title: [Interventional radiology for bone metastases].
abstract: The management of bone metastases requires a multidisciplinary staff to include systemic and local treatments like radiotherapy, surgery or interventional radiology (IR). Patients are often fragile. Imaging allows safe guidance to create "mini-invasive" procedures under adequate anesthesia. Patients' selection is important. If the goal is pain relief, cementoplasty provides a very effective bone consolidation and pain control. Simple and low-risk, vertebroplasty is the technique of choice in case of lytic bone metastases with spinal fracture risk or after failure of analgesic radiotherapy. If the medical project is curative, the tumor ablation procedures are realised through thermic or embolic techniques. After 60°C, the heat induces a coagulative necrose. Under -20°C, the cold leads to destroy the tissues. The major advantage of the cryotherapy is the predictibility of the ablation zone due to the well-visualized ice ball on perprocedural images. This technique is much more adapted to spare the nervous structures closed to the metastasis. The development of these new techniques of IR will treat bone metastases earlier, sometimes asymptomatic and thus improves the quality of life in patients with bone metastases.
authors.affiliation: Centre de lutte contre le cancer, centre Antoine-Lacassagne, département d'imagerie diagnostique et de radiologie interventionnelle, 33, avenue de Valombrose, 06189 Nice cedex 2, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Iannessi
authors.forename: Julien
authors.initials: J
authors.lastname: Garnon
authors.forename: Évelyne
authors.initials: É
authors.lastname: Cormier
authors.forename: Frédéric
authors.initials: F
authors.lastname: Clarencon
authors.forename: Jacques
authors.initials: J
authors.lastname: Chiras
mesh_terms: D001859:Bone Neoplasms / Q000556:secondary* / Q000628:therapy*; D060826:Cementoplasty / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D010146:Pain / Q000209:etiology; D059408:Pain Management / Q000379:methods; D010348:Patient Care Team; D015642:Radiology, Interventional / Q000379:methods*; D013125:Spinal Neoplasms / Q000556:secondary / Q000628:therapy; D054854:Vertebroplasty / Q000379:methods
keywords: bone metastasis; cancer; cryotherapy; pain palliation; radiofrequency; vertebroplasty