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Percutaneous MR-Guided Cryoablation of Morton’s Neuroma: Rationale and Technical Details After the First 20 Patients

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Abstract

Objectives

The purpose of this study is to discuss technical aspects and rationales of magnetic resonance (MR)-guided cryoablation (CA) of Morton’s neuroma (MN); preliminary clinical experience is also retrospectively reviewed.

Methods

Procedures were performed under local anaesthesia on an outpatient basis. Lesion size and location, procedural (technical success, procedural time, complications) and clinical outcomes (patient satisfaction according to a four-point scale, residual pain according to a 0–10 visual analogue scale and instances of “stump neuroma”) were assessed via chart review and cross-sectional telephone survey after the 20th case.

Results

Twenty patients (15 female, 5 male; mean age 50.3 years) were included; 24 MN (mean size 12.7 mm) were treated. Technical success was 100 %. Mean procedural time was 40.9 ± 10.4 min (range 35–60). One minor complication (superficial cellulitis) was reported (4.2 %). Follow-up (mean 19.7 months) was available for 18/24 MN. Patient satisfaction on a per-lesion basis was as follows: “completely satisfied” in 77.7 %, “satisfied with minor reservations” in 16.6 % and “satisfied with major reservations” in 5.7 % of cases. Mean pain score at last follow-up post-CA was 3.0. No instances of “stump neuroma” were reported.

Conclusions

MR-guided CA of MN is a novel therapy which appears technically feasible. Clinical advantages of the procedure are high patient satisfaction, reduced risk of “stump neuroma” syndrome and good patient tolerance on an outpatient basis. Further, prospective studies are needed to confirm these encouraging results.

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Authors and Affiliations

  1. Department of Interventional Radiology, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, HUS), 1, place de l’ Hôpital, 67000, Strasbourg, France

    Roberto Luigi Cazzato, Julien Garnon, Georgia Tsoumakidou, Jean Caudrelier, Marie-Aude Thenint, Pramod Rao, Guillaume Koch & Afshin Gangi

  2. Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK

    Nitin Ramamurthy

Authors
  1. Roberto Luigi Cazzato
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  2. Julien Garnon
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  3. Nitin Ramamurthy
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  4. Georgia Tsoumakidou
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  5. Jean Caudrelier
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  6. Marie-Aude Thenint
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  7. Pramod Rao
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  8. Guillaume Koch
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  9. Afshin Gangi
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Correspondence to Roberto Luigi Cazzato.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest. Authors #1, #3, #5, #6, #7, #8 and #9 have no conflict of interest to disclose. Authors #2, #4 and #10 are proctor for Galil Medical, Inc.

Human and animal rights informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. Informed consent was obtained from all individual participants included in the study.

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Cazzato, R.L., Garnon, J., Ramamurthy, N. et al. Percutaneous MR-Guided Cryoablation of Morton’s Neuroma: Rationale and Technical Details After the First 20 Patients. Cardiovasc Intervent Radiol 39, 1491–1498 (2016). https://doi.org/10.1007/s00270-016-1365-7

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  • DOI: https://doi.org/10.1007/s00270-016-1365-7

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