MRI-guided percutaneous cryotherapy for soft-tissue and bone metastases: Initial experience

Kemal Tuncali, Paul R. Morrison, Carl S. Winalski, John A. Carrino, Sridhar Shankar, John E. Ready, Eric Vansonnenberg, Stuart G. Silverman

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Abstract

OBJECTIVE. We sought to determine the safety and feasibility of percutaneous MRI-guided cryotherapy in the care of patients with refractory or painful metastatic lesions of soft tissue and bone adjacent to critical structures. MATERIALS AND METHODS. Twenty-seven biopsy-proven metastatic lesions of soft tissue (n = 17) and bone (n = 10) in 22 patients (15 men, seven women; age range, 24-85 years) were managed with MRI-guided percutaneous cryotherapy. The mean lesion diameter was 5.2 cm. Each lesion was adjacent to or encasing one or more critical structures, including bowel, bladder, and major blood vessels. A 0.5-T open interventional MRI system was used for cryoprobe placement and ice-ball monitoring. Complications were assessed for all treatments. CT or MRI was used to determine local control of 21 tumors. Pain palliation was assessed clinically in 19 cases. The mean follow-up period was 19.5 weeks. RESULTS. Twenty-two (81%) of 27 tumors were managed without injury to adjacent critical structures. Two patients had transient lower extremity numbness, and two had both urinary retention and transient lower extremity paresthesia. One patient had chronic serous vaginal discharge, and one sustained a femoral neck fracture at the ablation site 6 weeks after treatment. Thirteen (62%) of the 21 tumors for which follow-up information was available either remained the same size as before treatment or regressed. Eight tumors progressed (mean local progression-free interval, 5.6 months; range, 3-18 months). Pain was palliated in 17 of 19 patients; six of the 17 experienced complete relief, and 11 had partial relief. CONCLUSION. MRI-guided percutaneous cryotherapy for metastatic lesions of soft tissue and bone adjacent to critical structures is safe and can provide local tumor control and pain relief in most patients.

Original languageEnglish (US)
Pages (from-to)232-239
Number of pages8
JournalAmerican Journal of Roentgenology
Volume189
Issue number1
DOIs
StatePublished - Jul 1 2007

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Cryotherapy
Neoplasm Metastasis
Bone and Bones
Neoplasms
Pain
Lower Extremity
Interventional Magnetic Resonance Imaging
Vaginal Discharge
Femoral Neck Fractures
Urinary Retention
Hypesthesia
Paresthesia
Ice
Blood Vessels
Patient Care
Urinary Bladder
Therapeutics
Biopsy
Safety
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Tuncali, K., Morrison, P. R., Winalski, C. S., Carrino, J. A., Shankar, S., Ready, J. E., ... Silverman, S. G. (2007). MRI-guided percutaneous cryotherapy for soft-tissue and bone metastases: Initial experience. American Journal of Roentgenology, 189(1), 232-239. https://doi.org/10.2214/AJR.06.0588

MRI-guided percutaneous cryotherapy for soft-tissue and bone metastases : Initial experience. / Tuncali, Kemal; Morrison, Paul R.; Winalski, Carl S.; Carrino, John A.; Shankar, Sridhar; Ready, John E.; Vansonnenberg, Eric; Silverman, Stuart G.

In: American Journal of Roentgenology, Vol. 189, No. 1, 01.07.2007, p. 232-239.

Research output: Contribution to journalArticle

Tuncali, K, Morrison, PR, Winalski, CS, Carrino, JA, Shankar, S, Ready, JE, Vansonnenberg, E & Silverman, SG 2007, 'MRI-guided percutaneous cryotherapy for soft-tissue and bone metastases: Initial experience', American Journal of Roentgenology, vol. 189, no. 1, pp. 232-239. https://doi.org/10.2214/AJR.06.0588
Tuncali, Kemal ; Morrison, Paul R. ; Winalski, Carl S. ; Carrino, John A. ; Shankar, Sridhar ; Ready, John E. ; Vansonnenberg, Eric ; Silverman, Stuart G. / MRI-guided percutaneous cryotherapy for soft-tissue and bone metastases : Initial experience. In: American Journal of Roentgenology. 2007 ; Vol. 189, No. 1. pp. 232-239.
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abstract = "OBJECTIVE. We sought to determine the safety and feasibility of percutaneous MRI-guided cryotherapy in the care of patients with refractory or painful metastatic lesions of soft tissue and bone adjacent to critical structures. MATERIALS AND METHODS. Twenty-seven biopsy-proven metastatic lesions of soft tissue (n = 17) and bone (n = 10) in 22 patients (15 men, seven women; age range, 24-85 years) were managed with MRI-guided percutaneous cryotherapy. The mean lesion diameter was 5.2 cm. Each lesion was adjacent to or encasing one or more critical structures, including bowel, bladder, and major blood vessels. A 0.5-T open interventional MRI system was used for cryoprobe placement and ice-ball monitoring. Complications were assessed for all treatments. CT or MRI was used to determine local control of 21 tumors. Pain palliation was assessed clinically in 19 cases. The mean follow-up period was 19.5 weeks. RESULTS. Twenty-two (81{\%}) of 27 tumors were managed without injury to adjacent critical structures. Two patients had transient lower extremity numbness, and two had both urinary retention and transient lower extremity paresthesia. One patient had chronic serous vaginal discharge, and one sustained a femoral neck fracture at the ablation site 6 weeks after treatment. Thirteen (62{\%}) of the 21 tumors for which follow-up information was available either remained the same size as before treatment or regressed. Eight tumors progressed (mean local progression-free interval, 5.6 months; range, 3-18 months). Pain was palliated in 17 of 19 patients; six of the 17 experienced complete relief, and 11 had partial relief. CONCLUSION. MRI-guided percutaneous cryotherapy for metastatic lesions of soft tissue and bone adjacent to critical structures is safe and can provide local tumor control and pain relief in most patients.",
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T2 - Initial experience

