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Il Giornale Italiano di Radiologia Medica 2018 Gennaio-Febbraio;5(1):53-8

DOI: 10.23736/S2283-8376.17.00007-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: Italian

Combined percutaneous biopsy, microwave thermoablation and cementoplasty, performed with a CT-guided approach

Vincenzo COSTANZO 1 , Massimo MIDIRI 1, Angelo TOSCANO 2, Stefano ZAFFAGNINI 2, Sergio MONTALBANO 3, Francesca VERDERAME 4, Tommaso ANGILERI 4

1 Azienda Ospedaliera Universitaria Policlinico Universitario “P. Giaccone”, Palermo, Italia; 2 Istituto Ortopedico Rizzoli Sicilia, presso Villa Santa Teresa Diagnostica per Immagini e Radioterapia S.r.l., Bagheria, Palermo, Italia; 3 Unità Operative di Anestesia e Rianimazione, Villa Santa Teresa Diagnostica per Immagini e Radioterapia S.r.l., Bagheria, Palermo, Italia; 4 Unità Operative di Diagnostica per Immagini, Villa Santa Teresa Diagnostica per Immagini e Radioterapia S.r.l., Bagheria, Palermo, Italia


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BACKGROUND: The skeleton is the third most common site of carcinoma metastasis. The possibility of survival of the patient with bone metastases is the key aspect of choosing the type of treatment to be performed. Aim of this study was to evaluate the results and complications of combined percutaneous biopsy, microwave thermoablation and cementoplasty, performed at the same time using a CT-guided approach, to obtain pain resolution.
METHODS: Our series was collected between March 2015 and July 2016. We performed 19 procedures in patients with skeletal metastases (hip, femur, tibia and spine) from breast (12), lung (4), colon (2) and prostate (1) cancer. All procedure was performed with multislice CT-guide with or without fluoroscopy. For patient selection and during the follow-up visits, we evaluate pain (10-point VAS) and analgesic use (3-point scale). All the lesions were osteolytic.
RESULTS: Partial or complete pain relief was obtained in 84,2% of patients within 24 h and after 1 month from the treatment. No severe or mild complications were observed. Asymptomatic cement leakages were identified in 5 patients (26.3%).
CONCLUSIONS: Our personal experience confirms that combined technique, with CT-guided approach, is an opritimal first-line procedure for treating pain in patients with symptomatic bone metastases. The use of the CT-guide increases accuracy and safety in the various phases of the procedure, reducing the risk of complications.


KEY WORDS: Bone and bones - Neoplasm metastasis - Ablation techniques - Cementoplasty - Biopsy - Radiology, interventional

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