Interventional Radiology, Thermoablation and Cryoablation

  • Mario Raguso
  • Salvatore Marsico
  • Christine Ojango
  • Salvatore MasalaEmail author


It is estimated that each year around 5% of all cancer patients develop metastases to the spine. In these patients, pain is the most cardinal symptom. The treatment of bone metastases is determined by a multidisciplinary team where the interventional radiologist is increasingly taking on a crucial role. Open surgery is not frequently used for treatment of bone metastases, owing to its morbidity and the often short life span of the patients. Surgical indications include a fracture with associated a neurologic compromise or high risk of developing pathologic fracture, which could result in neurological damage. Percutaneous cryoablation and thermoablation procedures are the therapeutic choices with a good efficacy in the treatment of painful metastatic lesions refractory to traditional therapies. These ablative methods can also be performed in combination with percutaneous cementoplasty to support and stabilisation for metastases in weight-bearing bones at risk for pathologic fracture.


Cryosurgery Cryoablation (CA) Percutaneous Cementoplasty Thermal Ablation Procedures Painful Bone Metastases 
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  1. 1.
    Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2008. CA Cancer J Clin. 2008;59(4):225–49.CrossRefGoogle Scholar
  2. 2.
    Ferlay J, Autier P, Boniol M, Heanue M, Colombet M, Boyle P. Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol. 2007;18(3):581–92.CrossRefPubMedGoogle Scholar
  3. 3.
    Ashford RU, Randall RL. Bone metastases: epidemiology and societal effect. In: Randall RL, editor. Metastatic bone disease. New York: Springer; 2006. p. 793–810.Google Scholar
  4. 4.
    Schulman KL, Kohles J. Economic burden of metastatic bone disease. Cancer. 2007;109(11):2334–42.CrossRefPubMedGoogle Scholar
  5. 5.
    Coleman RE. Clinical features of metastatic bone disease and risk of skeletal morbidity. Clin Cancer Res. 2006;12(20 Pt 2):6243s–9s.CrossRefPubMedGoogle Scholar
  6. 6.
    Georgy BA. Metastatic spinal lesions: state-of-the-art treatment options and future trends. Am J Neuroradiol. 2008;29(9):1605–11.CrossRefPubMedGoogle Scholar
  7. 7.
    Ringe KI, Panzica M, von Falck C. Thermoablation of bone tumors. Fortschr Röntgenstr. 2016;188(6):539–50.CrossRefGoogle Scholar
  8. 8.
    Santiago FR, del Mar Castellano García M. Treatment of bone tumours by radiofrequency thermal ablation. Eur Oncol. 2008;4(2):92–9.Google Scholar
  9. 9.
    Thanos L, Mylona S, Galani P, et al. Radiofrequency ablation of osseous metastases for the palliation of pain. Skelet Radiol. 2008;37(3):189–94.CrossRefGoogle Scholar
  10. 10.
    Callstrom MR, Atwell TD, Charboneau JW, et al. Painful metastases involving bone: percutaneous image-guided cryoablation--prospective trial interim analysis. Radiology. 2006;241(2):572–80.CrossRefPubMedGoogle Scholar
  11. 11.
    Callstrom MR, Kurup AN. Percutaneous ablation for bone and soft tissue metastases-why cryoablation? Skelet Radiol. 2009;38(9):835–9.CrossRefGoogle Scholar
  12. 12.
    Nicholas Kurup A, Callstrom MR. Ablation of musculoskeletal metastases: pain palliation, fracture risk reduction, and oligometastatic disease. Tech Vasc Interv Radiol. 2013;16(4):253–61.CrossRefGoogle Scholar
  13. 13.
    Rosenthal D, Callstrom MR. Critical review and state of the art in interventional oncology: benign and metastatic disease involving bone. Radiology. 2012;262(3):765–80.CrossRefPubMedGoogle Scholar
  14. 14.
    Goetz MP, Callstrom MR, Charboneau JW, et al. Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study. J Clin Oncol. 2004;22(2):300–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Dupuy DE, Liu D, Hartfeil D, et al. Percutaneous radiofrequency ablation of painful osseous metastases: a multi-center American College of Radiology Imaging Network trial. Cancer. 2010;116(4):989–007.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Davis KW, Choi JJ, Blankenbaker DG. Radiofrequency ablation in the musculoskeletal system. Semin Roentgenol. 2004;39(1):129–44.CrossRefPubMedGoogle Scholar
  17. 17.
    Curley SA. Radiofrequency ablation of malignant liver tumors. Ann Surg Oncol. 2003;10(4):338–47.CrossRefPubMedGoogle Scholar
  18. 18.
