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Bone Hyperthermia Treatments: Temperature Monitoring
Bone metastases and osteoid osteoma (OO) have a high incidence in patients facing primary lesions in many organs. In this arena, hyperthermia treatments (HTs) have gaining momentum as valuable alternatives to traditional therapies owing to their minimally invasive nature, the success rate in tumor control and the immediate effect in pain relief affecting the majority of patients. Temperature monitoring during HTs may significantly improve the clinical outcomes since the amount of thermal injury depends on the tissue temperature and the exposure time. This is particularly relevant in bone tumors due to the adjacent vulnerable structures (e.g., spinal cord and nerve roots).
Hyperthermia treatments (hereafter HTs) have gaining momentum in the treatment of bone cancer. Such procedures have emerged as valuable alternatives to traditional therapies, owing to their minimally invasive nature . Given the success rate in tumor control and the immediate effect of pain relief, HTs have been identified as a possible treatment in bone metastases by the National Comprehensive Cancer Network in its November 2020 guidelines . The main principle of HTs is to achieve complete and effective cancer removal by raising cytotoxic temperatures (i.e., > 50 °C) . Among HTs, radiofrequency ablation (RFA), laser ablation (LA), microwave ablation (MWA) and high focused ultrasound (HIFU) are well documented in the literature for bone malignancy management . RFA, LA and MWA are performed via percutaneous access whereby a needlelike applicator is positioned within the tumor tissue under imaging guidance (e.g., computed tomography -CT-, magnetic resonance -MR-). Differently, HIFU is totally non-invasive and the treatment is carried out by means of a transducer placed on the external body surface corresponding to the area to be treated . Working principles of these techniques differ according to the energy source employed, and cell necrosis is achieved by a localized increase in temperature because of energy-tissue interaction . During HTs, the amount of thermal injury is strongly related to the temperature experienced by the tissue during the procedure and the exposure time, as outlined by the most popular models (e.g., Arrhenius’ law, CEM 43 °C ). Therefore, keeping track of temperature changes over time accounts for valuable information to the clinician performing the procedure. Real-time temperature understanding allows adjusting treatment settings (e.g., input power and treatment time) to clearly identify the endpoint and ensure damage to the tumor portion plus a reasonable safety margin while preserving healthy surrounding anatomical structures . Temperature tissue monitoring may be accomplished by many either contact or contactless techniques with different purposes. Among others, temperature map reconstruction resulting from tissue temperature measurements allows accurately estimating tissue damage, thus achieving a good match between the portion of tissue that should be damaged and the one that experiences cytotoxic temperatures during the procedure. Temperature knowledge gains further relevance in bone tumors growing adjacent to vulnerable structures such as the spinal cord and nerve roots . The dealing of such lesions is characterized by the major challenge of preventing cytotoxic temperatures in susceptible areas . Indeed, neural elements are not allowed experiencing temperatures higher than 45 °C since this would lead to permanent damage including in the worst cases paralysis or paresis that severely impact the patients’ status . Therefore, both thermal insulation techniques and/or temperature monitoring are mandatory in this scenario to improve the procedure’s safety and efficacy . While the firsts are carried out by injecting CO2 or saline solution to create thermal dissection, temperature monitoring leads the way to correctly gather temperature information in the treated tissue without compromising sensitive elements . Moreover, temperature measurement plays a key role in investigating the effectiveness of either available or novel ablation devices, thus affording optimization and understanding their performances, as well as gaining new findings on how various HT settings affect the treatment effects. In addition, single-point temperature measurements are broadly accepted in clinical settings to protect vulnerable anatomical areas from cytotoxic temperatures. In these cases, thermometers must be carefully inserted in the proximity of these structures by avoiding undesirable injuries. In spite of this potential impact, temperature monitoring is not well established in clinical settings since it presents several open challenges when performed during HTs.
2. Temperature Monitoring: Main Techniques and Applications in Bone HTs
Extensive investigations have been devoted to providing suitable solutions for continuous temperature monitoring during HT since the knowledge of temperature may be beneficial to ensure the procedure’s safety. Basically, thermometric techniques employed in this scenario can be classified as either contact-based or contactless methods . Contact-based techniques involve the insertion of the sensing element within the treated tissue. This category includes thermocouples, thermistors, fluoroptic sensors, and fiber Bragg grating (FBG) sensors. Contactless techniques do not require direct contact with the measurement site. This category involves diagnostic imaging techniques (i.e., magnetic resonance imaging, MRI, computed tomography, CT, and ultrasound thermometry), allowing a temperature mapping reconstruction during the procedure.
