Radiofrequency Ablation Of Osteoid Osteoma Research Articles

CT-guided radiofrequency ablation of osteoid osteoma in the long bones of the lower extremity

To present our initial experience with computed tomography guided radiofrequency ablation (RFA) of osteoid osteoma (OO) in our institution. RFA was performed on eight patients (5 males and 3 females) with clinically and radiologically diagnosed OO (femoral neck, n = 4; femoral diaphysis, n = 2; tibial diaphysis, n = 1; fibular diaphysis, n = 1). Ablation was performed using an electrode with a 10-mm exposed tip for a total of 4-6 min at a targeted temperature of 90 degrees Celsius. No cooling system was used. The intervention was accepted as technically successful if the tip of the electrode could be placed within the center of the nidus. We defined clinical success as a disappearance within 2 wk after treatment of symptoms that had manifested at presentation. All procedures were technically successful. No major or immediate complications were observed. Clinical success was achieved in six of eight patients in the first procedure. A second procedure was performed for two patients who had recurrent or continued pain, and one of these cases was successfully treated. The overall rate of success was 87.5% (7/8). No complication was observed. Our preliminary results indicate a favorable success rate and no complications and are compatible with the previous reports of RFA of OO.

Radiofrequency Ablation of Osteoid Osteoma in Atypical Locations: A Case Series

Radiofrequency Ablation of Osteoid Osteoma in Atypical Locations: A Case Series

CT fluoroscopy-guided radiofrequency ablation of osteoid osteoma with double nidi

Osteoid osteoma (OO) is a common benign bone tumor, usually found in children and young adults. Fewer than 30 cases of multicentric OO in a single bone have been reported in the world literature. We present the case of a 17-year-old boy with OO in the left tibia, containing double nidi. Plain radiography and computed tomography (CT) revealed two adjacent nidi surrounded by bony sclerosis within the distal left tibia. The tumor was successfully treated using two separate CT fluoroscopy-guided percutaneous radiofrequency ablations during a single session. The patient achieved complete pain relief the next day, and has remained asymptomatic for 9 months since treatment.

CT-guided percutaneous radiofrequency ablation of osteoid osteoma in pregnancy

Akhlaghpoor, Shahram; Tomasian, Anderanik; Shabestari, Abbas Arjmand; Alinaghizadeh, Mohammad Reza Author Information

Perioperative nursing of children in CT-guided radiofrequency ablation of osteoid osteoma

Objective To sulnmarize the perioperative nursing experience of CT-guided radiofrequency ablation of fight tibia osteoid osteoma in children.Methods One case of CT-guided radiofrequency ablation was clinically observed and nursed.Results The patient underwent a successful surgery without complications,healing well.Condusions Good psychological care,safety care before the operation and improved preoperative preparation are the key to make sure that the operation goes smoothly.Strengthening the observation and care after surgery could effectively reduce complications and improve cure rate. Key words: Osteoid osteoma; CT guidance; Radiofrequency ablation; Nursing

Percutaneous radiofrequency ablation of osteoid osteoma using cool-tip electrodes without the cooling system

The aim of this study was to evaluate the efficacy of percutaneous radiofrequency ablation (RFA) for osteoid osteoma (OO) using cool-tip electrodes without the cooling system. A total of 17 patients (13 males, 4 females; mean age 19.1 years; range 7-49 years) with OO (tibia, n = 7; femur, n = 5; acetabulum, n = 2; radius, n = 1; talus, n = 1; lumbar spine, n = 1) underwent RFA. Using a cool-tip electrode without the cooling system, the lesion was heated to 90°C for 4 or 5 min. Procedures were considered technically successful if the electrode was placed into the nidus and the target temperature was reached and maintained for at least 4 min. Clinical success of the treatment was defined as complete or partial pain relief after RFA. All procedures were considered technically successful, although two patients encountered complications (pes equinus contracture, skin burn). Altogether, 16 of the 17 patients (94.1%) achieved complete or partial pain relief after primary RFA. Two patients had pain recurrence, with one of them treated successfully with a second RFA. The overall clinical success rate was 88.2%. Histological findings confirmed the presence of OO in 13 patients (76.5%). Percutaneous RFA of OO using cool-tip electrodes without the cooling system is a safe, effective procedure.

