Innovative Brachytherapy Techniques and Radiofrequency Ablation

Brachytherapy is a type of radiation therapy that utilizes natural or manufactured radioactive isotopes or radionuclides implanted in the internal organs of the body, to treat cancer lesions, with the aim to deliver high radiation doses to neoplastic cells, without damaging adjacent normal tissues. New instrumentations can allow a safe and effective delivery of radioactive source directly inside the vertebral body, to treat metastatic spine disease. Vertebroplasty (VP) procedure may further stabilizes the radioactive sources and prevents vertebral fractures. Percutaneous thermal ablation techniques (radiofrequency ablation, cryoablation, microwave ablation) are minimally invasive treatment options for bone metastases that are increasingly employed in the interventional oncology practice. Thermal ablation induces low ( 60 °C) temperatures within the targeted tumors, leading to tissue necrosis and cell death. The main indications for thermal ablation procedures (treatment of painful bone metastases, refractory or unsuitable to conventional therapies, local control of limited metastatic disease) and the surgical approach (transpedicular) are similar to those for augmentation techniques, favoring their combined approach.