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Assessing long-term locoregional control of spinal osseous metastases after microwave ablation

  • Mina Motaghi
    Affiliations
    Department of Internal Medicine, Brookdale University Medical Center, Brooklyn, NY 11212, USA
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  • Ryan W. England
    Affiliations
    Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, the Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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  • Nima Hafezi Nejad
    Affiliations
    Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, the Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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  • Nisha Sankaran
    Affiliations
    Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, the Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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  • Akash M. Patel
    Affiliations
    Department of Radiology, Division of Interventional Radiology, The University of Mississippi Medical Center, Jackson, MS 39216, USA
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  • Majid A. Khan
    Correspondence
    Corresponding author at: Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
    Affiliations
    Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, the Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

    Department of Radiology. Division of Neuroradiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA
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      Highlights

      • Microwave ablation is a safe ablation technique for treating spinal metastasis.
      • Microwave ablation is an effective technique for pain palliation in patients with spinal metastasis.
      • Microwave ablation as an effective technique for long-term locoregional tumor control of oligometastatic spinal disease.

      Abstract

      Osseous metastases to the spine result in significant pain and decreased quality of life. The purpose of this study was to evaluate the long-term efficacy of microwave ablation (MWA) for the treatment of spinal metastases regarding pain reduction and local control of disease progression. In this single center retrospective study, patients with osseous metastases to the spine undergoing MWA with vertebroplasty from 2013 to 2020 were included. Locoregional control of metabolic activity at the treated level was assessed using PET/CT scan both pre- and post-procedure. Pain reduction was measured using change in visual analog scale (VAS) pain score. Forty-eight spinal levels were treated with MWA in 28 patients (57 % male, mean age 68 ± 9 years). Median ablation time, energy, and temperature were 4 min and 13 s, 3.6 kJ, and 80 °C, respectively. Median pre-procedure maximum standard uptake value (SUVmax) was significantly reduced following ablation, from 4.55 (IQR 3.65–6.1) to 0 (IQR 0–1.8; p < 0.001), over an average of 29 ± 14.1 month follow up period. Pre-procedure VAS pain score was reduced from median (IQR) of 8 (6.5–9) to 1(1–2), 2(1–3) and 1(0.5–3) at 24 h, four weeks, and six months post-procedure, respectively (all p < 0.001 with respect to pre-procedure scores). In conclusion, this study supports microwave ablation as an effective technique for pain palliation and long-term locoregional tumor control of oligometastatic spinal disease as assessed by metabolic response.

      Keywords

      Abbreviations:

      PET/CT (Positron Emission Tomography ? Computer Tomography), MWA (MIcrowave Ablation), VAS (Visual Analogue Scale), ESCC (Epidural Spinal Cord Compression), RT/ SBRT (Radiation therapy/ Stereotactic body Radiation therapy)
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      References

        • Metser U.
        • Lerman H.
        • Blank A.
        • Lievshitz G.
        • Bokstein F.
        • Even-Sapir E.
        Malignant involvement of the spine: assessment by 18F-FDG PET/CT.
        J Nucl Med. 2004; 45: 279-284
        • Macedo F.
        • Ladeira K.
        • Pinho F.
        • Saraiva N.
        • Bonito N.
        • Pinto L.
        • et al.
        Bone metastases: an overview.
        Oncol Rev. 2017; 11: 321
        • Barzilai O.
        • Boriani S.
        • Fisher C.G.
        • Sahgal A.
        • Verlaan J.J.
        • Gokaslan Z.L.
        • et al.
        Essential concepts for the management of metastatic spine disease: what the surgeon should know and practice.
        Global Spine J. 2019; 9: 98S-107S
        • Harris A.A.
        • Hartsell W.F.
        Palliation of bone metastases.
        in: Halperin E.C. Wazer D.E. Perez C.A. Brady L.W. Perez and Brady's principles and practice of radiation oncology. seventh ed. Wolters Kluwer, Philadelphia2019
        • Gomi D.
        • Fukushima T.
        • Kobayashi T.
        • Sekiguchi N.
        • Koizumi T.
        • Oguchi K.
        Fluorine-18-fluorodeoxyglucose-positron emission tomography evaluation in metastatic bone lesions in lung cancer: Possible prediction of pain and skeletal-related events.
        Thorac Cancer. 2019; 10: 980-987
        • Tharmalingam S.
        • Chow E.
        • Harris K.
        • Hird A.
        • Sinclair E.
        Quality of life measurement in bone metastases: A literature review.
        J Pain Res. 2008; 1: 49-58
        • Chan-Seng E.
        • Charissoux M.
        • Larbi A.
        • Tétreau R.
        • Gerber Y.N.
        • De Verbizier-Lonjon D.
        • et al.
        Spinal metastases in breast cancer: single center experience.
        World Neurosurg. 2014; 82: 1344-1350
        • Hellman S.
        • Weichselbaum R.R.
        Oligometastases.
        J Clin Oncol. 1995; 13: 8-10
      1. Halperin EC, Wazer DE, Perez CA, Brady LW. Perez and Brady's principles and practice of radiation oncology; 2019.

