Percutaneous microwave ablation of bone lesions: a retrospective cohort study.

Purpose: To evaluate the feasibility, safety, and efficacy of microwave ablation (MWA) of bone lesions with regard to local control and pain palliation.

Materials and methods: We reviewed 43 patients (23 males, 20 females) with 51 lesions (44 metastatic, 7 benign) treated with MWA from January 2016 to December 2023. Pain intensity was measured using the Visual Analogue Scale (VAS), SF-36 Bodily Pain Scale, and Patient Global Impression of Change (PGIC) from pre-operation to various follow-up stages. Adverse events were categorized according to the Society of Interventional Radiology (SIR) grading system.

Results: The procedure demonstrated 100% technical success. Grades I and III adverse events were observed in 8.3% (3/36) and 2.8% (1/36) of patients with metastatic disease, respectively. In those with benign lesions, no adverse events were reported. A significant reduction in pain was observed, with the VAS score decreasing by 74.3% from baseline to the last follow-up [6.7 ± 2.3 (range: 0-10) to 1.8 ± 2.3 (range: 0-7) (p < 0.001)] for metastatic patients, and from 5.7 ± 2.1 (range: 3-8) to 0 ± 0 (range: 0-0) by the final follow-up (p = 0.0011) for benign lesions. 77.8% (29/36) of metastatic patients, and all (7/7) benign patients were much or very much improved according to Patient Global Impression Change. Complete imaging response was achieved in 55.6% (20/36) of metastatic lesions. At last follow-up, 25% (9/36) had radiological evidence of recurrence, with a median recurrence time of 13 months (IQR: 8-14). Complete response was achieved in all benign lesions.

Conclusions: MWA is a safe and effective treatment for pain management in patients with bone lesions.

Critical relevance statement: This study confirms the potential of microwave ablation as a treatment for bone lesions, providing significant pain relief with a favorable safety profile.

Key points: Microwave ablation (MWA) significantly reduced pain scores in patients with bone lesions, maintaining pain relief over time. The procedure exhibited high technical success with minimal adverse events, indicating a high safety profile. Subgroup analysis revealed no significant differences in pain reduction among different procedural combinations over time.