Avoiding Complications in Bone and Soft Tissue Ablation

A. Nicholas Kurup, Grant D. Schmit, Jonathan M. Morris, Thomas D. Atwell, John J. Schmitz, Adam J. Weisbrod, David A Woodrum, Patrick W. Eiken, Matthew R Callstrom

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

As with percutaneous ablation of tumors in the liver, lungs, and kidneys, ablation of bone and non-visceral soft tissue tumors carries risk, primarily from collateral damage to vital structures in proximity to the target tumor. Certain risks are of particular interest when ablating bone and non-visceral soft tissue tumors, namely neural or skin injury, bowel injury, fracture, and gas embolism from damaged applicators. Ablation of large volume tumors also carries special risk. Many techniques may be employed by the interventional radiologist to minimize complications when treating tumors in the musculoskeletal system. These methods include those to depict, displace, or monitor critical structures. Thus, measures to provide thermoprotection may be active, such as careful ablation applicator placement and use of various displacement techniques, as well as passive, including employment of direct temperature, radiographic, or neurophysiologic monitoring techniques. Cementoplasty should be considered in certain skeletal locations at risk of fracture. Patients treated with large volume tumors should be monitored for renal dysfunction and properly hydrated. Finally, ablation applicators should be cautiously placed in the constrained environment of intact bone.

Original languageEnglish (US)
Pages (from-to)166-176
Number of pages11
JournalCardioVascular and Interventional Radiology
Volume40
Issue number2
DOIs
StatePublished - Feb 1 2017

Keywords

  • Ablation
  • Bone tumors
  • Cryoablation
  • Musculoskeletal
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Kurup, A. N., Schmit, G. D., Morris, J. M., Atwell, T. D., Schmitz, J. J., Weisbrod, A. J., Woodrum, D. A., Eiken, P. W., & Callstrom, M. R. (2017). Avoiding Complications in Bone and Soft Tissue Ablation. CardioVascular and Interventional Radiology, 40(2), 166-176. https://doi.org/10.1007/s00270-016-1487-y