        • Khan M.A.
        • Deib G.
        • Deldar B.
        • Patel A.M.
        • Barr J.S.
        Efficacy and safety of percutaneous microwave ablation and cementoplasty in the treatment of painful spinal metastases and myeloma.
        AJNR Am J Neuroradiol. 2018; 39: 1376-1383
        • Deib G.
        • Deldar B.
        • Hui F.
        • Barr J.S.
        • Khan M.A.
        Percutaneous microwave ablation and cementoplasty: clinical utility in the treatment of painful extraspinal osseous metastatic disease and myeloma.
        AJR Am J Roentgenol. 2019; 212: 1377-1384
        • Pusceddu C.
        • Sotgia B.
        • Fele R.M.
        • Ballicu N.
        • Melis L.
        Combined microwave ablation and cementoplasty in patients with painful bone metastases at high risk of fracture.
        Cardiovasc Intervent Radiol. 2016; 39: 74-80
        • Hinshaw J.L.
        • Lubner M.G.
        • Ziemlewicz T.J.
        • Lee Jr., F.T.
        • Brace C.L.
        Percutaneous tumor ablation tools: microwave, radiofrequency, or cryoablation–what should you use and why?.
        Radiographics. 2014; 34: 1344-1362
        • Gangi A.
        • Buy X.
        Percutaneous bone tumor management.
        Semin Intervent Radiol. 2010; 27: 124-136
        • Lucchina N.
        • Tsetis D.
        • Ierardi A.M.
        • Giorlando F.
        • Macchi E.
        • Kehagias E.
        • et al.
        Current role of microwave ablation in the treatment of small hepatocellular carcinomas.
        Ann Gastroenterol. 2016; 29: 460-465
        • Liu B.
        • Yuan Z.
        • Wei C.Y.
        Combined microwave ablation and minimally invasive open decompression for the management of thoracic metastasis in breast cancer.
        Cancer Manag Res. 2018; 10: 1397-1401
        • Lubner M.G.
        • Brace C.L.
        • Hinshaw J.L.
        • Lee Jr., F.T.
        Microwave tumor ablation: mechanism of action, clinical results, and devices.
        J Vasc Interv Radiol. 2010; 21: S192-S203
        • Simon C.J.
        • Dupuy D.E.
        • Mayo-Smith W.W.
        Microwave ablation: principles and applications.
        Radiographics. 2005; 25: S69-S83
        • Stauffer P.R.
        • Rossetto F.
        • Prakash M.
        • Neuman D.G.
        • Lee T.
        Phantom and animal tissues for modelling the electrical properties of human liver.
        Int J Hyperthermia. 2003; 19: 89-101
        • Wu M.H.
        • Xiao L.F.
        • Yan F.F.
        • Chen S.L.
        • Zhang C.
        • Lei J.
        • et al.
        Use of percutaneous microwave ablation for the treatment of bone tumors: a retrospective study of clinical outcomes in 47 patients.
        Cancer Imaging. 2019; 19: 87
        • Sagoo N.S.
        • Haider A.S.
        • Rowe S.E.
        • Haider M.
        • Sharma R.
        • Neeley O.J.
        • et al.
        Microwave ablation as a treatment for spinal metastatic tumors: a systematic review.
        World Neurosurg. 2021; 148: 15-23
        • Palma D.A.
        • Salama J.K.
        • Lo S.S.
        • Senan S.
        • Treasure T.
        • Govindan R.
        • et al.
