Pneumodissection for skin protection in image-guided cryoablation of superficial musculoskeletal tumours Journal Article


Authors: Maybody, M.; Tang, P. Q.; Moskowitz, C. S.; Hsu, M.; Yarmohammadi, H.; Boas, F. E.
Article Title: Pneumodissection for skin protection in image-guided cryoablation of superficial musculoskeletal tumours
Abstract: Purpose: Pneumodissection is described as a simple method for preventing skin injury during cryoablation of superficial musculoskeletal tumours. Methods: Superficial tumour cryoablations performed from 2009 to 2015 were retrospectively reviewed. Pneumodissection was performed in 13 patients when the shortest tumour-skin distance was less than 25 mm. Indications were pain palliation (n = 9) and local tumour control (n = 4). Patients, target tumours, technical characteristics and complications up to 60 days post ablation were reviewed. The ice ball-skin distances with and without pneumodissection were compared by a paired t-test and further assessed for association with covariates using ANCOVA. Results: Technical success for ablation was 12 of 13. The mean shortest tumour-skin distance was 15.0 mm (3.2–24.5 mm). The mean thickness of pneumodissection was 9.6 mm (5.2–16.6 mm) resulting in mean elevation of skin of 3.4 mm (1.2–5.3 mm). Mean shortest ice ball-skin distance after pneumodissection was 10.5 mm (4.2–19.7 mm). No infection or systemic air embolism was noted. No intraprocedural frostbite was observed. Conclusion: Pneumodissection is feasible, effective and safe in protecting the skin during image-guided cryoablation of superficial tumours. Key Points: • Frostbite during image-guided cryoablation of superficial tumours is commonly under-reported. • Frostbites are painful and may introduce infection into the superficial ablation zone. • Warm compress, saline and CO2have shortcomings in protecting the skin. • Pneumodissection is free, readily available, easy to use and safe and effective. © 2016, European Society of Radiology.
Keywords: skin; cryoablation; superficial; frostbite; pneumodissection
Journal Title: European Radiology
Volume: 27
Issue: 3
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2017-03-01
Start Page: 1202
End Page: 1210
Language: English
DOI: 10.1007/s00330-016-4456-6
PROVIDER: scopus
PUBMED: 27287479
PMCID: PMC5499669
DOI/URL:
Notes: Article -- Export Date: 2 March 2017 -- Source: Scopus
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MSK Authors
  1. Meier Hsu
    169 Hsu
  2. Chaya S. Moskowitz
    278 Moskowitz
  3. Majid Maybody
    98 Maybody
  4. Franz Edward Boas
    77 Boas