Neuroanatomic considerations in percutaneous tumor ablation

A. Nicholas Kurup, Jonathan M. Morris, Grant D. Schmit, Thomas D. Atwell, Adam J. Weisbrod, Naveen S Murthy, David A Woodrum, Matthew R Callstrom

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Percutaneous ablation is increasingly being used as focal therapy for tumors in the chest, abdomen, and pelvis, including tumors in proximity to neural structures. To ensure that tumor ablation is performed safely, knowledge of the regional neuroanatomy is particularly important because most relevant nerves are not visualized with the conventional imaging techniques used to guide ablation procedures. Familiarity with the expected course of nerves in commonly targeted areas is helpful in preventing inadvertent nerve injury and in accurately informing the patient of potential risks. In the chest and shoulder girdle, the brachial plexus as well as the phrenic, recurrent laryngeal, intercostal-subcostal, long thoracic, dorsal scapular, and suprascapular nerves may be encountered. Vulnerable neural structures in the abdomen and pelvis arise from the lumbar and sacral plexuses and include the femoral, obturator, sciatic, and pudendal nerves. Nerve protection and monitoring techniques should be used, when appropriate, to minimize the risk of neural injury during percutaneous tumor ablation and depend on the vulnerable nerve, the location of the targeted tumor, and the ablation device used for treatment. Nerves may be protected using displacement techniques, including instillation of air or fluid, insertion and insuffation of angioplastic or endoscopic balloons, and mechanical manipulation of the ablation device. Nerves may be monitored with cross-sectional imaging evaluation of the critical nerve or ablation zone, or with functional evaluation using electromyographic equipment or focused clinical examination.

Original languageEnglish (US)
Pages (from-to)1195-1215
Number of pages21
JournalRadiographics
Volume33
Issue number4
DOIs
StatePublished - Jul 2013

Fingerprint

Lumbosacral Plexus
Thorax
Neoplasms
Pelvis
Equipment and Supplies
Abdomen
Obturator Nerve
Pudendal Nerve
Femoral Nerve
Neuroanatomy
Brachial Plexus
Wounds and Injuries
Sciatic Nerve
Diaphragm
Air
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Kurup, A. N., Morris, J. M., Schmit, G. D., Atwell, T. D., Weisbrod, A. J., Murthy, N. S., ... Callstrom, M. R. (2013). Neuroanatomic considerations in percutaneous tumor ablation. Radiographics, 33(4), 1195-1215. https://doi.org/10.1148/rg334125141/-/DC1

Neuroanatomic considerations in percutaneous tumor ablation. / Kurup, A. Nicholas; Morris, Jonathan M.; Schmit, Grant D.; Atwell, Thomas D.; Weisbrod, Adam J.; Murthy, Naveen S; Woodrum, David A; Callstrom, Matthew R.

In: Radiographics, Vol. 33, No. 4, 07.2013, p. 1195-1215.

Research output: Contribution to journalArticle

Kurup, AN, Morris, JM, Schmit, GD, Atwell, TD, Weisbrod, AJ, Murthy, NS, Woodrum, DA & Callstrom, MR 2013, 'Neuroanatomic considerations in percutaneous tumor ablation', Radiographics, vol. 33, no. 4, pp. 1195-1215. https://doi.org/10.1148/rg334125141/-/DC1
Kurup AN, Morris JM, Schmit GD, Atwell TD, Weisbrod AJ, Murthy NS et al. Neuroanatomic considerations in percutaneous tumor ablation. Radiographics. 2013 Jul;33(4):1195-1215. https://doi.org/10.1148/rg334125141/-/DC1
Kurup, A. Nicholas ; Morris, Jonathan M. ; Schmit, Grant D. ; Atwell, Thomas D. ; Weisbrod, Adam J. ; Murthy, Naveen S ; Woodrum, David A ; Callstrom, Matthew R. / Neuroanatomic considerations in percutaneous tumor ablation. In: Radiographics. 2013 ; Vol. 33, No. 4. pp. 1195-1215.
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