Bodard Sylvain, Moussa Amgad M, Vaynrub Max, Bartelstein Meredith, Santos-Martin Ernesto, Maybody Majid, Cornelis Francois H
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Insights Imaging. 2025 Sep 17;16(1):193. doi: 10.1186/s13244-025-02083-6.
To evaluate the feasibility, safety, and efficacy of microwave ablation (MWA) of bone lesions with regard to local control and pain palliation.
We reviewed 43 patients (23 males, 20 females) with 51 lesions (44 metastatic, 7 benign) treated with MWA from January 2016 to December 2023. Pain intensity was measured using the Visual Analogue Scale (VAS), SF-36 Bodily Pain Scale, and Patient Global Impression of Change (PGIC) from pre-operation to various follow-up stages. Adverse events were categorized according to the Society of Interventional Radiology (SIR) grading system.
The procedure demonstrated 100% technical success. Grades I and III adverse events were observed in 8.3% (3/36) and 2.8% (1/36) of patients with metastatic disease, respectively. In those with benign lesions, no adverse events were reported. A significant reduction in pain was observed, with the VAS score decreasing by 74.3% from baseline to the last follow-up [6.7 ± 2.3 (range: 0-10) to 1.8 ± 2.3 (range: 0-7) (p < 0.001)] for metastatic patients, and from 5.7 ± 2.1 (range: 3-8) to 0 ± 0 (range: 0-0) by the final follow-up (p = 0.0011) for benign lesions. 77.8% (29/36) of metastatic patients, and all (7/7) benign patients were much or very much improved according to Patient Global Impression Change. Complete imaging response was achieved in 55.6% (20/36) of metastatic lesions. At last follow-up, 25% (9/36) had radiological evidence of recurrence, with a median recurrence time of 13 months (IQR: 8-14). Complete response was achieved in all benign lesions.
MWA is a safe and effective treatment for pain management in patients with bone lesions.
This study confirms the potential of microwave ablation as a treatment for bone lesions, providing significant pain relief with a favorable safety profile.
Microwave ablation (MWA) significantly reduced pain scores in patients with bone lesions, maintaining pain relief over time. The procedure exhibited high technical success with minimal adverse events, indicating a high safety profile. Subgroup analysis revealed no significant differences in pain reduction among different procedural combinations over time.
评估微波消融（MWA）治疗骨病变在局部控制和缓解疼痛方面的可行性、安全性和有效性。
我们回顾性分析了2016年1月至2023年12月期间接受MWA治疗的43例患者（23例男性，20例女性）的51处病变（44处转移性病变，7处良性病变）。使用视觉模拟量表（VAS）、SF - 36身体疼痛量表和患者总体变化印象（PGIC）在术前至不同随访阶段测量疼痛强度。不良事件根据介入放射学会（SIR）分级系统进行分类。
该手术技术成功率达100%。转移性疾病患者中分别有8.3%（3/36）和2.8%（1/36）观察到I级和III级不良事件。在良性病变患者中，未报告不良事件。观察到疼痛显著减轻，转移性患者的VAS评分从基线到最后一次随访下降了74.3%[6.7±2.3（范围：0 - 10）降至1.8±2.3（范围：0 - 7）（p < 0.001）]，良性病变患者到最终随访时从5.7±2.1（范围：3 - 8）降至0±0（范围：0 - 0）（p = 0.0011）。根据患者总体变化印象，77.8%（29/36）的转移性患者和所有（7/7）良性患者有很大或非常大的改善。55.6%（20/36）的转移性病变实现了完全影像学缓解。在最后一次随访时，25%（9/36）有复发的影像学证据，中位复发时间为13个月（IQR：8 - 14）。所有良性病变均实现了完全缓解。
MWA是治疗骨病变患者疼痛的一种安全有效的方法。
本研究证实了微波消融作为骨病变治疗方法的潜力，能显著缓解疼痛且安全性良好。
微波消融（MWA）显著降低了骨病变患者的疼痛评分，并随时间维持疼痛缓解。该手术技术成功率高，不良事件极少，表明安全性良好。亚组分析显示不同手术组合随时间在疼痛减轻方面无显著差异。
