Feasibility of Intraoperative Nerve Monitoring in Preventing Thermal Damage to the "Nerve at Risk" During Image-Guided Ablation of Tumors.

Overview

PURPOSE: To assess feasibility of intraoperative neurophysiologic monitoring (IONM) during image-guided, percutaneous thermal ablation of tumors. MATERIALS AND METHODS: From February 2009 to October 2013, a retrospective review of all image-guided percutaneous thermal ablation interventions using IONM was performed and data was compiled using electronic medical records and imaging studies. RESULTS: Twelve patients were treated in 13 ablation interventions. In 4 patients, real-time feedback from the monitoring neurologist was used to adjust applicator placement and ablation settings. IONM was technically feasible in all procedures and there were no complications related to monitoring or ablation. All nerves at risk remained intact and of the 11 patients who could be followed, none developed new nerve deficit up to a minimum of 2 months after ablation. CONCLUSION: IONM is safe and feasible for use during image-guided thermal ablation of tumors in the vicinity of nerves. Outcomes in this study demonstrate its potential utility in image-guided ablation interventions.