418 Contribution of Interventional Radiology in Pediatrics

Background and aims: Interventional radiology is established as a diagnostic and therapeutic method in adults. Since lately it's use in children was limited due to lack of clinical experience. The aim is to detect the effectiveness and safety of invasive radiology as a method of diagnosis and treatment in pediatric patients. Methods: A total of 138 children underwent a CT guided invasive procedure during the last 3 years. Their age ranged from 3-14 years with a mean age of 8 years. Most of our diagnostic cases referred to liver, kidney, lung, mediastinum and bone percutaneous biopsies (82 patients) and diagnostic drainages. Therapeutic approaches referred to drainage of abscesses or fluid collections (32 patients), radiofrequency ablation of osteoid osteomas (17 patients), radiofrequency ablation of liver (4 patients) and lung (3 patients) malignancies. All procedures were performed under sedation. Depending on the kind of interventional procedure, the age and the figure of each patient different material was used. Biopsies were performed with needles 18G and cutting trocar system 14G with a needle of 18G, drainages with drainage catheters trocar, pigtail 7 or 8F, and RFAs with spiral electrodes. Results: Adequate diagnostic cytologic material was obtained in 90.2% of the diagnostic procedures. Therapeutic procedures were successful in 96% of our patients. None major complication was obtained in our patients. Conclusions: Interventional radiology is a minimal invasive, simple, effective and safe method of diagnosis and treatment for children with no major complications. It results in low morbidity and short term hospitalization of pediatric patients.

Percutaneous Radiofrequency Ablation of Osteoid Osteomas with Use of Real-Time Needle Guidance for Accurate Needle Placement: A Pilot Study

PurposeTo evaluate the accuracy and technical success of positioning a radiofrequency ablation (RFA) electrode in osteoid osteomas by use of a new real-time needle guidance technology combining cone-beam computed tomography (CT) and fluoroscopy.Materials and MethodsPercutaneous RFA of osteoid osteomas was performed in five patients (median age 18 years), under general anesthesia, with the use of cone-beam CT and fluoroscopic guidance for electrode positioning. The outcome parameters were technical success, meaning correct needle placement in the nidus; accuracy defined as the deviation (in mm) from the center of the nidus; and clinical outcome at follow-up.ResultsIn all five cases, positioning was possible within 3 mm of the determined target location (median nidus size 6.8 mm; range 5–10.2 mm). All procedures were technically successful. All patients were free of pain at clinical follow-up. No complications were observed.ConclusionReal-time fluoroscopy needle guidance based on cone-beam CT is a useful tool to accurately position radiofrequency needles for minimally invasive treatment of osteoid osteomas.

Radiofrequency Ablation of Osteoid Osteoma: Initial Experience with a New Monopolar Ablation Device

The purpose of this article is to report our initial experience with the "off-label" use of a new monopolar radiofrequency (RF) probe for percutaneous ablation of osteoid osteomas. Seventeen patients (12 male and 5 female, mean age 24.8 [range 9-49]) with osteoid osteoma were treated by computed tomography (CT)-guided RF ablation (RFA). All procedures were performed with the patient under general aesthesia. After localization of the nidus, a 13G hollow drill was introduced into the nidus through a 7F introducer sheath. A monopolar 16.5G RF probe with a 9-mm active tip (Soloist; Boston Scientific, Natick, MA) was inserted through the introducer sheath and connected to the RF generator. Energy application was started at 2 W and subsequently increased every 2 min by 1 W to a maximum of 8 W. The procedure ended if impedance increased by 500 Ω. Mean duration of energy deposition was 14.2±3.3 min. Fourteen of 17 patients (82%) were free of symptoms at 29.9±14.8 (range 4 to 47) months of follow-up. The primary and secondary success rates were 83% and 100%, respectively. In 3 patients, recurrence of pain at 6 (n=1) and 15 (n=2) months after the initial procedure was successfully treated by reablation. There were no complications. Monopolar RFA using the Soloist probe is effective and safe for the treatment of osteoid osteoma. It results in comparable success rates as other monopolar or bipolar RF systems in the treatment of osteoid osteoma.

