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MRI-guided Percutaneous Cryotherapy for Soft-tissue and Bone Metastases: Initial Experience
Institution:
 Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115, USA. ktuncali&partners.org
Publisher:
 AJR Am J Roentgenol
Publication Date:
 Jul-2007
Volume Number:
 189
Issue Number:
 1
Pages:
 232-239
Citation:
 AJR Am J Roentgenol. 2007 Jul;189(1):232-9.
PubMed ID:
 17579176
Appears in Collections:
NCIGT
Sponsors:
 U41 RR019703 (RR) funded by NCRR
Generated Citation:
 Tuncali K., Morrison P.R., Winalski C.S., Carrino J.A., Shankar S., Ready J.E., vanSonnenberg E., Silverman S.G. MRI-guided Percutaneous Cryotherapy for Soft-tissue and Bone Metastases: Initial Experience. AJR Am J Roentgenol. 2007 Jul;189(1):232-9. PMID: 17579176.
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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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