Interventional radiology in bone metastases: Current concepts and perspectives

Area of Science:

• Oncology
• Interventional Radiology
• Skeletal Metastases

Background:

• Bone metastases frequently cause skeletal-related events (SREs), impacting patient survival and quality of life.
• Traditional management includes radiotherapy, surgery, and systemic treatments.
• Interventional Radiology (IR) is emerging as a crucial component in bone metastasis care.

Purpose of the Study:

• To review the state-of-the-art Interventional Radiology techniques for bone metastases.
• To highlight the integration of IR into modern, multidisciplinary oncology care pathways.
• To emphasize the shift towards proactive, curative-intent strategies enabled by IR.

Main Methods:

• High-resolution image-guided procedures.
• Diagnostic tissue sampling for molecular profiling.
• Mechanical reinforcement (osteosynthesis, cementoplasty).
• Local tumor control (thermal ablation, cryoablation, embolization).

Main Results:

• IR offers immediate mechanical stabilization and local tumor destruction.
• Emerging evidence suggests immunomodulatory effects of ablation techniques, potentially enhancing systemic anti-tumor immunity (abscopal effect).
• IR facilitates a transition from palliative care to aggressive, personalized treatment strategies.

Conclusions:

• Interventional Radiology is the "fourth pillar" of oncology for bone metastases.
• IR techniques are integral to precision medicine and multidisciplinary decision-making.
• IR bridges conservative medical therapy and invasive surgery, improving patient outcomes.