Presented at the 2013 AAPM Annual Meeting « Back

Microwave Ablation Under Local Anesthesia of Bone and Soft-Tissue Tumors: Preliminary Results

Adrian Kastler, MD, adriankastler@gmail.com¹, Hussein Alnassan¹, Sébastien Aubry, MD PhD¹, Bruno A. Kastler, MD, PhD¹, (1) Centre Hospitalier Universitaire, Besançon, Franche Comté, France

Objectives: To evaluate the feasibility and efficacy of percutaneous microwave ablation (MWA) under CT guidance in the management of refractory pain in bone and soft tissue tumors. Material and Methods: 20 MWA were performed in 13 adult patients using an Acculis MTA-2 Generator, 4,5GHz with a 17 gauge antenna. Topography of lesions were as follows: 15 bone lesions (rib: 8, spine: 3, sacrum: 2, scapula 1, clavicle 1) and 5 soft tissue lesions (subcutaneous: 2, axillary: 1, peri-scapular: 1, subclavicular: 1). 12 of 15 bone lesions were osteolytic. 16 of 20 ablated lesions were metastases (Lung: 8, Leiomyosarcoma: 3, Thyroid: 2, Kidney: 1, Prostate: 2). All procedures were performed with CT guidance under local anesthesia and nitrous oxide. Follow-up was performed either by contrast ultrasound or MRI. Pain prior procedure, immediately after and distance was assessed using a VAS pain score. Results: Lesion size ranged from 12 mm to 120 mm. Technical success was 100%. Mean ablation time was 4.85 minutes (1-13) with an average of 4.2 cycles per ablation lasting from 30 seconds to 3 minutes with a mean ablation power of 60W Mean VAS before procedure was 7.29/10. Immediate pain relief was greater than or equal to 50% in 19/20 cases with and lasting for an average of 4.36 months (range 0.5-15months). We report one case of secondary abcess at ablation site requiring further management (drainage). Conclusions: When other therapies provide insufficient pain relief, percutaneous MWA treatment appears to be a feasible and effective technique for the management of refractory pain in bone and soft-tissue tumors. Ablation time appears to be highly reduced compared to radiofrequency ablation.

Funding: None