Imaging-guided radiofrequency ablation of osteoid osteoma in typical and atypical sites: Long term follow up.

Francesco Fiore,Vincenzo Stoia,Roberto D’Angelo,Francesco Somma

doi:10.1371/journal.pone.0248589

Abstract

PurposeTo assess efficacy and safety of imaging-guided radiofrequency ablation (RFA) of Osteoid Osteoma (OO) in both typical and atypical sites.Methods and materialsBetween January 2014 and March 2019, 102 consecutive percutaneous RFA were performed and retrospectively reviewed. The procedures were performed using a RFA bipolar ablation system (Covidien, exposed tip of 0.7-1cm), under Computed Tomography (CT) guidance or using a navigation system (Masmec) under CT and Cone Beam CT (CBCT) guidance. Patients were followed up over 24 months. Clinical success and recurrences were considered on the base of established criteria. In patients with clinical failure and/or imaging evidence of relapse, retreatment was considered.ResultsAdministered power per-procedure was ≤8 W (mean temperature, 90°C). The pre-procedure average value of visual analog scale (VAS) was 8.33+/-0.91. Primary and secondary success rate 96.08% (98/102) and100% (102/102), respectively. No major complication was described. Technical success was proved in every patient by CT scan acquisition after needle positioning. Relapse and tumour location were significantly correlated (p-value = 0.0165). The mean dose-length product was 751.55 mGycm2. Advanced bone healing was noted in 68 lesions after 1y-follow up and in 86 lesions after 2y-follow up.ConclusionImaging-guided percutaneous RFA is a highly effective technique for OO, both in typical and atypical sites. CT or CBCT guidance, navigation systems and operator experience grant the technical success, which is the most crucial parameter affecting outcome.

Highlights

Osteoid osteoma (OO) is a benign bone tumor (10% of benign bone tumors), composed of a central nidus generally of less than 15 mm in diameter and surrounded by osteoblasts and peripheral reactive zone of thickened cortical or trabecular bone and loose fibro vascular tissue [1]
Technical success was proved in every patient by Computed Tomography (CT) scan acquisition after needle positioning
Advanced bone healing was noted in 68 lesions after 1y-follow up and in 86 lesions after 2y-follow up

Summary

Introduction

Osteoid osteoma (OO) is a benign bone tumor (10% of benign bone tumors), composed of a central nidus generally of less than 15 mm in diameter and surrounded by osteoblasts and peripheral reactive zone of thickened cortical or trabecular bone and loose fibro vascular tissue [1]. It is more frequent in males, usually in young adults [2]. Scoliosis, osteoarthritis, located within the capsule of a joint, swelling, synovitis, restricted movement, and contracture are rare manifestations [4]

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