Image-Guided Palliative Musculoskeletal Oncologic Interventions

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Computed Tomography: 0.75
Procedures: 0.75
Head, Spine, and Musculoskeletal: 0.50
Neck and Chest: 0.25

Magnetic Resonance Imaging: 0.50
Procedures: 0.50
Neurological: 0.25
Musculoskeletal: 0.25

Nuclear Medicine Technology: 0.25
Procedures: 0.25
Endocrine and Oncology Procedures: 0.25

Registered Radiologist Assistant: 2.50
Procedures: 2.50
Musculoskeletal and Endocrine Sections: 1.50
Neurological, Vascular, and Lymphatic Sections: 1.00

Vascular-Interventional Radiography: 2.50
Procedures: 2.50
Vascular Interventional Procedures: 0.50
Nonvascular Procedures: 2.00

Outline

1. Introduction

Objectives

Upon completion of this course, students will:

1. identify the rank of cancer as a cause of death in the U.S.
2. be familiar with the advances in percutaneous image-guided minimally invasive musculoskeletal interventions for cancer management
3. be familiar with the percentage of patients with osseous metastatic disease who experience SREs
4. identify the primary limitations of surgical interventions for patients with bone metastases
5. recognize the limitation for opioids in managing cancer-related bone pain
6. be familiar with the primary consideration supporting the incorporation of percutaneous thermal ablation into treatment guidelines for bone metastases
7. be familiar with the patient indicator for percutaneous thermal ablation for managing bone metastases
8. be familiar with the effectiveness of radiofrequency ablation for treating painful bone metastases
9. be familiar with the pain palliation when using RFA for bone metastases
10. identify the complication rate reported by Deib et al when using microwave ablation for extraspinal bone metastases
11. be familiar with the finding of the CAFÉ trial regarding VA
12. be familiar with the main benefit of VA in terms of pain relief and fracture reduction
13. identify the contraindication for percutaneous thermal ablation
14. be familiar with the use of thermal ablation as an alternative plan for managing spinal metastases
15. be familiar with the range of statistically significant pain palliation observed in percutaneous ablation and VA
16. identify when musculoskeletal soft-tissue tumors are considered for thermal ablation
17. be familiar with the ice ball extension while performing cryoablation
18. understand the treatment criteria for patient receiving cryoablation
19. be familiar with the major complications with cryoablation for desmoid tumors
20. be familiar with a limitation in managing transfixing pathologic fractures
21. identify the anatomical areas where osteosynthesis or percutaneous fixation is performed
22. be familiar with technical advancements that have contributed to the recent expansion of percutaneous FICs application
23. be familiar with observed opioid use at 6 weeks post-procedure per Roux et al.’s study
24. be familiar technique that broadened the spectrum of available nerve targets for deployment of establish agents
25. be familiar with the success of percutaneous image-guided splanchnic nerve cryoneurolysis for palliation of intractable pain in patients with pancreatic cancer
26. be familiar with the use of implanted drug delivery systems used in pain management
27. be familiar with the routes of palliative pain injections in cancer patients
28. be familiar with the indications for perineural injections
29. identify specific cancer surgeries where perineural injections have been suggested to reduce postsurgical pain
30. identify the musculoskeletal metastases that are treated with preoperative embolization
31. identify the embolic agent use for selective embolization of bone metastases