventional procedures, bone and soft tissue lesions require an integrated approach to disease management to determine the optimum type of and timing for ablation techniques within the context of the patient care plan.