Percutaneous Ablation in Painful Bone Tumors

Percutaneous image-guided ablation has been shown to be safe and effective for the treatment of benign osseous lesions and has evolved into the treatment of metastatic lesions for both pain palliation and local tumor control. Ablation is increasingly becoming part of the treatment algorithm of painful bone lesions, requiring multidisciplinary input from radiation, surgical, and medical oncologists. Substantial pain reduction is often possible in those who have failed to benefit from conventional therapies such as systemic and radiation therapy. This review details the basics of bone ablation including indications, treatment algorithms, ablation modalities, role of imaging, thermo-protective techniques, and the emerging use for local tumor control in patients with oligometastatic disease.