The main benefits and drawbacks of thermometric techniques employed during HTs are summarized in Table 1.
Low cost; small size; robustness; wide measurement range; and short response time
Invasive; single point measurement; metallic composition; potential measurement artifacts
Low cost; small size; robustness; high sensitivity; short response time; good accuracy
Invasive; single point measurement; potential measurement artifacts
Biocompatibility; small size, immunity to electromagnetic fields; wide measuring range; high accuracy
Invasive; single point measurement; fragility; potential measurement artifacts
Biocompatibility; small size; immunity to electromagnetic fields; high accuracy; short response time; multi-point temperature measurements;
Invasive; fragility; cross-sensitivity to strain; high-cost
Non-invasive; thermal map reconstruction; good spatial resolution; fast acquisition time; temperature precision around 3 ◦C
Ionizing radiation dose; potential measurement artifacts; quite expensive
Non-invasive; thermal map reconstruction; absence of ionizing radiation; quite inexpensive
Potential measurement artifacts
Non-invasive; thermal map reconstruction; absence of ionizing radiation; linear relationship between T1 and temperature variations in the range of 30 ◦C and 70 ◦C; no tissue type dependence for PRF method
Potential measurement artifacts; lack of MR signal in cortical bone; expensive
The first application of bone RFA in a clinical trial dates back to 1992, as reported in a scientific article published by Rosenthal et al. . Among a huge number of studies focused on bone RFA, many of them have also investigated temperature. During RFA in bone cancer, temperature monitoring was mainly accomplished by thermocouples and thermistors as evidenced by studies reported in the literature . The aim of these studies was to highlight the key role of temperature knowledge in preventing acute complications in lesions involving vulnerable structures (e.g., nerve roots and spinal cord) close to tumor mass and to evaluate the influence of specific anatomical parameters or the design of ablation devices on temperature distribution.
On the other hand, LA found application in bone a few years later by Gangi et al.  for the treatment of OO. Only few studies investigated temperature monitoring during LA . All these studies carried out MR-thermometry to evaluate temperature distribution during HT. This technique allows displaying in real-time temperature map and keeping track of thermal injuries in the vertebral bodies and spinal canal.
The first scientific investigations on MWA in bone go back to 1996 . Studies concerning temperature monitoring during MWA in bone are lacking in the literature and the few research articles found are quite recent . The main thermometric techniques used in this scenario to monitor temperature were thermocouples and FBGs. While some of the studies mentioned performed temperature monitoring to preserve nearby structures from irreversible injuries, others have demonstrated the usefulness of multipoint temperature measurements by FBGs to gain information regarding the heat distribution not only near the treated area but also in the surrounding ones.
Lastly, a feasibility assessment about the efficacy of HIFU treatment for the treatment of primary and secondary bone tumors appears in 2001 . Other relevant studies have also explored temperature monitoring using MR-thermometry . Temperature measurements were carried out to ensure the safety of the procedure and thermal map of bone tissue was also derived to obtain temperature information about bone and soft tissue. Also, one of these studies proposed a predictive temperature model to tune the acoustical energy deposition automatically with the aim of controlling temperature rise at the focal point.