Radiofrequency Ablation of Osteoid Osteoma in Atypical Locations: A Case Series

Osteoid osteoma has a nidus surrounded by sclerotic bone with a size usually less than 20 mm. Its diagnosis is made on typical presentation of nocturnal pain and imaging findings. Excision of the niduses, which are often small and difficult to precisely identify, sometimes may result in resection of surrounding normal bone. Minimally invasive percutaneous treatments have been used to try to minimize resection of normal bone. Although minimally invasive radiofrequency ablation generally relieves pain, its ability to relieve pain is less well known in locations other than lower extremity long bones. We determined the pain relief and complication rates after radiofrequency ablation of osteoid osteomas presenting in atypical locations and followed patients to assess possible recurrence or late complications. We retrospectively reviewed 21 patients with osteoid osteomas in unusual locations (eg, hip, radioulnar joint, and proximal phalanx) in whom we used radiofrequency ablation. Postoperative activities were not restricted for any of the patients. We assessed the time for patients to become symptom free, their activity status, and possible recurrence or complications. The minimum clinical followup was 12 months (mean, 27.8 months; range, 12-37 months). All patients became symptom free within 24 hours to 1 week. During followup, none of the patients experienced recurrence or any major complications. Radiofrequency ablation for osteoid osteomas in unusual locations reliably relieves pain with few complications and recurrences at short-term followup. Level IV, case series. See Guidelines for Authors for a complete description of level of evidence.

Percutaneous radiofrequency ablation for osteoid osteoma in femoral lesser trochanter

Percutaneous radiofrequency ablation for osteoid osteoma in femoral lesser trochanter

Perkutane Radiofrequenzablation von Osteoidosteomen: Technik und Ergebnisse

Osteoid osteoma is a benign primary bone tumor that typically occurs in children and young adults. Besides local pain, which is often worse at night, prompt relief due to medication with acetylsalicylic acid (ASS) is characteristic for this bone lesion. Because long-term medication with ASS does not represent an alternative treatment strategy due to its potentially severe side effects, different minimally invasive image-guided techniques for the therapy of osteoid osteoma have been developed. In this context radiofrequency (RF) ablation in particular has become part of the clinical routine. The technique and results of image-guided RF ablation are compared to alternative treatment strategies. Using this technique, an often needle-shaped RF applicator is percutaneously placed into the tumor under image guidance. Then a high-frequency alternating current is applied by the tip of the applicator which leads to ionic motion within the tissue resulting in local heat development and thus in thermal destruction of the surrounding tissue including the tumor. The published primary and secondary success rates of this technique are 87 and 83 %, respectively. Surgical resection and open curettage show comparable success rates but are associated with higher complication rates. In addition image-guided RF ablation of osteoid osteomas is associated with low costs. In conclusion image-guided RF ablation can be considered the gold standard for the treatment of osteoid osteoma.

Low radiation dose CT technique for guidance of radiofrequency ablation of osteoid osteoma

Low radiation dose CT technique for guidance of radiofrequency ablation of osteoid osteoma

Percutaneous radiofrequency ablation for osteoid osteoma: How we do it

Aims and Objectives:To describe our technique for performing radiofrequency ablation (RFA) in osteoid osteoma and to evaluate the results of treatment.Materials and Methods:We evaluated 40 patients in whom RFA was performed for osteoid osteomas between October 2005 and February 2008. The lesions were located in the femur (n = 22), tibia (n = 10), humerus (n = 2), acetabulum (n = 2), radius (n = 1), fibula (n = 1), patella (n = 1), and calcaneum (n = 1). The procedure was performed using a standard technique.Results:Technical success was achieved in all patients, with intranidal localization of the needle and complete ablation. All patients were fully weight bearing 2–3 h after the procedure. Successful pain relief was achieved in all patients within 48 h. Immediate complications included a case of minor thermal skin burn and a small cortical chip fracture, which healed on its own. There were no delayed complications. The average follow-up period was 12 months. Two patients (5% of cases) had recurrence of pain after intervals of 5 and 8 months, respectively, following the ablation; this was due to recurrence of the lesion. Complete pain relief was however achieved after a second ablation in both cases. Thus, our primary and secondary clinical success rates were 95 and 100%, respectively.Conclusion:RFA is a safe, quick, minimally invasive, and extremely effective method for the management of osteoid osteomas.

