14/01/2026
with Glen Schlaphoff
Multimodality Hybrid IR in Action
Case 2: Cryoablation of a Spinal Osteoid Osteoma via MRI-Angio-CT (IR-MACS)
We recently treated a 64-year-old female patient presenting with long-standing back pain secondary to a 9 mm biopsy-proven Osteoid Osteoma located in the left L3 pedicle. This case perfectly demonstrates the power of hybrid multimodality imaging in Interventional Radiology.
Following an outpatient clinical consultation, the patient underwent cryoablation under general anesthesia in our IR-MACS Suite. The workflow leveraged the strengths of both CT and MRI:
1. Precision Access (CT): Under CT guidance, we gained access to the lesion using a 13G Arrow OnControl bone drill. A metal stylet was exchanged for a 6 Fr 11 cm vascular sheath to facilitate probe placement.
2. Advanced Monitoring (MRI): The patient was transferred to the in-suite MRI, where an IceSeed 1.5 MRI Cryoprobe was advanced through the sheath.
3. Controlled Ablation: MRI provided superior visualization of the ice ball, which was critical given the proximity to the spinal canal. We utilized a graduated freeze/thaw profile:
• 10-min freeze (25% power) / 8-min passive thaw
• 10-min freeze (50% power) / 8-min passive thaw
• 10-min freeze (100% power) / 6-min passive thaw
The patient was discharged the same day. She reported being completely symptom-free by the following morning—a fantastic clinical outcome made possible by hybrid imaging precision.
We are interested to hear from our global colleagues: In which cases are you utilizing hybrid Angio-CT or Angio-CT-MRI suites? Let’s discuss in the comments!
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