In view of the above, pre-clinical and clinical studies were found to explore the applicability of specific thermometric techniques tailored to this specific scenario. Among contact-based and contactless techniques used to record temperature during HTs, only some of them were adopted in this specific context. Thermocouples, thermistors, and MR-thermometry play a leading role during HTs in bone. Very few studies addressed the potential of FBGs for temperature measurements purposes during bone ablation, despite their popularity in other hyperthermia applications. Otherwise, fluoroptic sensors were only used in the validation of MR-thermometry during bone HIFU procedures. To the best of our knowledge, to date, literature lacks investigations regarding CT and ultrasound thermometry in bone ablation. From non-exhaustive inferences, contactless techniques could be expected preferably in bone ablation context where preserving vulnerable structures is a priority. Unfortunately, despite this category of techniques is capable of reconstructing temperature tissue map, it is not immune to drawbacks which severely limits its use. Of course, the use of sophisticated algorithms to estimate temperature and the high costs of diagnostic imaging techniques are two of the negative issues to noteworthy. In case of CT-thermometry the radiation dose is another aspect to be kept in mind. Furthermore, contactless thermometry is affected by measurement artefacts due to patients’ movements, especially those due to breathing, hence the need to implement alternative solutions to overcome this concern (e.g., signal acquisition during breathing holding, algorithms devoted to artifact removal). Unexpected, contact-based techniques are so far well suited to the context. The broad implementation of transducers such as thermocouples and thermistors are mainly due to their low cost, small size, robustness, wide measuring range, short response time and ease to use which make them preferable to other techniques involving a high level of expertise. Despite their invasiveness, many studies exploring temperature monitoring in bone employed such kind of solution offering the right balance between affordability and reliability. Also, the use of these techniques overcomes the issue of breathing-related artifacts. On the other hand, thermocouples and thermistors provide a single-point measurement, thus it is not feasible to obtain temperature map for estimating thermal tissue damage. Moreover, owing to their metallic composition, these thermometers cannot work in presence of high electromagnetic fields (e.g., MR). Although FBGs are currently lacking special attention in the field of bone ablation, they appear very promising in this arena because of their countless features, among others biocompatibility, small size, immunity to electromagnetic fields, wide measuring range and high sensitivity. A special mention deserves their multiplexing capability which allows temperature measurements in several point with high resolution (even less than 1 mm) and an accuracy around 0.1 °C (but strongly dependent to the quality of the interrogator system). Thus, it is possible to obtain reliable temperature map which is the key aspect especially in this specific context where incorrect estimation could lead to irreversible injuries in healthy susceptible areas.
Summing up, the literature and the clinical practice corroborated the importance of this key aspect during bone HTs. Most of the studies aimed at assessing tissue thermal response (e.g., in cortical bone, epidural space, bone marrow) and preventing permanent damage in vulnerable structures, which represents the most challenging aspect of this scenario. Other works investigated the suitability of specific thermometric techniques in monitoring and predicting temperature under particular settings. Only some explored the performances of specific devices in terms of enhancement in safety and clinical outcomes improvement. However, despite many investigations were performed during clinical trials, nowadays, temperature monitoring during bone ablation is still severely restricted in this scenario. In our view, substantial research efforts are still necessary for making practical some technologies in medical scenarios where clinicians may benefit of being led by real-time temperature knowledge during the procedures without being forced to alter their clinical practice.
The entry is from 10.3390/s21165470
- Rosenthal, D.; Callstrom, M.R; Critical review and state of the art in interventional oncology: Benign and metastatic disease involving bone.. Radiology 2012, 262, 765-780, 10.1148/radiol.11101384.
- A. Nicholas Kurup; Matthew R. Callstrom; Michael R. Moynagh; Thermal Ablation of Bone Metastases. Seminars in Interventional Radiology 2018, 35, 299-308, 10.1055/s-0038-1673422.
- Ringe, K.I.; Panzica, M.; Von Falck, C.; Thermoablation of Bone Tumors. RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren 2016, 188, 539-550, .
- Tomasian, A.; Jennings, J.W.; Percutaneous Minimally Invasive Thermal Ablation of Osseous Metastases: Evidence-Based Practice Guidelines.. Am. J. Roentgenol. 2020, 215, 502-510, 10.2214/AJR.19.22521.
- Heymann, D. Bone Cancer. 2020 . National Comprehensive Cancer Network. Retrieved 2021-8-30
- S. Nahum Goldberg; G. Scott Gazelle; Peter R. Mueller; Thermal Ablation Therapy for Focal Malignancy. American Journal of Roentgenology 2000, 174, 323-331, 10.2214/ajr.174.2.1740323.
- Matthew P. Goetz; Matthew R. Callstrom; J. William Charboneau; Michael A. Farrell; Timothy P. Maus; Timothy J. Welch; Gilbert Y. Wong; Jeff A. Sloan; Paul J. Novotny; Ivy A. Petersen; et al. Percutaneous Image-Guided Radiofrequency Ablation of Painful Metastases Involving Bone: A Multicenter Study. Journal of Clinical Oncology 2004, 22, 300-306, 10.1200/jco.2004.03.097.
