CT-guided ablation of bone tumors

Thermal percutaneous ablation of bone tumors is a minimally invasive therapeutic procedure, which is performed with a special needle that generates heat at the tip of an area of ​​several centimeters and thus destroys the tumor tissue.

The needle is introduced through a small opening, without the need for a large incision, and is introduced precisely under CT control to the tumor, which is then treated with heat, in order to destroy it and achieve the same effect as surgical removal.

When do you need thermal ablation of a bone tumor?

The bone system, especially the pelvis and spine, are often the site of metastases of various tumors. Certain tumors, such as breast and prostate cancer, give bone metastases at some point of the disease in up to 70% of patients. Other primary tumors can also often metastasize to bone, such as kidney, thyroid, or melanoma.

The bone system can also be the site of the development of primary tumors, which are often discovered accidentally or because of pain during CT or MR examinations.

When a primary bone tumor or metastasis is detected and confirmed, there are several treatment options, including radiation, surgical removal of the tumor, chemotherapy, or minimally invasive thermal ablation. Although bone metastases are often successfully treated with radiation, almost 40% of tumors are resistant to radiation. Ablation is a treatment option for patients with bone metastases up to 5 cm in size. Bone metastases are rarely accessible to surgical resection due to their location, but percutaneous thermal ablation enables the therapy of even the most difficult-to-reach metastases.

The advantage of ablation as a minimally invasive method is a shorter recovery, a lower risk of intervention and the possibility to repeat it in several locations in the organ if the disease returns later in another place.

What does percutaneous bone ablation involve?

Percutaneous thermal ablation of bone tumors is a minimally invasive method, which means that it is performed by guiding a needle with a diameter of about 1.5-2 mm precisely to the tumor under CT control. After that, with an ablation needle for 5-10 minutes, depending on the size of the tumor, heat of about 100 degrees thermally destroys tumor tissue.

The procedure is performed under local anesthesia and sedation, less often under general anesthesia, with the patient lying down.

How to prepare?

When making an appointment for ablation, the patient receives information from the specialist interventional radiologist about the procedure, possible advantages and risks, as well as written instructions on preparation (instructions on laboratory findings that need to be done, on antibiotic protection - prophylaxis and on the procedure if anticoagulant therapy is taken).

The procedure is usually performed under local anesthesia and sedation and lasts about 60-90 minutes.

After the procedure, the patient remains in the ward for 24 hours for observation in order to rule out complications.

 

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Croatian Medical Association

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10000 Zagreb, CRO

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