ABSTRACT
The advances in image-guided thermoablation continue to expand the treatment options for many oncology patients, reflecting the growing trend toward minimally invasive cancer therapy. Having established its efficacy for the treatment of benign osteoid osteomas, radiofrequency ablation (RFA) has become an increasingly recognized and applied alternative for malignancies affecting the musculoskeletal system. Although vastly different in terms of prognosis and therapeutic aims, the benign and malignant skeletal tumors have in common the potential for causing severe, debilitating pain throughout their course. For the typical patient diagnosed with osteoid osteoma, it is the impact of this pain on an often active, normal level of functioning that prompts early referral. For patients experiencing the pain of bone metastases, effective and durable symptom relief is similarly urgent, but in the setting of an often terminal disease. Together, these tumors represent a disease spectrum where the efficacious, minimally invasive therapy offered by thermoablation may provide the best outcomes, for local cure and palliation alike. This chapter offers a brief introduction to the percutaneous image-guided thermoablation techniques that are currently being applied within the musculoskeletal system. Radiofrequency ablation and its related modalities, including microwave ablation (MWA) and cryoablation, are discussed individually, and in the context of the traditional therapies with which they are increasingly being integrated.