- A. Gangi; A. Basile; Xavier Buy; H. Alizadeh; B. Sauer; G. Bierry; Radiofrequency and laser ablation of spinal lesions. Seminars in Ultrasound, CT and MRI 2005, 26, 89-97, 10.1053/j.sult.2005.02.005.
- Afshin Gangi; Houman Alizadeh; Lisa Wong; Xavier Buy; Jean-Louis Dietemann; Catherine Roy; Osteoid Osteoma: Percutaneous Laser Ablation and Follow-up in 114 Patients. Radiology 2007, 242, 293-301, 10.1148/radiol.2421041404.
- J. Palussière; A. Pellerin-Guignard; E. Descat; F. Cornélis; F. Dixmérias; Radiofrequency ablation of bone tumours. Diagnostic and Interventional Imaging 2012, 93, 680-684, 10.1016/j.diii.2012.06.008.
- Roberto Luigi Cazzato; Gianluca de Rubeis; Pierre de Marini; Danoob Dalili; Guillaume Koch; Pierre Auloge; Julien Garnon; Afshin Gangi; Percutaneous microwave ablation of bone tumors: a systematic review. European Radiology 2020, 31, 3530-3541, 10.1007/s00330-020-07382-8.
- Claudio Pusceddu; Barbara Sotgia; Rosa Maria Fele; Luca Melis; Treatment of Bone Metastases with Microwave Thermal Ablation. Journal of Vascular and Interventional Radiology 2013, 24, 229-233, 10.1016/j.jvir.2012.10.009.
- David Gianfelice; Chander Gupta; Walter Kucharczyk; Patrice Bret; Deborah Havill; Mark Clemons; Palliative Treatment of Painful Bone Metastases with MR Imaging–guided Focused Ultrasound. Radiology 2008, 249, 355-363, 10.1148/radiol.2491071523.
- A. Napoli; Valeria de Soccio; G. Cartocci; F. Boni; M. Anzidei; C. Catalano; Osteoid osteoma: Magnetic resonance guided high intensity focused ultrasound for entirely non-invasive treatment. A prospective developmental study. AIP Conference Proceedings 2017, 1821, 020002, 10.1063/1.4977611.
- Thomas A. Leslie; James E. Kennedy; High-intensity Focused Ultrasound Principles, Current Uses, and Potential for the Future. Ultrasound Quarterly 2006, 22, 263-272, 10.1097/01.ruq.0000237259.25885.72.
- John A. Pearce; Models for Thermal Damage in Tissues: Processes and Applications. Critical Reviews in Biomedical Engineering 2010, 38, 1-20, 10.1615/critrevbiomedeng.v38.i1.20.
- H. Petra Kok; Erik N. K. Cressman; Wim Ceelen; Christopher L. Brace; Robert Ivkov; Holger Grüll; Gail Ter Haar; Peter Wust; Johannes Crezee; Heating technology for malignant tumors: a review. International Journal of Hyperthermia 2020, 37, 711-741, 10.1080/02656736.2020.1779357.
- Paola Saccomandi; Emiliano Schena; Sergio Silvestri; Techniques for temperature monitoring during laser-induced thermotherapy: An overview. International Journal of Hyperthermia 2013, 29, 609-619, 10.3109/02656736.2013.832411.
- Matthieu Lepetit-Coiffé; Hervé Laumonier; Olivier Seror; Bruno Quesson; Musa-Bahazid Sesay; Chrit T. W. Moonen; Nicolas Grenier; Hervé Trillaud; Real-time monitoring of radiofrequency ablation of liver tumors using thermal-dose calculation by MR temperature imaging: initial results in nine patients, including follow-up. European Radiology 2009, 20, 193-201, 10.1007/s00330-009-1532-1.
- Solenn Toupin; Pierre Bour; Matthieu Lepetit-Coiffé; Valéry Ozenne; Baudouin Denis de Senneville; Rainer Schneider; Alexis Vaussy; Arnaud Chaumeil; Hubert Cochet; Frédéric Sacher; et al. Feasibility of real-time MR thermal dose mapping for predicting radiofrequency ablation outcome in the myocardium in vivo. Journal of Cardiovascular Magnetic Resonance 2017, 19, 1-12, 10.1186/s12968-017-0323-0.
