Approximately 30-70% of all cancer patients will eventually experience tumor metastasis to the spine. Such tumors are often excruciatingly painful and debilitating to the patient. Treatment strategies for metastatic spinal lesions are palliative in nature and are targeted toward reduction of tumor mass, alleviation of pain, preservation of neurological function, and stabilization of the spinal column. Percutaneous vertebroplasty, whereby liquid cement is injected into the body of the affected vertebra has become a popular method for managing spinal metastases. Currently, vertebroplasty is performed in conjunction with tumor reduction most often through radiation or chemotherapy. This dual treatment approach increases the cost of management and may leave patients with continuing pain until both treatment regimens have been completed. ? ? Recently, intravertebral ablation of spinal tumors using both laser and RF heating has been suggested. Coupling targeted thermal ablation of tumors with percutaneous vertebroplasty may result in a single treatment technique, which is effective at accomplishing all the goals of current therapies at once. BioTex has previously developed a magnetic resonance image guided laser therapy system, which allows visualization of laser heating in tissue structures. This system may be ideal for guidance of safe laser ablation of spinal tumors in conjunction with vertebroplasty. ? ? In this proposal, we investigate the technical feasibility of MR-guided laser ablation therapy adjuvant to percutaneous vertebropasty in a canine model. Appropriate laser treatment catheters and imaging sequences will be developed, and procedures will be carried out by interventional radiologists at the M.D. Anderson Cancer Center in Houston, Texas. Canine studies will allow for a critical evaluation of the safety and effectiveness of MR-guided laser ablation/vertebroplasty. If successful, this technique could lead to an improved treatment option for certain intravertebral spinal lesions. ? ? ?
