Proschek D, Tonak M, Zangos S, Mack M G, Kurth A A
Center for Musculoskeletal Surgery, Department of Orthopaedic Surgery, University Medical Center Mainz, Germany.
Department of Diagnostic and Interventional Radiology, University Hospital, Frankfurt, Germany.
J Bone Oncol. 2012 Aug 9;1(2):63-6. doi: 10.1016/j.jbo.2012.07.001. eCollection 2012 Sep.
Radiofrequency ablation is a minimal invasive therapy in the treatment of bone metastases. In this study we present a new ablation system enabling an ablation in multiple directions and with an adaptable size and shape.
VX-2 tumor was used for the induction of experimental bone metastases in the femur of six New Zealand white rabbits. X-ray imaging as well as CT and MRI scans before and after treatment was carried out. After detecting bone tumor, radiofrequency ablation was performed. The ablation instrument contained a 10 g bipolar, articulated extendable electrode and a proprietary generator with an impedance controlled algorithm. All bones and the soft tissue were examined histologically.
All animals developed local bone tumor. Mean duration until first osteolytic lesions on CT-scans was 48±14 days. The mean lesion area was 26 mm(2). No systemic tumor spread was seen. 6 radiofrequency procedures were carried out with a mean application time of 6 min±2:30 and an average temperature in the region of effect of 55 °C±4. MRI imaging demonstrated an ablation zone of 23±6 mm around the electrode. Histopathology showed an extensive heat necrosis with no remaining tumor cells in the ablation area.
Radiofrequency ablation is a quickly developing treatment option on the field of minimal invasive bone tumor therapy. The electrode enables an ablation adapted to size and shape of the metastases. Further clinical studies are necessary to test and enhance this radiofrequency system.
射频消融是治疗骨转移瘤的一种微创治疗方法。在本研究中，我们展示了一种新的消融系统，该系统能够进行多方向消融，且消融范围和形状可调节。
采用VX-2肿瘤诱导6只新西兰白兔股骨发生实验性骨转移。在治疗前后进行X线成像以及CT和MRI扫描。检测到骨肿瘤后，进行射频消融。消融仪器包括一个10g双极、可弯曲伸展的电极和一个具有阻抗控制算法的专利发生器。对所有骨骼和软组织进行组织学检查。
所有动物均发生局部骨肿瘤。CT扫描上首次出现溶骨性病变的平均时间为48±14天。平均病变面积为26mm²。未观察到全身肿瘤扩散。进行了6次射频手术，平均手术时间为6分钟±2分30秒，消融区域的平均温度为55°C±4。MRI成像显示电极周围有一个23±6mm的消融区。组织病理学显示广泛的热坏死，消融区域无残留肿瘤细胞。
射频消融是微创骨肿瘤治疗领域中一种快速发展的治疗选择。该电极能够使消融适应转移瘤的大小和形状。需要进一步的临床研究来测试和改进这种射频系统。