- Gideon Lorber; Michael Glamore; Mehul Doshi; Merce Jorda; Gaston Morillo-Burgos; Raymond J. Leveillee; Long-term oncologic outcomes following radiofrequency ablation with real-time temperature monitoring for T1a renal cell cancer. Urologic Oncology: Seminars and Original Investigations 2014, 32, 1017-1023, 10.1016/j.urolonc.2014.03.005.
- Damian E. Dupuy; Raymond Hong; Brian Oliver; S. Nahum Goldberg; Radiofrequency Ablation of Spinal Tumors: Temperature Distribution in the Spinal Canal. American Journal of Roentgenology 2000, 175, 1263-1266, 10.2214/ajr.175.5.1751263.
- Anderanik Tomasian; Jack W. Jennings; Vertebral Metastases: Minimally Invasive Percutaneous Thermal Ablation. Techniques in Vascular and Interventional Radiology 2020, 23, 100699, 10.1016/j.tvir.2020.100699.
- Anderanik Tomasian; Jack W. Jennings; Percutaneous Minimally Invasive Thermal Ablation of Osseous Metastases: Evidence-Based Practice Guidelines. American Journal of Roentgenology 2020, 215, 502-510, 10.2214/ajr.19.22521.
- R. Bornemann; S. F. Grötz; P. H. Pennekamp; K. E. Wilhelm; K. Sander; D. C. Wirtz; R. Pflugmacher; Radiofrequency Ablation: Temperature Distribution in Adjacent Tissues. Zeitschrift für Orthopädie und Unfallchirurgie 2016, 154, 294-298, 10.1055/s-0042-103930.
- Georgia Tsoumakidou; Xavier Buy; Julien Garnon; Julian Enescu; Afshin Gangi; Percutaneous Thermal Ablation: How to Protect the Surrounding Organs. Techniques in Vascular and Interventional Radiology 2011, 14, 170-176, 10.1053/j.tvir.2011.02.009.
- Atsuhiro Nakatsuka; Koichiro Yamakado; Masayuki Maeda; Masayo Yasuda; Masao Akeboshi; Haruyuki Takaki; Ayumi Hamada; Kan Takeda; Radiofrequency Ablation Combined with Bone Cement Injection for the Treatment of Bone Malignancies. Journal of Vascular and Interventional Radiology 2004, 15, 707-712, 10.1097/01.rvi.0000133507.40193.e4.
- A. Gangi; G. Tsoumakidou; Xavier Buy; E. Quoix; Quality Improvement Guidelines for Bone Tumour Management. CardioVascular and Interventional Radiology 2010, 33, 706-713, 10.1007/s00270-009-9738-9.
- Julien Garnon; Roberto Luigi Cazzato; Jean Caudrelier; Maud Nouri-Neuville; Pramod Rao; Emanuele Boatta; Nitin Ramamurthy; Guillaume Koch; Afshin Gangi; Adjunctive Thermoprotection During Percutaneous Thermal Ablation Procedures: Review of Current Techniques. CardioVascular and Interventional Radiology 2018, 42, 344-357, 10.1007/s00270-018-2089-7.
- Leon D. Rybak; Afshin Gangi; Xavier Buy; Renata La Rocca Vieira; James Wittig; Thermal Ablation of Spinal Osteoid Osteomas Close to Neural Elements: Technical Considerations. American Journal of Roentgenology 2010, 195, W293-W298, 10.2214/ajr.10.4192.
- R. Lecigne; J. Garnon; R.L. Cazzato; P. Auloge; D. Dalili; G. Koch; A. Gangi; Transforaminal Insertion of a Thermocouple on the Posterior Vertebral Wall Combined with Hydrodissection during Lumbar Spinal Radiofrequency Ablation. American Journal of Neuroradiology 2019, 40, 1786-1790, 10.3174/ajnr.a6233.
- D I Rosenthal; A Alexander; A E Rosenberg; D Springfield; Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure.. Radiology 1992, 183, 29-33, 10.1148/radiology.183.1.1549690.
- F. Rachbauer; J. Mangat; G. Bodner; P. Eichberger; M. Krismer; Heat distribution and heat transport in bone during radiofrequency catheter ablation. Archives of Orthopaedic and Trauma Surgery 2003, 123, 86-90, 10.1007/s00402-003-0478-z.