        The oligometastatic state – separating truth from wishful thinking.
        Nat Rev Clin Oncol. 2014; 11: 549-557
        • Cazzato R.L.
        • de Rubeis G.
        • de Marini P.
        • Dalili D.
        • Koch G.
        • Auloge P.
        • et al.
        Percutaneous microwave ablation of bone tumors: a systematic review.
        Eur Radiol. 2021; 31: 3530-3541
        • Guo L.
        • Ke L.
        • Zeng Z.
        • Yuan C.
        • Wu Z.
        • Chen L.
        • et al.
        Stereotactic body radiotherapy for spinal metastases: a review.
        Med Oncol. 2022; 39: 103
        • Deschamps F.
        • Farouil G.
        • Ternes N.
        • Gaudin A.
        • Hakime A.
        • Tselikas L.
        • et al.
        Thermal ablation techniques: a curative treatment of bone metastases in selected patients?.
        Eur Radiol. 2014; 24: 1971-1980
        • Wallace A.N.
        • Tomasian A.
        • Vaswani D.
        • Vyhmeister R.
        • Chang R.O.
        • Jennings J.W.
        Radiographic local control of spinal metastases with percutaneous radiofrequency ablation and vertebral augmentation.
        AJNR Am J Neuroradiol. 2016; 37: 759-765
        • Luigi Cazzato R.
        • Auloge P.
        • De Marini P.
        • Rousseau C.
        • Chiang J.B.
        • Koch G.
        • et al.
        Percutaneous image-guided ablation of bone metastases: local tumor control in oligometastatic patients.
        Int J Hyperthermia. 2018; 35: 493-499
        • Lutz S.
        • Chow E.
        A review of recently published radiotherapy treatment guidelines for bone metastases: contrasts or convergence?.
        J Bone Oncol. 2012; 1: 18-23
        • Kastler A.
        • Alnassan H.
        • Aubry S.
        • Kastler B.
        Microwave thermal ablation of spinal metastatic bone tumors.
        J Vasc Interv Radiol. 2014; 25: 1470-1475
        • Lu C.-W.
        • Shao J.
        • Wu Y.-G.
        • Wang C.
        • Wu J.-H.
        • Lv R.-X.
        • et al.
        Which combination treatment is better for spinal metastasis: percutaneous vertebroplasty with radiofrequency ablation, 125I seed, zoledronic acid, or radiotherapy?.
        Am J Ther. 2019; 26: e38-e44
        • Goetz M.P.
        • Callstrom M.R.
        • Charboneau J.W.
        • Farrell M.A.
        • Maus T.P.
        • Welch T.J.
        • et al.
        Percutaneous image-guided radiofrequency ablation of painful metastases involving bone: a multicenter study.
        J Clin Oncol. 2004; 22: 300-306
        • Blake-Cerda M.
        • Lozano-Ruíz F.
        • Maldonado-Magos F.
        • de la Mata-Moya D.
        • Díaz-García D.
        • Lara-Mejía L.
        • et al.
        Consolidative stereotactic ablative radiotherapy (SABR) to intrapulmonary lesions is associated with prolonged progression-free survival and overall survival in oligometastatic NSCLC patients: A prospective phase 2 study.
        Lung Cancer. 2021; 152: 119-126
        • Ghosn M.
        • Solomon S.B.
        Current management of oligometastatic lung cancer and future perspectives: results of thermal ablation as a local ablative therapy.
        Cancers (Basel). 2021; 13: 5202