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MRI-guided cryoablation for metastatic spine disease: intermediate-term clinical outcomes in 14 consecutive patients
Ziev B Moses1, Thomas C Lee2, Kevin T Huang1
11Department of Neurosurgery and.
Objective:
Minimal access ablative techniques have emerged as a less invasive option for spinal metastatic disease reduction and separation from neural tissue. Compared with heat-based ablation modalities, percutaneous image-guided cryoablation allows for more distinct visualization of treatment margins. The authors report on a series of patients undergoing MRI-guided cryoablation as a feasible method for treating spinal metastatic disease.
Methods:
A total of 14 patients with metastatic spine disease undergoing MR-monitored cryoablation were prospectively enrolled. Procedures were performed in an advanced imaging operating suite with the use of both CT and MRI to gain access to the spinal canal and monitor real-time cryoablation.
Results:
The average age was 54.5 years (range 35-81 years). The mean preoperative Karnofsky Performance Status score was 79.3 (range 35-90). The average radiographic follow-up was 7.1 months (range 25-772 days), and the average clinical follow-up was 9.8 months (range 7-943 days). In 10 patients with epidural disease, 7 patients underwent postprocedural imaging, and of these 71% (5/7) had stable or reduced radiographic disease burden. Bone regrowth was observed in 63% (5/8) of patients with bone ablation during the treatment who had postoperative imaging. Pre- and postoperative visual analog scale scores were obtained, and a significant reduction in these scores was found following ablation. There were no complications.
Conclusions:
MR-guided cryoablation is a minimally invasive treatment option for metastatic spine disease. In patients with epidural disease, the majority experienced tumor reduction or arrest at follow-up. In addition, pain was significantly improved following ablation. The average hospital stay was short, and the procedure was safe in a range of patients who are otherwise not ideal candidates for standard treatment.
Insights
MRI-guided cryoablation offers a minimally invasive approach for spinal metastatic disease. This technique effectively reduced tumor burden and improved pain in patients, demonstrating a safe and feasible treatment option.
Area of Science:
- Oncology
- Interventional Radiology
- Neurosurgery
Background:
- Spinal metastatic disease requires effective, minimally invasive treatments.
- Percutaneous image-guided cryoablation offers distinct visualization of treatment margins compared to heat-based methods.
Purpose of the Study:
- To evaluate the feasibility and efficacy of MRI-guided cryoablation for treating spinal metastatic disease.
- To assess tumor response, pain reduction, and safety of the procedure.
Main Methods:
- Prospective enrollment of 14 patients with metastatic spine disease undergoing MR-monitored cryoablation.
- Procedures utilized both CT and MRI for precise access and real-time monitoring of cryoablation.
- Pre- and postoperative pain scores (Visual Analog Scale) were recorded.
Main Results:
- 71% of patients with epidural disease showed stable or reduced tumor burden on postprocedural imaging.
- Significant reduction in Visual Analog Scale pain scores was observed post-ablation.
- The procedure was safe with no reported complications and a short hospital stay.
Conclusions:
- MR-guided cryoablation is a feasible and safe minimally invasive treatment for metastatic spine disease.
- The majority of patients with epidural disease experienced tumor control.
- Significant pain improvement was noted, making it a viable option for patients unsuitable for standard treatments.