- Rudi G. Bitsch; Rüdiger Rupp; Ludger Bernd; Karl Ludwig; Osteoid Osteoma in an ex Vivo Animal Model: Temperature Changes in Surrounding Soft Tissue during CT-guided Radiofrequency Ablation. Radiology 2006, 238, 107-112, 10.1148/radiol.2381041500.
- Akira Adachi; Toshio Kaminou; Toshihide Ogawa; Tsuyoshi Kawai; Yasunobu Takaki; Kimihiko Sugiura; Yasufumi Ohuchi; Masayuki Hashimoto; Heat Distribution in the Spinal Canal during Radiofrequency Ablation for Vertebral Lesions: Study in Swine. Radiology 2008, 247, 374-380, 10.1148/radiol.2472070808.
- Atsuhiro Nakatsuka; Koichiro Yamakado; Haruyuki Takaki; Junji Uraki; Masashi Makita; Fumiyoshi Oshima; Kan Takeda; Percutaneous Radiofrequency Ablation of Painful Spinal Tumors Adjacent to the Spinal Cord with Real-Time Monitoring of Spinal Canal Temperature: A Prospective Study. CardioVascular and Interventional Radiology 2008, 32, 70-75, 10.1007/s00270-008-9390-9.
- Simon F. Groetz; Klaus Birnbaum; Carsten Meyer; Holger Strunk; Hans H. Schild; Kai E. Wilhelm; Thermometry during coblation and radiofrequency ablation of vertebral metastases: a cadaver study. European Spine Journal 2013, 22, 1389-1393, 10.1007/s00586-012-2647-7.
- Padina S. Pezeshki; Jason Woo; Margarete K. Akens; John E. Davies; Michael Gofeld; Cari M. Whyne; Albert J.M. Yee; Evaluation of a bipolar-cooled radiofrequency device for ablation of bone metastases: preclinical assessment in porcine vertebrae. The Spine Journal 2014, 14, 361-370, 10.1016/j.spinee.2013.08.041.
- Alexander Greenberg; T. Berenstein Weyel; J. Sosna; J. Applbaum; A. Peyser; The distribution of heat in bone during radiofrequency ablation of an ex vivo bovine model of osteoid osteoma. The Bone & Joint Journal 2014, 96-B, 677-683, 10.1302/0301-620x.96b5.32822.
- Rahel Bornemann; Robert Pflugmacher; Sönke P. Frey; Philip P. Roessler; Yorck Rommelspacher; Kai E. Wilhelm; Kirsten Sander; Dieter C. Wirtz; Simon F. Grötz; Temperature distribution during radiofrequency ablation of spinal metastases in a human cadaver model: Comparison of three electrodes. Technology and Health Care 2016, 24, 647-653, 10.3233/THC-161160.
- Wei Zhao; Zhao-Hong Peng; Jin-Zhou Chen; Ji-Hong Hu; Jian-Qiang Huang; Yong-Neng Jiang; Gang Luo; Gen-Fa Yi; Hui Wang; Shen Jin; et al. Thermal effect of percutaneous radiofrequency ablation with a clustered electrode for vertebral tumors: In vitro and vivo experiments and clinical application. Journal of Bone Oncology 2018, 12, 69-77, 10.1016/j.jbo.2018.07.001.
- T. Mayer; R.L. Cazzato; P. De Marini; P. Auloge; D. Dalili; G. Koch; J. Garnon; A. Gangi; Spinal metastases treated with bipolar radiofrequency ablation with increased (> 70 °C) target temperature: Pain management and local tumor control. Diagnostic and Interventional Imaging 2020, 102, 27-34, 10.1016/j.diii.2020.04.012.
- A Gangi; J L Dietemann; S Guth; L Vinclair; J Sibilia; R Mortazavi; J P Steib; C Roy; Percutaneous laser photocoagulation of spinal osteoid osteomas under CT guidance.. American Journal of Neuroradiology 1999, 19, 1955-1958, .
- Christoph A. Binkert; Daniel Nanz; Frank Bootz; Dirk Nehrbass; Andreas Pospischil; Norbert Boos; Thomas Pfammatter; Karl Treiber; Juerg Hodler; Laser-Induced Thermotherapy of the Vertebral Body. Investigative Radiology 2002, 37, 557-561, 10.1097/00004424-200210000-00004.
