Painful metastases involving bone: Feasibility of percutaneous CT- and US-guided radio-frequency ablation

Matthew R. Callstrom, J. William Charboneau, Matthew P. Goetz, Joseph Rubin, Gilbert Y. Wong, Jeff A. Sloan, Paul J. Novotny, Bradley D. Lewis, Timothy J. Welch, Michael A. Farrell, Timothy P. Maus, Robert A. Lee, Carl C. Reading, Ivy A. Petersen, Deitra D. Pickett

Research output: Contribution to journalArticle

235 Scopus citations

Abstract

PURPOSE: To determine the safety and efficacy of radio-frequency (RF) ablation for pain reduction, quality of life improvement, and analgesics use reduction in patients with skeletal metastases. MATERIALS AND METHODS: Over 10 months, 12 adult patients with a single painful osteolytic metastasis in whom radiation therapy or c hemotherapy had failed and who reported severe pain (pain score ≥ 4 [scale of 0-10]) over a 24-hour period were treated with percutaneous imaging-guided RF ablation with a multitined electrode while under general anesthesia. Patient pain was measured with a Brief Pain Inventory 1 day after the procedure, every week for 1 month, and thereafter every other week (total follow-up, 6 months). Patient analgesics use was also recorded at these follow-up intervals. Follow-up contrast material-enhanced computed tomography was performed 1 week after the procedure. Complications were monitored. Analysis of the primary end point was undertaken with paired comparison procedures. RESULTS: Lesion size was 1-11 cm. Before RF ablation, mean worst pain score in a 24-hour period in 12 patients was 8.0 (range, 6-10). At 4 weeks after treatment, mean worst pain decreased to 3.1 (P = .001). Mean pain before treatment was 6.5 and decreased to 1.8 (P < .001) 4 weeks after treatment. Mean pain interference in general activity decreased from 6.6 to 2.7 (P = .002) 4 weeks after treatment. Eight of 10 patients using analgesics reported reduced use at some time after RF ablation. No serious complications were observed. CONCLUSION: RF ablation of painful osteolytic metastases is safe, and the relief of pain is substantial.

Original languageEnglish (US)
Pages (from-to)87-97
Number of pages11
JournalRadiology
Volume224
Issue number1
DOIs
StatePublished - Jan 1 2002

Keywords

  • Bone neoplasms, secondary
  • Bone neoplasms, therapeutic radiology
  • Computed tomography (CT), guidance
  • Radio-frequency (RF) ablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Callstrom, M. R., Charboneau, J. W., Goetz, M. P., Rubin, J., Wong, G. Y., Sloan, J. A., Novotny, P. J., Lewis, B. D., Welch, T. J., Farrell, M. A., Maus, T. P., Lee, R. A., Reading, C. C., Petersen, I. A., & Pickett, D. D. (2002). Painful metastases involving bone: Feasibility of percutaneous CT- and US-guided radio-frequency ablation. Radiology, 224(1), 87-97. https://doi.org/10.1148/radiol.2241011613