Image-guided ablation destroys a target lesion in situ using thermal or non-thermal energy delivered through a percutaneous probe. In musculoskeletal oncology it has become a valuable tool for pain palliation and, in selected cases, local control of bone tumors, often preserving surrounding bone and function better than open resection.
Clinical applications
- Osteoid osteoma. Percutaneous ablation is a well-established, highly effective treatment for this painful benign lesion.
- Painful bone metastases. Ablation provides durable pain relief, frequently combined with cementoplasty for structural support.
- Oligometastatic disease. In selected patients, ablation contributes to local control as part of a multidisciplinary plan.
Ablation techniques
Several energy modalities are used, chosen by lesion location, size, and proximity to critical structures:
- Radiofrequency ablation generates frictional heat from a high-frequency current.
- Microwave ablation produces rapid, high-temperature heating with larger zones.
- Cryoablation forms an iceball that is well visualized on cross-sectional imaging, useful near sensitive structures.
Thermal protection techniques — hydrodissection, gas insufflation, and active thermal monitoring — safeguard nearby nerves and skin.
Technique and outcomes
Procedures are performed under CT or combined imaging guidance with meticulous probe placement. Reported outcomes show high rates of pain reduction for benign lesions and metastatic disease, with a favorable safety profile when protective measures are applied. Combination with stabilization procedures addresses both pain and mechanical integrity in weight-bearing bone.
INVAMED technologies in this space
INVAMED develops ablation probes and interventional oncology tools; explore the oncology ablation category and the patient-facing tumor ablation condition guide.
Device availability and approved indications vary by country. This content is prepared for healthcare professionals and does not replace clinical judgment or the instructions for use.