- Sequeiros Rb; Hyvönen; Jyrkinen L; Ojala R; Klemola R; Vaara T; Tervonen O; Sequeiros Ab; MR imaging-guided laser ablation of osteoid osteomas with the use of optical instrument guidance at 0.23 T. Clinical Imaging 2004, 28, 155, 10.1016/s0899-7071(03)00312-7.
- F. Streitparth; B. Gebauer; I. Melcher; K. Schaser; C. Philipp; J. Rump; B. Hamm; U. Teichgräber; MR-Guided Laser Ablation of Osteoid Osteoma in an Open High-Field System (1.0 T). CardioVascular and Interventional Radiology 2008, 32, 320-325, 10.1007/s00270-008-9447-9.
- Florian Streitparth; Ulf Teichgräber; Thula Walter; Klaus Dieter Schaser; Bernhard Gebauer; Recurrent osteoid osteoma: interstitial laser ablation under magnetic resonance imaging guidance. Skeletal Radiology 2010, 39, 1131-1137, 10.1007/s00256-010-0977-2.
- Claudio E. Tatsui; R. Jason Stafford; Jing Li; Jonathan N. Sellin; Behrang Amini; Ganesh Rao; Dima Suki; Amol J. Ghia; Paul D Brown; Sun-Ho Lee; et al. Utilization of laser interstitial thermotherapy guided by real-time thermal MRI as an alternative to separation surgery in the management of spinal metastasis. Journal of Neurosurgery: Spine 2015, 23, 400-411, 10.3171/2015.2.spine141185.
- Claudio E. Tatsui; Sun-Ho Lee; Behrang Amini; Ganesh Rao; Dima Suki; Marilou Oro; Paul D. Brown; Amol J. Ghia; Shreyas Bhavsar; Keyuri Popat; et al. Spinal Laser Interstitial Thermal Therapy: A novel alternative to surgery for metastatic epidural spinal cord compression. Neurosurgery 2016, 79, S73-S82, 10.1227/neu.0000000000001444.
- Qing-Yu Fan; Bao-An Ma; Xiu-Chun Qiu; Yu-Lin Li; Jun Ye; Yong Zhou; Preliminary report on treatment of bone tumors with microwave-induced hyperthermia. Bioelectromagnetics 1996, 17, 218-222, 10.1002/(sici)1521-186x(1996)17:3<218::aid-bem7>3.0.co;2-6.
- Q Fan; B Ma; Ailin Guo; Y Li; J Ye; Y Zhou; X Qiu; Surgical treatment of bone tumors in conjunction with microwave-induced hyperthermia and adjuvant immunotherapy. A preliminary report.. Chinese Medical Journal 1996, 109, 425-431, .
- Adrian Kastler; Hussein Alnassan; Sébastien Aubry; Bruno Kastler; Microwave Thermal Ablation of Spinal Metastatic Bone Tumors. Journal of Vascular and Interventional Radiology 2014, 25, 1470-1475, 10.1016/j.jvir.2014.06.007.
- Qing-Yu Fan; Yong Zhou; Minghua Zhang; Baoan Ma; Tongtao Yang; Hua Long; Zhe Yu; Zhao Li; Microwave ablation of malignant extremity bone tumors.. SpringerPlus 2016, 5, 1373, 10.1186/s40064-016-3005-8.
- Adrian Kastler; Alexandre Krainik; Linda Sakhri; Mireille Mousseau; Bruno Kastler; Feasibility of Real-Time Intraprocedural Temperature Control during Bone Metastasis Thermal Microwave Ablation: A Bicentric Retrospective Study. Journal of Vascular and Interventional Radiology 2017, 28, 366-371, 10.1016/j.jvir.2016.09.030.
- Elena De Vita; Martina Zaltieri; Francesca De De Tommasi; Carlo Massaroni; Eliodoro Faiella; Bruno Beomonte Zobel; Agostino Iadicicco; Emiliano Schena; Rosario Francesco Grasso; Stefania Campopiano; et al. Multipoint Temperature Monitoring of Microwave Thermal Ablation in Bones through Fiber Bragg Grating Sensor Arrays. Sensors 2020, 20, 3200, 10.3390/s20113200.
