Percutaneous Spinal Ablation in a Sheep Mannequin: Protecting Capability of an Intact Cortex, Correlation of Ablation Parameters with Ablation Zone Measurement, and Correlation of Postablation MRI and Pathologic Findings.
AJNR Am J Neuroradiol. 2017 Aug;38(eight):1653-1659
Authors: Wallace AN, Hillen TJ, Friedman MV, Zohny ZS, Stephens BH, Greco SC, Talcott MR, Jennings JW
BACKGROUND AND PURPOSE: Regardless of the rising use of percutaneous ablation remedy for the therapy of metastatic backbone illness, a number of points have but to be absolutely addressed. Our goals had been to find out whether or not the vertebral physique cortex protects in opposition to ablation-induced spinal twine harm; correlate radiofrequency, cryo-, and microwave ablation parameters with ensuing spinal ablation zone dimensions and describe regular spinal marrow postablation adjustments on MR imaging.
MATERIALS AND METHODS: Ten thoracolumbar vertebrae in three sheep had been handled with radiofrequency ablation, cryoablation, or microwave ablation beneath fluoroscopic steerage. Method parameters had been chosen to provide ablation zones that exceeded the amount of the vertebral our bodies in sheep 1 and had been confined to the vertebrae in sheep 2 and three. Anticipated ablation zone dimensions had been primarily based on information offered by the machine producers. Postablation MR imaging was carried out at 48 hours (sheep 1) or 7 days (sheep 2 and three).
RESULTS: In sheep 1, cryoablation and microwave ablations prolonged into the spinal canal and brought on histologically confirmed neurologic harm, however radiofrequency ablation didn’t. The imply distinction between the lengths of the radiofrequency ablation zone dimensions measured on gross pathology in contrast with these anticipated was 9.6 ± four.1 mm. The gross pathologic cryo- and microwave ablation zone dimensions had been inside 1 mm of these anticipated. All modalities produced a nonenhancing ablation zone with a rim of enhancement, corresponding histologically to marrow necrosis and hemorrhagic congestion.
CONCLUSIONS: An intact cortex seems to guard in opposition to radiofrequency ablation-induced spinal twine harm, however not in opposition to non-impedance-based modalities. Ablation dimensions produced by microwave and cryoablation are much like these anticipated, whereas radiofrequency ablation dimensions are smaller. Ablation of regular marrow produces a rim of enhancement on the margin of the ablation zone on MR imaging.
PMID: 28572150 [PubMed – indexed for MEDLINE]