PT  - JOURNAL ARTICLE
AU  - Melinda Reyes
AU  - Mark Georgy
AU  - Lorenzo Brook
AU  - Orlando Ortiz
AU  - Allan Brook
AU  - Vikas Agarwal
AU  - Mario Muto
AU  - Luigi Manfre
AU  - Stefano Marcia
AU  - Bassem A Georgy
TI  - Multicenter clinical and imaging evaluation of targeted radiofrequency ablation (t-RFA) and cement augmentation of neoplastic vertebral lesions
AID  - 10.1136/neurintsurg-2016-012908
DP  - 2017 Apr 06
TA  - Journal of NeuroInterventional Surgery
PG  - neurintsurg-2016-012908
4099  - http://jnis.bmj.com/content/early/2017/04/06/neurintsurg-2016-012908.short
4100  - http://jnis.bmj.com/content/early/2017/04/06/neurintsurg-2016-012908.full
AB  - Background Treatment of spinal metastatic lesions by radiofrequency ablation (RFA) before cementation can potentially help in local tumor control and pain relief. This is often limited by access and tumor location. This study reports multicenter clinical and imaging outcomes following targeted RFA (t-RFA) and cement augmentation in neoplastic lesions of the spine.Material and methods A retrospective multicenter study of 49 patients with 72 painful vertebral lesions, evaluated for clinical and imaging outcomes following RFA and cement augmentation of spinal metastatic lesions, was undertaken. Visual Analogue Pain score (VAS) and Oswestry Disability Index (ODI) were obtained before and 2–4 weeks after treatment. Pre- and post-procedure imaging examinations including MRI and positron emission tomography (PET) were also evaluated.Results Mean ablation time was 3.7±2.5 min (range 0.92–15). Mean VAS scores decreased from 7.9±2.5 pre-procedure to 3.5±2.6 post-procedure (p<0.0001). Mean ODI scores improved from 34.9±18.3 to 21.6±13.8 post-procedure (p<0.0001). Post-contrast MRI resulted in a predictable pattern of decreased tumor volume and an enhancing rim. Metabolically active lesions in pre-procedure PET scans (n=10 levels) showed decreased fluorodeoxyglucose activity after ablation.Conclusions t-RFA followed by vertebral augmentation in malignant vertebral lesions resulted in significant pain reduction and functional status improvement, with no major complications. t-RFA permitted access to vertebral lesions and real-time accurate monitoring of the ablation zone temperature. Post-procedure MRI and PET examinations correlated with a favorable tumor response and helped to monitor tumor growth and the timing of adjuvant therapy.