AU - Tuncali, Kemal

AU - Morrison, Paul R.

AU - Winalski, Carl S.

AU - Carrino, John A.

AU - Shankar, Sridhar

AU - Ready, John E.

AU - Vansonnenberg, Eric

AU - Silverman, Stuart G.

PY - 2007/7/1

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N2 - OBJECTIVE. We sought to determine the safety and feasibility of percutaneous MRI-guided cryotherapy in the care of patients with refractory or painful metastatic lesions of soft tissue and bone adjacent to critical structures. MATERIALS AND METHODS. Twenty-seven biopsy-proven metastatic lesions of soft tissue (n = 17) and bone (n = 10) in 22 patients (15 men, seven women; age range, 24-85 years) were managed with MRI-guided percutaneous cryotherapy. The mean lesion diameter was 5.2 cm. Each lesion was adjacent to or encasing one or more critical structures, including bowel, bladder, and major blood vessels. A 0.5-T open interventional MRI system was used for cryoprobe placement and ice-ball monitoring. Complications were assessed for all treatments. CT or MRI was used to determine local control of 21 tumors. Pain palliation was assessed clinically in 19 cases. The mean follow-up period was 19.5 weeks. RESULTS. Twenty-two (81%) of 27 tumors were managed without injury to adjacent critical structures. Two patients had transient lower extremity numbness, and two had both urinary retention and transient lower extremity paresthesia. One patient had chronic serous vaginal discharge, and one sustained a femoral neck fracture at the ablation site 6 weeks after treatment. Thirteen (62%) of the 21 tumors for which follow-up information was available either remained the same size as before treatment or regressed. Eight tumors progressed (mean local progression-free interval, 5.6 months; range, 3-18 months). Pain was palliated in 17 of 19 patients; six of the 17 experienced complete relief, and 11 had partial relief. CONCLUSION. MRI-guided percutaneous cryotherapy for metastatic lesions of soft tissue and bone adjacent to critical structures is safe and can provide local tumor control and pain relief in most patients.

AB - OBJECTIVE. We sought to determine the safety and feasibility of percutaneous MRI-guided cryotherapy in the care of patients with refractory or painful metastatic lesions of soft tissue and bone adjacent to critical structures. MATERIALS AND METHODS. Twenty-seven biopsy-proven metastatic lesions of soft tissue (n = 17) and bone (n = 10) in 22 patients (15 men, seven women; age range, 24-85 years) were managed with MRI-guided percutaneous cryotherapy. The mean lesion diameter was 5.2 cm. Each lesion was adjacent to or encasing one or more critical structures, including bowel, bladder, and major blood vessels. A 0.5-T open interventional MRI system was used for cryoprobe placement and ice-ball monitoring. Complications were assessed for all treatments. CT or MRI was used to determine local control of 21 tumors. Pain palliation was assessed clinically in 19 cases. The mean follow-up period was 19.5 weeks. RESULTS. Twenty-two (81%) of 27 tumors were managed without injury to adjacent critical structures. Two patients had transient lower extremity numbness, and two had both urinary retention and transient lower extremity paresthesia. One patient had chronic serous vaginal discharge, and one sustained a femoral neck fracture at the ablation site 6 weeks after treatment. Thirteen (62%) of the 21 tumors for which follow-up information was available either remained the same size as before treatment or regressed. Eight tumors progressed (mean local progression-free interval, 5.6 months; range, 3-18 months). Pain was palliated in 17 of 19 patients; six of the 17 experienced complete relief, and 11 had partial relief. CONCLUSION. MRI-guided percutaneous cryotherapy for metastatic lesions of soft tissue and bone adjacent to critical structures is safe and can provide local tumor control and pain relief in most patients.

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