    Dupuy DE, Hong R, Oliver B, et al. Radiofrequency ablation of spinal tumors: temperature distribution in the spinal canal. AJR Am J Roentgenol. 2000;175(5):1263–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Mertyna P, Dewhirst MW, Halpern E, et al. Radiofrequency ablation: the effect of distance and baseline temperature on thermal dose required for coagulation. Int J Hyperth. 2008;24(7):550–9.CrossRefGoogle Scholar
  20. 20.
    Di Staso M, Zugaro L, Gravina GL, et al. A feasibility study of percutaneous radiofrequency ablation followed by radiotherapy in the management of painful osteolytic bone metastases. Eur Radiol. 2011;21(9):2004–10.CrossRefPubMedGoogle Scholar
  21. 21.
    Frezza EE. Therapeutic management algorithm in cirrhotic and noncirrhotic patients in primary or secondary liver masses. Dig Dis Sci. 2004;49(5):866–71.CrossRefPubMedGoogle Scholar
  22. 22.
    Haines DE, Verow AF. Observations on electrode-tissue interface temperature and effect on electrical impedance during radiofrequency ablation of ventricular myocardium. Circulation. 1990;82(3):1034–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Buy X, Basile A, Bierry G, et al. Saline-infused bipolar radiofrequency ablation of high-risk spinal and paraspinal neoplasms. AJR Am J Roentgenol. 2006;186(5 Suppl):S322–6.CrossRefPubMedGoogle Scholar
  24. 24.
    Gazis AN, Beuing O, Franke J, et al. Bipolar radiofrequency ablation of spinal tumors: predictability, safety and outcome. Spine J. 2014;14(4):604–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Gulesserian T, Mahnken AH, Schernthaner R, et al. Comparison of expandable electrodes in percutaneous radiofrequency ablation of renal cell carcinoma. Eur J Radiol. 2006;59(2):133–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Pereira PL, Trübenbach J, Schenk M, et al. Radiofrequency ablation: in vivo comparison of four commercially available devices in pig livers. Radiology. 2004;232(2):482–90.CrossRefPubMedGoogle Scholar
  27. 27.
    Masala S, Fiori R, Massari F, et al. Kyphoplasty and vertebroplasty: new equipment for vertebral fractures treatment. J Exp Clin Cancer Res. 2003;22(4 Suppl):75–9.PubMedGoogle Scholar
  28. 28.
    Tsoumakidou G, Buy X, Garnon J, et al. Percutaneous thermal ablation: how to protect the surrounding organs. Tech Vasc Interv Radiol. 2011;14(3):170–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Callstrom MR, Charboneau JW, Goetz MP, et al. Image-guided ablation of painful metastatic bone tumors: a new and effective approach to a difficult problem. Skelet Radiol. 2006;35(1):1–15.CrossRefGoogle Scholar
  30. 30.
    Callstrom MR, Dupuy DE, Solomon SB, et al. Percutaneous image-guided cryoablation of painful metastases involving bone: multicenter trial. Cancer. 2013;119(5):1033–41.CrossRefPubMedGoogle Scholar
  31. 31.
    Di Staso M, Gravina GL, Zugaro L, et al. Treatment of solitary painful osseous metastases with radiotherapy, cryoablation or combined therapy: propensity matching analysis in 175 patients. PLoS One. 2015;10(6):1–11.CrossRefGoogle Scholar
  32. 32.
    Zugaro L, Di Staso M, Gravina GL, et al. Treatment of osteolytic solitary painful osseous metastases with radiofrequency ablation or cryoablation: a retrospective study by propensity analysis. Oncol Lett. 2016;11(3):1948–54.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Muto M, Guarnieri G, Giurazza F, Manfrè L. What’s new in vertebral cementoplasty? Br J Radiol. 2016;89(1059):20150337. Scholar
  34. 34.
    Katsanos K, Sabharwal T, Adam A. Percutaneous cementoplasty. Semin Interv Radiol. 2010;27(2):137–47. Scholar
  35. 35.
    Yilmaz S, Özdoğan M, Cevener M, et al. Use of cryoablation beyond the prostate. Insights Imaging. 2016;7(2):223–32. Scholar
  36. 36.
    Laredo J-D, Chiras J, Kemel S, Taihi L, Hamze B. Vertebroplasty and interventional radiology procedures for bone metastases. Joint Bone Spine. 2017.
  37. 37.
    Masala S, Chiocchi M, Taglieri A, et al. Combined use of percutaneous cryoablation and vertebroplasty with 3D rotational angiograph in treatment of single vertebral metastasis: comparison with vertebroplasty. Neuroradiology. 2013;55(2):193–200.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Mario Raguso
    • 1
  • Salvatore Marsico
    • 1
  • Christine Ojango
    • 1
  • Salvatore Masala
    • 1
    Email author
  1. 1.Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation TherapyUniversity of Rome “Tor Vergata”RomeItaly

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