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Ablate (RFA) and Stabilize (Cement): OsteoCool RFA for Painful Bone Metastases, with Dr. Jason Levy (OPuS One)

October 21, 2026 · 16 min 20 sec

Show notes

This masterclass episode breaks down OPuS One, the prospective, multinational study of OsteoCool radiofrequency ablation (RFA) plus cement for painful lytic metastases of the spine and pelvis. Following, there is an expert commentary by Dr. Jason R. Levy of Northside Hospital, Atlanta.

  • The Premise: External beam radiation can take 3 to 6 weeks to relieve bone metastasis pain. OPuS One asked whether ablating the tumor and stabilizing the bone could bring relief faster and keep it.
  • The Study: 206 patients were treated at 15 centers, with lytic or mixed lesions in the thoracolumbar spine, periacetabulum, iliac crest or sacrum. Cement followed RFA in 97% of cases, and technical success was 99%.
  • Efficacy: Worst pain, average pain, pain interference and quality of life improved significantly by day 3, and the improvement was sustained through 12 months.
  • Durability: Complete or partial pain response rose from 53% at day 3 to 74% at 12 months (of n=59), and more patients lowered their opioid dose than raised it at every visit.
  • Safety: Device- or procedure-related adverse events occurred in 6 of 206 patients (2.9%), with no fractures at treated sites.
  • Caveats: OPuS One was a single-arm, industry-funded (Medtronic) study with no comparator and heavy dropout, and the effect of RFA can't be separated from the cement.
  • Expert Take: Dr. Levy explains where ablation and cement fit alongside radiation and systemic therapy in palliative oncology, and what endovascular and image-guided specialists can offer patients with painful bone metastases.

Tune in to learn how a single minimally invasive procedure can bring pain relief from bone metastases in days rather than weeks.

This podcast is generated using an AI model that has been trained in the context of endovascular surgery and interventional radiology in addition context of the article cited below. The content was reviewed and edited by multiple healthcare professionals in the field.

Levy J, David E, Hopkins T, et al. Radiofrequency Ablation Provides Rapid and Durable Pain Relief for the Palliative Treatment of Lytic Bone Metastases Independent of Radiation Therapy: Final Results from the OsteoCool Tumor Ablation Post-Market Study. Cardiovasc Intervent Radiol. 2023;46(5):600-609. https://doi.org/10.1007/s00270-023-03417-x