- DeTommasi,F.; Zaltieri,M.; Schena,E.; Massaroni,C.; Faiella,E.; Grasso,R.F.; Zobel,B.B.; DeVita,E.; Iadicicco,A.; Campopiano, S.; et al. Temperature Monitoring during Microwave Thermal Ablation of Ex Vivo Bovine Bone: A Pilot Test. . In Proceedings of the MetroInd 4.0 & IoT 2020: 2020 IEEE International Workshop on Metrology for Industry 4.0 and IoT 2020, /, 255-259, 10.1109/MetroInd4.0IoT48571.2020.9138272.
- Feng Wu; Wen-Zhi Chen; Jin Bai; Jian-Zhong Zou; Zhi-Long Wang; Hui Zhu; Pathological changes in human malignant carcinoma treated with high-intensity focused ultrasound. Ultrasound in Medicine & Biology 2001, 27, 1099-1106, 10.1016/s0301-5629(01)00389-1.
- D Geiger; A Napoli; A Conchiglia; A Bazzocchi; M Mastantuono; U Albisinni; C Masciocchi; C Catalano; MR-guided focused ultrasound (MRgFUS) ablation for non-spinal osteoid osteoma treatment: a prospective multicenter evaluation. Journal of Therapeutic Ultrasound 2014, 2, A24-A24, 10.1186/2050-5736-2-S1-A24.
- Elizabeth Ramsay; Charles Mougenot; Mohammad Kazem; Theodore W. Laetsch; Rajiv Chopra; Temperature-dependent MR signals in cortical bone: potential for monitoring temperature changes during high-intensity focused ultrasound treatment in bone.. Magnetic Resonance in Medicine 2014, 74, 1095-102, 10.1002/mrm.25492.
- Mie K Lam; Merel Huisman; Robbert J Nijenhuis; Maurice Aaj Van Den Bosch; Max A Viergever; Chrit Tw Moonen; Lambertus W Bartels; Quality of MR thermometry during palliative MR-guided high-intensity focused ultrasound (MR-HIFU) treatment of bone metastases.. Journal of Therapeutic Ultrasound 2015, 3, 5, 10.1186/s40349-015-0026-7.
- Eugene Ozhinsky; Misung Han; Matthew Bucknor; Roland Krug; Viola Rieke; T2-based temperature monitoring in bone marrow for MR-guided focused ultrasound. Journal of Therapeutic Ultrasound 2016, 4, 26, 10.1186/s40349-016-0073-8.
- Karun V. Sharma; Pavel S. Yarmolenko; Haydar Celik; Avinash Eranki; Ari Partanen; Anilawan Smitthimedhin; AeRang Kim; Matthew Oetgen; Domiciano Santos; Janish Patel; et al. Comparison of Noninvasive High-Intensity Focused Ultrasound with Radiofrequency Ablation of Osteoid Osteoma. The Journal of Pediatrics 2017, 190, 222-228.e1, 10.1016/j.jpeds.2017.06.046.
- Pauline Guillemin; Laura Gui; Orane Lorton; Thomas Zilli; Lindsey A. Crowe; Stéphane Desgranges; Xavier Montet; Sylvain Terraz; Raymond Miralbell; Rares Salomir; et al. Mild hyperthermia by MR-guided focused ultrasound in an ex vivo model of osteolytic bone tumour: optimization of the spatio-temporal control of the delivered temperature. Journal of Translational Medicine 2019, 17, 1-19, 10.1186/s12967-019-2094-x.
- Beatrice Lena; Lambertus W. Bartels; Cyril J. Ferrer; Chrit T. W. Moonen; Max A. Viergever; Clemens Bos; Interleaved water and fat MR thermometry for monitoring high intensity focused ultrasound ablation of bone lesions. Magnetic Resonance in Medicine 2021, /, 1-9, 10.1002/mrm.28877.
- Beatrice Lena; Lambertus W. Bartels; Cyril J. Ferrer; Chrit T. W. Moonen; Max A. Viergever; Clemens Bos; Interleaved water and fat MR thermometry for monitoring high intensity focused ultrasound ablation of bone lesions. Magnetic Resonance in Medicine 2021, /, 1-9, 10.1002/mrm.28877.