To assess the feasibility of using T2 relaxation time mapping at 3 Tesla (3T) magnetic resonance imaging (MRI) for detection and classification of lumbar intervertebral disc degeneration, introducing an objective model of disc segmentation for accurate disc assessment.
Metastases to the bone represent the third most common site of metastatic disease. More than 50% of patients with metastatic cancer will develop bone metastases. Associated morbidity is related to local tumor progression that destroys bone to result in pain, pathologic fracture, hypercalcemia, and neurologic deficits. Depending on the tumor biology, systemic chemotherapy or radiation therapy may not provide complete local control and may not adequately relieve associated pain. While surgical intervention may be beneficial in many patients, surgical options may also provide incomplete locoregional cure or palliation, and moreover may require extensive healing that can delay systemic therapy. Interventional oncology treatments can provide appealing alternative therapies for osseous metastases. These minimally-invasive therapies can augment existing conventional treatments and even provide a viable option for patients that have exhausted, or are not suitable candidates, for conventional treatments. Interventional oncology treatments are applied for either pain palliation, local tumor control, or both. The goals of treatment can include tumor remission or cure, as well as improved quality of life and mobility. An effective and durable interventional oncology treatment requires a tailored approach that considers the high variability in disease presentation. Osseous metastases may present throughout the skeleton, with low to high vascularity, and undulant to rapidly aggressive tumor biology. This article reviews the main percutaneous treatment for osseous metastases that include embolization, thermal ablation, vertebral augmentation, cementoplasty, and fixation by internal cemented screw (FICS).
Poster: ECR 2011 / C-1381 / Spine infiltrations: a pictorial review by: K. Filippiadis1, A. D. Kelekis2, A. Mazioti1, E. Alexopoulou3, E. Brountzos4, N. L. Kelekis2; 1MAROUSI - ATHENS/GR, 2Athens/GR, 3CHOLARGOS/GR, 4Haidari/GR
Different interventional procedures performed under imaging guidance permit the diagnosis and treatment of the many causes of back pain. Sources of pain amenable to be treated include facet joints, vertebral body, intervertebral disk, and paraspinal structures including nerves and ganglion roots. These procedures may be merely diagnostic, therapeutic, or intended for both purposes. We review the main indications, advantages, and complications of these techniques.
Poster: ECR 2014 / C-0857 / Baastrup disease: a commonly overlooked cause of low back pain by: K. Filippiadis, A. Mazioti, E. Alexopoulou, K. Malagari, E. Brountzos, N. L. Kelekis, A. D. Kelekis; Athens/GR
Poster: ECR 2013 / C-1376 / Imaging post liver thermal ablation: what you need to know by: K. Filippiadis, M. Mademli, A. Mazioti, N. Oikonomopoulos, S. Argentos, A. D. Kelekis, N. L. Kelekis; Athens/GR
To retrospectively evaluate feasibility and safety of CT-guided percutaneous radiofrequency ablation (RFA) of metastatic lymph nodes (LN) in terms of achieving local tumor control.Institutional database research identified 16 patients with 24 metastatic LNs who underwent percutaneous CT-guided radiofrequency ablation. Mean patient age was 66.6 ± 15.70 years (range 40-87) and male/female ratio was 8/8. Contrast-enhanced CT or MRI was used for post-ablation follow-up. Patient and tumor characteristics and RFA technique were evaluated. Technical and clinical success on per tumor and per patient basis as well as complication rates were recorded.Mean size of the treated nodes was 1.78 ± 0.83 cm. The mean number of tumors per patient was 1.5 ± 0.63. The mean procedure time was 56.29 ± 24.27 min including local anesthesia, electrode(s) placement, ablation and post-procedural CT evaluation. Median length of hospital stay was 1.13 ± 0.34 days. On a per lesion basis, the overall complete response post-ablation according to the mRECIST criteria applied was 75% (18/24) of evaluable tumors. Repeat treatment of an index tumor was performed on two patients (three lesions) with complete response achieved in 87.5% (21/24) of evaluable tumors following a second RFA. On a per patient basis, disease progression was noted in 10/16 patients at a mean of 13.9 ± 6.03 months post the ablation procedure.CT-guided percutaneous RFA for oligometastatic LNs is a safe and feasible therapy.With this percutaneous therapeutic option, metastatic LNs can be eradicated with a very low complication rate.
