title: Postoperative MRI Evaluation of a Radiofrequency Cordotomy Lesion for Intractable Cancer Pain.
abstract: There are limited data on the use of postoperative imaging to evaluate the cordotomy lesion. We aimed to describe the cordotomy lesion by using postoperative MR imaging in patients after percutaneous cordotomy for intractable cancer pain.
  
  
  
  Postoperative MR imaging and clinical outcomes were prospectively obtained for 10 patients after percutaneous cordotomy for intractable cancer pain. Area, signal intensity, and location of the lesion were recorded. Clinical outcomes were measured by using the Visual Analog Scale and the Brief Pain Inventory-Short Form, and correlations with MR imaging metrics were evaluated.
  
  
  
  Ten patients (5 men, 5 women; mean age, 58.5 ± 9.6 years) were included in this study. The cordotomy lesion was hyperintense with central hypointense foci on T2-weighted MR imaging, and it was centered in the anterolateral quadrant at the C1-C2 level. The mean percentage of total cord area lesioned was 24.9% ± 7.9%, and most lesions were centered in the dorsolateral region of the anterolateral quadrant (66% of the anterolateral quadrant). The number of pial penetrations correlated with the percentage of total cord area that was lesioned (r= 0.78; 95% CI, 0.44-0.89;P= .008) and the length of T2-weighted hyperintensity (r= 0.85; 95% CI, 0.54-0.89;P= .002). No significant correlations were found between early clinical outcomes and quantitative MR imaging metrics.
  
  
  
  We describe qualitative and quantitative characteristics of a cordotomy lesion on early postoperative MR imaging. The size and length of the lesion on MR imaging correlate with the number of pial penetrations. Larger studies are needed to further investigate the clinical correlates of MR imaging metrics after percutaneous cordotomy.
authors.affiliation: From the Department of Neurosurgery (A. Vedantam, A. Viswanathan), Baylor College of Medicine, Houston, Texas.
authors.forename: A
authors.identifier: 0000-0002-5212-0640
authors.initials: A
authors.lastname: Vedantam
authors.affiliation: Departments of Imaging Physics (P.H.).
authors.forename: P
authors.identifier: 0000-0002-1518-571X
authors.initials: P
authors.lastname: Hou
authors.affiliation: Diagnostic Radiology (T.L.C).
authors.forename: T L
authors.identifier: 0000-0001-7352-4890
authors.initials: TL
authors.lastname: Chi
authors.affiliation: Biostatistics (K.R.H.).
authors.forename: K R
authors.identifier: 0000-0003-1377-6070
authors.initials: KR
authors.lastname: Hess
authors.affiliation: Pain Medicine (P.M.D.).
authors.forename: P M
authors.identifier: 0000-0002-2177-2734
authors.initials: PM
authors.lastname: Dougherty
authors.affiliation: Palliative Care and Rehabilitation Medicine (E.B.), University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: E
authors.identifier: 0000-0002-8745-0412
authors.initials: E
authors.lastname: Bruera
authors.affiliation: From the Department of Neurosurgery (A. Vedantam, A. Viswanathan), Baylor College of Medicine, Houston, Texas ashwinv@ubcm.edu.
authors.forename: A
authors.identifier: 0000-0002-9602-8563
authors.initials: A
authors.lastname: Viswanathan
mesh_terms: D000328:Adult; D000368:Aged; D000072716:Cancer Pain / Q000601:surgery*; D002818:Cordotomy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010148:Intractable Pain / Q000601:surgery*; D010841:Pia Mater / Q000000981:diagnostic imaging / Q000293:injuries; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011184:Postoperative Period; D011446:Prospective Studies; D016634:Radiosurgery / Q000379:methods*; D016896:Treatment Outcome