Percutaneous computed tomography fluoroscopy-guided conformal ultrasonic ablation of vertebral tumors in a rabbit tumor model: Laboratory investigation

Daniel Sciubba, E. Clif Burdette, Jennifer J. Cheng, William A. Pennant, Joseph C. Noggle, Rory J. Petteys, Christopher Alix, Chris J. Diederich, Gabor Fichtinger, Ziya L. Gokaslan, Kieran P. Murphy

Research output: Contribution to journalArticle

Abstract

Object. Radiofrequency ablation (RFA) has proven to be effective for treatment of malignant and benign tumors in numerous anatomical sites outside the spine. The major challenge of using RFA for spinal tumors is difficulty protecting the spinal cord and nerves from damage. However, conforming ultrasound energy to match the exact anatomy of the tumor may provide successful ablation in such sensitive locations. In a rabbit model of vertebral body tumor, the authors have successfully ablated tumors using an acoustic ablator placed percutaneously via computed tomography fluoroscopic (CTF) guidance. Methods. Using CTF guidance, 12 adult male New Zealand White rabbits were injected with VX2 carcinoma cells in the lowest lumbar vertebral body. At 21 days, a bone biopsy needle was placed into the geographical center of the lesion, down which an acoustic ablator was inserted. Three multisensor thermocouple arrays were placed around the lesion to provide measurement of tissue temperature during ablation, at thermal doses ranging from 100 to 1,000,000 TEM (thermal equivalent minutes at 43°C), and tumor volumes were given a tumoricidal dose of acoustic energy. Animals were monitored for 24 hours and then sacrificed. Pathological specimens were obtained to determine the extent of tumor death and surrounding tissue damage. Measured temperature distributions were used to reconstruct volumetric doses of energy delivered to tumor tissue, and such data were correlated with pathological findings. Results. All rabbits were successfully implanted with VX2 cells, leading to a grossly apparent spinal and paraspinal tissue mass. The CTF guidance provided accurate placement of the acoustic ablator in all tumors, as corroborated through gross and microscopic histology. Significant tumor death was noted in all specimens without collateral damage to nearby nerve tissue. Tissue destruction just beyond the margin of the tumor was noted in some but not all specimens. No neurological deficits occurred in response to ablation. Reconstruction of measured temperature data allowed accurate assessment of volumetric dose delivered to tissues. Conclusions. Using a rabbit intravertebral tumor model, the authors have successfully delivered tumoricidal doses of acoustic energy via a therapeutic ultrasound ablation probe placed percutaneously with CTF guidance. The authors have thus established the first technical and preclinical feasibility study of controlled ultrasound ablation of spinal tumors in vivo.

Original languageEnglish (US)
Pages (from-to)773-779
Number of pages7
JournalJournal of Neurosurgery: Spine
Volume13
Issue number6
DOIs
StatePublished - Dec 2010

Fingerprint

Fluoroscopy
Ultrasonics
Tomography
Rabbits
Neoplasms
Acoustics
Temperature
Hot Temperature
Nerve Tissue
Spinal Nerves
Acoustic Neuroma
Feasibility Studies
Needle Biopsy
Tumor Burden
Spinal Cord
Anatomy
Histology
Spine
Carcinoma
Bone and Bones

Keywords

  • High-intensity ultrasound
  • Spine
  • Tumor
  • Ultrasonic ablation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

Percutaneous computed tomography fluoroscopy-guided conformal ultrasonic ablation of vertebral tumors in a rabbit tumor model : Laboratory investigation. / Sciubba, Daniel; Burdette, E. Clif; Cheng, Jennifer J.; Pennant, William A.; Noggle, Joseph C.; Petteys, Rory J.; Alix, Christopher; Diederich, Chris J.; Fichtinger, Gabor; Gokaslan, Ziya L.; Murphy, Kieran P.

In: Journal of Neurosurgery: Spine, Vol. 13, No. 6, 12.2010, p. 773-779.

Research output: Contribution to journalArticle

Sciubba, D, Burdette, EC, Cheng, JJ, Pennant, WA, Noggle, JC, Petteys, RJ, Alix, C, Diederich, CJ, Fichtinger, G, Gokaslan, ZL & Murphy, KP 2010, 'Percutaneous computed tomography fluoroscopy-guided conformal ultrasonic ablation of vertebral tumors in a rabbit tumor model: Laboratory investigation', Journal of Neurosurgery: Spine, vol. 13, no. 6, pp. 773-779. https://doi.org/10.3171/2010.5.SPINE09266
Sciubba, Daniel ; Burdette, E. Clif ; Cheng, Jennifer J. ; Pennant, William A. ; Noggle, Joseph C. ; Petteys, Rory J. ; Alix, Christopher ; Diederich, Chris J. ; Fichtinger, Gabor ; Gokaslan, Ziya L. ; Murphy, Kieran P. / Percutaneous computed tomography fluoroscopy-guided conformal ultrasonic ablation of vertebral tumors in a rabbit tumor model : Laboratory investigation. In: Journal of Neurosurgery: Spine. 2010 ; Vol. 13, No. 6. pp. 773-779.
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AU - Alix, Christopher

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N2 - Object. Radiofrequency ablation (RFA) has proven to be effective for treatment of malignant and benign tumors in numerous anatomical sites outside the spine. The major challenge of using RFA for spinal tumors is difficulty protecting the spinal cord and nerves from damage. However, conforming ultrasound energy to match the exact anatomy of the tumor may provide successful ablation in such sensitive locations. In a rabbit model of vertebral body tumor, the authors have successfully ablated tumors using an acoustic ablator placed percutaneously via computed tomography fluoroscopic (CTF) guidance. Methods. Using CTF guidance, 12 adult male New Zealand White rabbits were injected with VX2 carcinoma cells in the lowest lumbar vertebral body. At 21 days, a bone biopsy needle was placed into the geographical center of the lesion, down which an acoustic ablator was inserted. Three multisensor thermocouple arrays were placed around the lesion to provide measurement of tissue temperature during ablation, at thermal doses ranging from 100 to 1,000,000 TEM (thermal equivalent minutes at 43°C), and tumor volumes were given a tumoricidal dose of acoustic energy. Animals were monitored for 24 hours and then sacrificed. Pathological specimens were obtained to determine the extent of tumor death and surrounding tissue damage. Measured temperature distributions were used to reconstruct volumetric doses of energy delivered to tumor tissue, and such data were correlated with pathological findings. Results. All rabbits were successfully implanted with VX2 cells, leading to a grossly apparent spinal and paraspinal tissue mass. The CTF guidance provided accurate placement of the acoustic ablator in all tumors, as corroborated through gross and microscopic histology. Significant tumor death was noted in all specimens without collateral damage to nearby nerve tissue. Tissue destruction just beyond the margin of the tumor was noted in some but not all specimens. No neurological deficits occurred in response to ablation. Reconstruction of measured temperature data allowed accurate assessment of volumetric dose delivered to tissues. Conclusions. Using a rabbit intravertebral tumor model, the authors have successfully delivered tumoricidal doses of acoustic energy via a therapeutic ultrasound ablation probe placed percutaneously with CTF guidance. The authors have thus established the first technical and preclinical feasibility study of controlled ultrasound ablation of spinal tumors in vivo.

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