Evidence about the DFine STAR Tumour Ablation System | Which Medical Device

BACKGROUND AND PURPOSE:
Combination radiofrequency ablation and vertebral augmentation is an emerging minimally invasive therapy for patients with metastatic spine disease who have not responded to or have contraindications to radiation therapy. The purpose of this study was to evaluate the rate of radiographic local control of spinal metastases treated with combination radiofrequency ablation and vertebral augmentation.

MATERIALS AND METHODS:
We retrospectively reviewed our tumor ablation database for all patients who underwent radiofrequency ablation and vertebral augmentation of spinal metastases between April 2012 and July 2014. Tumors treated in conjunction with radiation therapy were excluded. Tumor characteristics, procedural details, and complications were recorded. Posttreatment imaging was reviewed for radiographic evidence of tumor progression.

RESULTS:
Fifty-five tumors met study inclusion criteria. Radiographic local tumor control rates were 89% (41/46) at 3 months, 74% (26/35) at 6 months, and 70% (21/30) at 1 year after treatment. Clinical follow-up was available in 93% (51/55) of cases. The median duration of clinical follow-up was 34 weeks (interquartile range, 15-89 weeks), during which no complications were reported and no patients had clinical evidence of metastatic spinal cord compression at the treated levels.

CONCLUSIONS:
Combination radiofrequency ablation and vertebral augmentation appears to be an effective treatment for achieving local control of spinal metastases. A prospective clinical trial is now needed to replicate these results.

Credits: AJNR Am J Neuroradiol. 2015 Dec 3. [Epub ahead of print]

Spinal metastatic lesions are a common occurrence among oncology patients and contribute to significant morbidity. Treatment options have been limited in their effectiveness and scope to this point. The STAR System is an RFA device that was safely and effectively used in the treatment of spine metastatic osseous lesions. This new device allows RFA treatment of previously untreatable lesions with resultant reduction in pain that was not controlled by systemic or radiation therapy.

Credits: Pain Physician. 2014 Jul-Aug;17(4):317-27.

This retrospective study was institutional review board approved and HIPAA compliant. No permanent neurologic injuries resulted from the procedure. Intraprocedural imaging demonstrated that the articulating bipolar instrument could be navigated into the posterior vertebral body tumors with a transpedicular approach. Postablation imaging confirmed necrosis within the ablation zone. Three patients showed progression of disease at the treated levels at follow-up. Systemic therapy was not interrupted to perform the procedures.

Credits: Radiology. 2014 Oct;273(1):261-7. doi: 10.1148/radiol.14131664. Epub 2014 Jun 13.

Radiation therapy (RT) is the current gold standard for palliation of painful vertebral metastases. However, other percutaneous modalities such as radiofrequency ablation (RFA), cryoablation, and vertebral augmentation have also been shown to be effective in alleviating symptoms. Combined RT and ablation may be more effective than either therapy alone in palliating painful metastatic disease to the spine. Percutaneous ablation and concurrent RT is safe and effective in palliating painful spinal metastases and can be effective in those who have radiation resistant tumor histology.

Credits: Pain Physician. 2015 Nov;18(6):573-81.

Percutaneous CT-guided radiofrequency ablation is a safe and effective minimally invasive treatment for osteoid osteomas. This technical case series describes the use of a recently introduced ablation system with a probe that can be curved in multiple directions, embedded thermocouples for real-time monitoring of the ablation volume, and a bipolar design that obviates the need for a grounding pad.
Safe and effective CT-guided radiofrequency ablation of osteoid osteomas can be performed in a variety of locations using a multidirectional bipolar system.

Credits: Cardiovasc Intervent Radiol. 2015 Nov 24. [Epub ahead of print]