Musculoskeletal radiologists can be highly involved in cryoablation for desmoid tumors. Interventional radiologist Dr. Jack Jennings from Washington University in St. Louis shares the finer points of his approach to this procedure. 

Desmoid tumor cryoablation cases require varying numbers of cryoablation probes, dependant on tumor morphology. The usual number of probes ranges from 5 to 10. To mitigate the risk of rhabdomyolysis, which increases with more than 10 probes, Dr. Jennings typically divides the procedure into two sessions. 

His patients are generally admitted for pain control, monitoring for rhabdomyolysis, and management of inflammatory responses, with steroids administered both intraoperatively and postoperatively. Imaging is conducted at 6 to 8 weeks after the procedure, with Initial imaging sometimes showing the tumor as larger due to the inflammatory reaction and ablation zone.

It is important that a multidisciplinary sarcoma tumor board, consisting of medical oncologists, surgical oncologists, and musculoskeletal radiologists, assesses each case. The first consideration is whether the tumor can be resected, based on its proximity to adjacent tissue. Following this, patients are evaluated for candidacy in clinical trials and potential ablation therapy. This multidisciplinary approach leads to better medicine and patient outcomes, as treatment decisions are rarely straightforward and should not be made by a single practitioner.

TIMESTAMPS

00:00 - Planning for Cryoablation Probes

02:32 - Clinical Management after Cryoablation

04:45 - Follow Up Imaging

05:52 - Challenging Cases

08:41 - Multidisciplinary Desmoid Tumor Treatment

CHECK OUT THE FULL EPISODE

BackTable MSK Ep. 7- Desmoid Tumors: IR’s Role in Diagnosis and Management

https://www.backtable.com/shows/msk/podcasts/22/genicular-nerve-ablation