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Prospective 1-year follow-up pilot study of CT-guided microwave ablation in the treatment of bone and soft-tissue malignant tumours

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Abstract

Purpose

The aims of this work were to assess the feasibility, efficacy, short-term outcome and safety of microwave ablation (MWA) in the treatment of malignant musculoskeletal tumours.

Materials and methods

Sixteen bone and soft-tissue malignant tumours were prospectively included and were treated by CT-guided MWA. The percentage and size of necrosis of the lesions were measured by contrast-enhanced MRI before the procedure and after 1, 3, 6 and 12 months. mRECIST criteria were used to assess tumour response. Procedural success was defined as ≥80 % necrosis. Patient pain (as assessed using a numeric visual scale (NVS)) and side effects were noted.

Results

Six osteolytic metastases, five osteoblastic metastases and five soft tissue sarcomas were treated. At 1 month, 40 % were treated completely, the percentage of necrosis was 85 ± 30.4 %, and the success rate was 80 %. At 3, 6 and 12 months the success rate was 80 %, 76.9 % and 63.6 %, respectively. At 12 months, four lesions (36.3 %) still had no recurrence. Mean NVS during the procedure was 3.5 ± 2.8. One patient had transitory sciatica without neurological deficit that was treated medically.

Conclusion

CT-guided MWA of bone and soft-tissue malignant tumours is efficient, well tolerated and has good short-term anti-cancer effects.

Key Points

• CT-guided MWA is efficient in treating musculoskeletal malignant tumours.

• This prospective pilot study showed MWA induces high percentages of tumour necrosis.

• MWA has good short-term anti-cancer effects.

• MWA has healing potential when lesions can be completely necrosed.

• CT-guided MWA under equimolar mixture of oxygen-nitrous oxide inhalation is well tolerated.

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Acknowledgments

The scientific guarantor of this publication is Dr Sébastien Aubry. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by the University Hospital of Besançon, France. One of the authors has significant statistical expertise (Chrystelle Vidal). Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: prospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Musculoskeletal Imaging, University Hospital of Besancon, 25000, Besancon, France

    Sébastien Aubry, Jonathan Dubut, Jean-Philippe Nueffer & Bruno Kastler

  2. I4S laboratory, INSERM EA4268, University of Franche-Comte, 25000, Besancon, France

    Sébastien Aubry & Bruno Kastler

  3. Department of Oncology, University Hospital of Besancon, 25000, Besancon, France

    Loic Chaigneau

  4. Clinical Investigation Center, INSERM CIT808, University Hospital of Besancon, 25000, Besancon, France

    Chrystelle Vidal

Authors
  1. Sébastien Aubry
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  2. Jonathan Dubut
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  3. Jean-Philippe Nueffer
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  4. Loic Chaigneau
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  5. Chrystelle Vidal
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  6. Bruno Kastler
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Correspondence to Sébastien Aubry.

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Aubry, S., Dubut, J., Nueffer, JP. et al. Prospective 1-year follow-up pilot study of CT-guided microwave ablation in the treatment of bone and soft-tissue malignant tumours. Eur Radiol 27, 1477–1485 (2017). https://doi.org/10.1007/s00330-016-4528-7

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  • DOI: https://doi.org/10.1007/s00330-016-4528-7

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