Mayo Clinic-led Multicenter Research Study Finds Image-Guided Cryoablation Useful for Painful Metastatic Bone Disease

Tuesday, November 30, 2010

CHICAGO — During a recent multicenter trial led by Mayo Clinic, 62 adults with painful bone metastases were treated with CT guided and monitored cryoablation, a treatment technique pioneered at Mayo Clinic. These patients were treated at eight medical facilities across the United States using one or more cryoprobes under general anesthesia. Results from the trial were presented Nov. 30 at the Radiological Society of North America's (RSNA) annual conference in Chicago.

Led by Matthew Callstrom, M.D., Ph.D., a radiologist at Mayo Clinic in Rochester, Minn., the study concluded that percutaneous cryoablation provides effective palliation for patients with painful metastatic disease. Cryoablation uses cold to destroy tumors and can be carefully monitored with CT imaging.

"Image-guided cryoablation provides a new option for many patients with metastatic bone disease. The ice that is generated in the body using cryoablation is clearly visible with CT imaging so the tumor can be treated aggressively, and in many cases completely, while avoiding critical normal structures," says Dr. Callstrom. "Cryoablation also is nearly painless, while other treatments, such as radiofrequency ablation, can require greater pain control."

"Approximately 75 percent of patients reported 90 percent pain relief at some point in the follow-up period," says Dr. Callstrom.

Previously, treatment options for patients with painful focal metastatic disease have been limited. External beam radiation therapy is the gold standard for treatment, but 30 percent of those treated fail to achieve a response. Of those who have a partial or complete response, 50 percent return to their initial pain score within two to three months.

Prior to cryoablation treatment as part of the study, the mean score for worst pain in a 24-hour period — reported on the standard pain scale of zero to 10 — was 7.1/10 with individual pain ratings ranging from four to 10. Four, eight and 24 weeks after treatment, the mean worst pain decreased to 4/10, 3.6/10 and 1.4/10, respectively.

In addition to Mayo Clinic's campuses in Rochester and Jacksonville, Fla., research study sites included Brown University in Providence, R.I.; Memorial Sloan-Kettering in New York City; St. Luke's Hospital in Milwaukee; the University of Wisconsin in Madison; Karmanos Cancer Center in Detroit; and the University of California, Los Angeles.

More than 80 presentations, posters and other sessions were delivered by Mayo Clinic staff at the annual conference from Nov. 28 to Dec. 3. In addition to the study on image-guided cryoablation, Mayo Clinic staff members addressed other interventional radiology topics, screening innovations such as molecular breast imaging, and computed tomography dose reduction.

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