Bellvitge University Hospital (HUB) shares its experience in percutaneous cryoablation in tumours of the locomotor system with interventional radiologists from centres all over Spain. It does so in the 1st theoretical-practical course on this procedure, which will be held 17 and 18 October at the HUB. The results of treatments will be reviewed, as well as the indications, advantages and possible complications of this technique, in addition to practical sessions in the CT scanning room of the hospital. Percutaneous cryoablation is a technique that allows the destruction of tumour lesions by introducing special needles, cryoprobes, into the tumour to freeze it. These needles allow temperatures below -40 ºC to be reached inside the tumour, causing the destruction of tumour cells in a precise manner. Placing the needles does not require incisions in the skin.
The interventional radiologists specialised for musculoskeletal pathology from the Diagnostic Imaging Service at the Bellvitge Hospital, in close collaboration with surgeons, anaesthesiologists and oncologists, carry out the procedure with the patient sedated, without the need for general anaesthesia and with a hospital stay of only 24 hours.
“One of its advantages is that it allows larger areas to be treated than with other techniques. The extent of the affected area is perfectly visualised, thus avoiding lesions in structures close to the tumour, and the effects of cryoablation can be seen immediately," says Dr José Antonio Narváez, clinical head of the Musculoskeletal Radiology section of the Diagnostic Imaging Service at the HUB. On the other hand, it also requires less anaesthesia than other procedures performed by radiologists, such as radiofrequency, and therefore requires less post-procedure analgesia.
Thanks to the computerised tomography, the limits of the tumour are precisely identified, and then the cryoprobes, which are used to freeze the tumour, are placed. According to Dr Narváez, the needles are placed under CT or ultrasound control, “it allows us to perfectly control the position of each needle in the tumour, with the ice ball at the end that freezes the tumour. Each needle makes a kind of ovoid that fuses with the one next to it and so on until the entire tumour is covered. Bellvitge University Hospital is a reference centre for tumours of the musculoskeletal system, soft tissue and bone, together with child hospital Sant Joan de Déu. The HUB-ICO Functional Bone Tumour and Sarcoma Unit treats tumours located in the soft parts, such as muscles or near the joints, and in the bones. For primary tumours, cryoablation can be curative. In the case of secondary tumours - which have metastasised – “the patient may experience episodes of intense pain and with freezing they notice a clear improvement in their symptoms. It is a less aggressive alternative to surgery for certain bone and soft tissue tumours which can also be used for kidney and prostate tumours,” says Dr Narváez.
Bellvitge Hospital began using percutaneous cryoablation in 2015, making it the first centre in Catalonia and one of the pioneers in Spain to use this procedure to treat tumours of the locomotor system. To date, more than 80 treatments have been carried out. The results have been presented at various national and international congresses. In this line, the HUB's Musculoskeletal Radiology section has led a study on the treatment of desmoid tumours, a specific type of benign but locally aggressive soft tissue tumour, which confirms the benefits of using cryoablation instead of surgery.