Ultrasound-Guided Intratumoral Radiofrequency Ablation Coagulation to Facilitate Meningioma Resection: Preliminary Experience

J Ultrasound Med. 2018 Mar;37(3):577-583. doi: 10.1002/jum.14365. Epub 2017 Sep 9.

Abstract

Objectives: This study aimed to explore the feasibility and safety of intratumoral radiofrequency ablation (RFA) in meningioma resection.

Methods: This study was approved by the Xijing Ethics Committee, and informed consent was obtained from all of the patients. Thirteen patients with meningiomas were recruited in the Neurosurgery Department of Xijing Hospital. These patients were treated with intratumoral RFA and surgery. We also chose 13 patients with meningiomas treated with traditional surgery as the control group. Two-dimensional ultrasound, color Doppler flow imaging, contrast-enhanced ultrasound, and magnetic resonance imaging were used to identify the location, border, and blood supply of the meningiomas preoperatively and to assess the therapeutic effect intraoperatively. Finally, the meningiomas were dissected and removed by surgery.

Results: All procedures were technically successful without serious complications. Intraoperative ultrasound was able to provide a clear display of the location, shape, size, and boundary of the tumor and its relationship with other tissues and reveal the vascular distribution in and around the tumors. With intratumoral RFA, coagulative necrosis was induced, and the meningiomas became hard in texture with a decreased blood supply. Blood loss was significantly lower in the RFA group versus control group (320.0 ± 24.8 versus 390.4 ± 36.8 mL; P < .001). The RFA group spent fewer days in the hospital (6.0 ± 0.9 versus 7.0 ± 1.2 days; P = .022). However, the surgical time of the RFA group was relatively longer (3.5 ± 0.5 versus 3.0 ± 0.3 hours, P = .007).

Conclusions: The application of intratumoral RFA in meningioma resection is effective and safe. It may be a useful adjunct for meningioma treatment.

Keywords: intraoperative; meningioma; meningioma resection; neurosurgery; radiofrequency ablation; therapeutic; ultrasound.

MeSH terms

  • Catheter Ablation / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Meningeal Neoplasms / diagnostic imaging*
  • Meningeal Neoplasms / surgery*
  • Meningioma / diagnostic imaging*
  • Meningioma / surgery*
  • Middle Aged
  • Treatment Outcome
  • Ultrasonography, Interventional / methods*