Search

Historically, musculoskeletal (MSK) tumors, which include both bone and soft tissue tumors, have been managed as distinct entities. The incidence of metastases, particularly bone metastasis, in patients with MSK tumors can result in the emergence of significant complications such as pain, impairment of vital anatomical structures, or pathological fractures. Given these issues, a diverse team of experts is typically engaged in intricate treatment decision-making concerning the necessity of surgery, radiation, chemotherapy, or a mix of these methodologies. Nevertheless, percutaneous image-guided minimally invasive interventional therapy for MSK tumors represent a promising approach for treating such tumors. Over the past decade, significant progress has been made in this technique, leading to its growing acceptance in ordinary clinical practice. MSK tumors can be effectively treated by the use of ablation techniques, either as standalone procedures or in conjunction with other percutaneous treatments. Various image-guided techniques have been employed to observe the ablation zone and nearby structures, such as fluoroscopy, ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). However, CT is the favored method due to its widespread availability and ability to visualize the tumor and its environs. The procedures employed include ethanol injection, radiofrequency ablation, microwave ablation, cryoablation, and magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU). The technique can be performed in combination with cementation, with or without additional metallic stabilizing devices, depending on the location of the lesion. Improved local tumor control can be attained by combining ablation with bland embolization or transarterial chemoembolization. This article provides an overview of the fundamental elements of minimally invasive interventional guided imaging therapy for MSK malignancies., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-24-452/coif). The special issue “Advances in Diagnostic Musculoskeletal Imaging and Image-guided Therapy” was commissioned by the editorial office without any funding or sponsorship. X.T. and J.M.V. served as the unpaid Guest Editors of the issue. The authors have no other conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Duodeno-duodenostomy (DD) has been proposed as a more physiological alternative to conventional duodeno-jejunostomy (DJ) for pancreas transplantation. Accessibility of percutaneous biopsies in these grafts has not yet been assessed. We conducted a retrospective study including all pancreatic percutaneous graft biopsies requested between November 2009 and July 2021. Whenever possible, biopsies were performed under ultrasound (US) guidance or computed tomography (CT) guidance when the US approach failed. Patients were classified into two groups according to surgical technique (DJ and DD). Accessibility, success for histological diagnosis and complications were compared. Biopsy was performed in 93/136 (68.4%) patients in the DJ group and 116/132 (87.9%) of the DD group ( p = 0.0001). The graft was not accessible for biopsy mainly due to intestinal loop interposition (n = 29 DJ, n = 10 DD). Adequate sample for histological diagnosis was obtained in 86/93 (92.5%) of the DJ group and 102/116 (87.9%) of the DD group ( p = 0.2777). One minor complication was noted in the DD group. The retrocolic position of the DD pancreatic graft does not limit access to percutaneous biopsy. This is a safe technique with a high histological diagnostic success rate., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Bassaganyas, Darnell, Soler-Perromat, Rafart, Ventura-Aguiar, Cuatrecasas, Ferrer-Fàbrega, Ayuso and García-Criado.)