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. 2021 Sep 24;3(5):e210039. doi: 10.1148/rycan.2021210039

Figure 9:

Images from integrated fluoroscopy and CT for palliative treatment in an 87-year-old woman with cholangiocarcinoma metastatic to the iliac bone. (A, B) Images from contrast-enhanced CT and MRI, respectively, show the metastasis (arrow) resulting in both resting and mechanical pain that severely impaired quality of life. Given the large tumor size and instability from the osseous defect, a comprehensive combination treatment with local-regional control by cryoablation followed by fixation by internal cemented screw procedure was pursued. (C) Image from CT-guided cryoablation performed via a posterior approach shows the cryoprobe placement (arrow). After completion of cryoablation, (D) fixation and injection of polymethyl methacrylate (PMMA) cement was performed under fluoroscopic guidance. Image shows screws and cement needle (arrow). (E, F) Oblique sagittal and axial postprocedure CT images confirm screws and PMMA (arrows).

Images from integrated fluoroscopy and CT for palliative treatment in an 87-year-old woman with cholangiocarcinoma metastatic to the iliac bone. (A, B) Images from contrast-enhanced CT and MRI, respectively, show the metastasis (arrow) resulting in both resting and mechanical pain that severely impaired quality of life. Given the large tumor size and instability from the osseous defect, a comprehensive combination treatment with local-regional control by cryoablation followed by fixation by internal cemented screw procedure was pursued. (C) Image from CT-guided cryoablation performed via a posterior approach shows the cryoprobe placement (arrow). After completion of cryoablation, (D) fixation and injection of polymethyl methacrylate (PMMA) cement was performed under fluoroscopic guidance. Image shows screws and cement needle (arrow). (E, F) Oblique sagittal and axial postprocedure CT images confirm screws and PMMA (arrows).