Interventional radiology in bone metastases: Current concepts and perspectives
Abstract
The skeleton is a frequent site of metastatic spread, leading to skeletal-related events (SREs) such as pathological fractures, spinal cord compression, and refractory pain that profoundly impact patient survival and quality of life. Traditionally managed by a triad of radiotherapy, surgery, and systemic treatments, the landscape of bone metastasis care has undergone a major paradigm shift. Interventional Radiology (IR) has emerged as the "fourth pillar" of oncology, evolving from a palliative last-resort tool into a proactive specialty integrated into precision medicine and multidisciplinary decision-making. Through high-resolution image guidance, IR provides critical diagnostic tissue sampling for molecular profiling, immediate mechanical reinforcement via hybrid stabilization-combining percutaneous osteosynthesis and cementoplasty-and local tumor control through thermal ablation and cryoablation.
Beyond its mechanical and local effects, an emerging body of research highlights the immunomodulatory potential of cryoablation and thermablation technics. IR-induced tumor necrosis may act as a potent "in situ" vaccine, releasing tumor-associated antigens and damage-associated molecular patterns that could trigger a systemic abscopal effect, especially when synergistic with immune checkpoint inhibitors. This review details the state-of-the-art IR techniques, from devascularization via embolization to advanced cryoablation, emphasizing their strategic integration into modern care pathways. It highlights the transition from simple symptom management to aggressive, curative-intent strategies in the era of personalized oncology, where IR serves as a bridge between conservative medical therapy and invasive surgical intervention.
Related
- Percutaneous Insertion of Hepatic Arterial Infusion Ports by Interventional Radiology for Colorectal Liver Metastases
- Large Language Models in the Radiology Workflow: Current Applications, Challenges, and Future Perspectives.
- Oral Frailty: Current Concepts, Assessment, Systemic Implications, and Future Perspectives.
- Long-Term Outcomes of Interventional Treatments for Lung Cancer Liver Metastases: Transarterial Chemoembolization and Microwave Ablation
- Ileal Arteriovenous Malformation after Laparoscopic Right Hemicolectomy Successfully Treated with Interventional Radiology: A Case Report.
BibTeX
@article{stacoffe2026interventional,
title = {{Interventional radiology in bone metastases: Current concepts and perspectives}},
author = {Nicolas Stacoffe and Emmanuel Mesny and Mathilde Proriol and Aurélie Fontana and Bastien Chalamet and Mohamed-Ilyess Benrejeb and Edith Bonnelye and Jean-Baptiste Pialat and Cyrille Confavreux and Emmanuel Massy},
journal = {Joint Bone Spine},
year = {2026},
month = sep,
doi = {10.1016/j.jbspin.2026.106076},
url = {https://hal.science/hal-05761696v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Interventional radiology in bone metastases: Current concepts and perspectives
AU - Nicolas Stacoffe
AU - Emmanuel Mesny
AU - Mathilde Proriol
AU - Aurélie Fontana
AU - Bastien Chalamet
AU - Mohamed-Ilyess Benrejeb
AU - Edith Bonnelye
AU - Jean-Baptiste Pialat
AU - Cyrille Confavreux
AU - Emmanuel Massy
PY - 2026
DA - 2026/09/23
JO - Joint Bone Spine
DO - 10.1016/j.jbspin.2026.106076
UR - https://hal.science/hal-05761696v1
AB - The skeleton is a frequent site of metastatic spread, leading to skeletal-related events (SREs) such as pathological fractures, spinal cord compression, and refractory pain that profoundly impact patient survival and quality of life. Traditionally managed by a triad of radiotherapy, surgery, and systemic treatments, the landscape of bone metastasis care has undergone a major paradigm shift. Interventional Radiology (IR) has emerged as the "fourth pillar" of oncology, evolving from a palliative last-resort tool into a proactive specialty integrated into precision medicine and multidisciplinary decision-making. Through high-resolution image guidance, IR provides critical diagnostic tissue sampling for molecular profiling, immediate mechanical reinforcement via hybrid stabilization-combining percutaneous osteosynthesis and cementoplasty-and local tumor control through thermal ablation and cryoablation. Beyond its mechanical and local effects, an emerging body of research highlights the immunomodulatory potential of cryoablation and thermablation technics. IR-induced tumor necrosis may act as a potent "in situ" vaccine, releasing tumor-associated antigens and damage-associated molecular patterns that could trigger a systemic abscopal effect, especially when synergistic with immune checkpoint inhibitors. This review details the state-of-the-art IR techniques, from devascularization via embolization to advanced cryoablation, emphasizing their strategic integration into modern care pathways. It highlights the transition from simple symptom management to aggressive, curative-intent strategies in the era of personalized oncology, where IR serves as a bridge between conservative medical therapy and invasive surgical intervention.
SN - 1297-319X
ER -