類骨骨腫に対する経皮的CTガイド下ラジオ波焼灼術(RFA)の治療経験

類骨骨腫に対する経皮的CTガイド下ラジオ波焼灼術(RFA)の治療経験

Efficacy of percutaneous radiofrequency ablation of osteoid osteoma in children

Sir, We read with a great deal of interest the article by Donkol et al. “Efficacy of percutaneous radiofrequency ablation of osteoid osteoma in children” [1] that describes the authors’ experience in treating osteoid osteoma (OO) in 23 children. From June 2001 to now we have treated over 140 osteoid osteomas in children (age range 3–16 years; girl/ boy ratio 1:1.7). We fully agree with the authors regarding the advantages of radiofrequency ablation (RFA) for the treatment of OO in children. To avoid skin burns when the lesion is very superficial or involves small bones, besides placing the active tip in the bone, we put ice on the skin near the needle throughout RF delivery, and in addition, we use a low mA and two adhesive plates (10×15 cm) near the lesion. We have never had a case of hyperthermia. Our patients resume normal daily activities around 12 h after the thermal ablation procedure, with the exception of sport that is resumed after 3 months. The patients usually need no further treatment at home. The diagnosis is based on the correlation of history, clinical examination, and radiological data (conventional radiographs, CT, MRI). We hardly ever perform scintigraphy (to avoid further radiation exposure). When possible, we also prefer to use spinal rather than general anaesthesia, although in very small or uncooperative children there is no choice. Antibiotic (cefazolin 1–2 g) is administered intravenously as a single dose during the procedure. We use a coaxial system formed by the 14-G Bonopty needle biopsy set (Radi, Uppsala, Sweden) after inserting an 18-G needle and Kirschner wire (0.8 mm) as a guide. The needle electrode and the generator are the same type as used by Donkol et al., and we use three different lengths of active tip (5, 10, and 15 mm) according to the dimensions of the lesion. Before delivering the RF we always perform a biopsy and only then insert the needle electrode. The delivery temperature never exceeds 95°C. The procedure time is approximately 20–30 min. We agree with the Donkol et al. regarding the greater risk of recurrences in children, which we think might be because of the greater “skeletal activity”. Despite this high recurrence rate, albeit lower than that reported in the literature for surgical treatment, we believe that thermal ablation of OO with RFA should be considered the gold standard for children as well as adults.

Computed Tomography–Guided Radiofrequency Ablation of Osteoid Osteomas

To report on 14 patients with osteoid osteomas treated by computed tomography-guided radiofrequency ablation. Nine males and 5 females aged 13 to 45 (mean, 25) years with osteoid osteomas were included. The proximal tibia was the commonest site involved. A bipolar 18-gauge radiofrequency probe with a 9- mm active tip was used. A 4.5-mm hollow drill was introduced into the nidus. Energy application was started at 2 W and increased to a maximum of 5 W. Heat was applied for 4 to 6 minutes at 90 degrees Celsius. 12 (86%) of the 14 patients had prompt pain relief; the remaining 2 underwent a repeat ablation. After a mean follow-up period of 19 (range, 9-25) months, no patient had pain recurrence. Radiofrequency ablation is a minimally invasive and cost-effective treatment for osteoid osteomas.

Ablation des tumeurs osseuses sous contrôle de l’imagerie : revue des techniques actuelles

Multiple interventional radiology techniques are available for percutaneous ablation of bone tumors: alcohol, laser, radiofrequency, microwave, ultrasound, and cryogenic ablation. Several indications have already been validated, including radiofrequency ablation of osteoid osteoma and bone metastases, with results superior to conventional treatment. More indications should be added over the coming years. The purpose of this article is to review the principles of the different ablation techniques, summarize their respective indications and results and discuss their implementation and the eventual combination with cementoplasty techniques.

Low radiation dose CT technique for guidance of radiofrequency ablation of osteoid osteoma

Low radiation dose CT technique for guidance of radiofrequency ablation of osteoid osteoma

Abstract No. 327: Clinical and Imaging Outcomes of Radiofrequency Ablation of Osteoid Osteoma

Abstract No. 327: Clinical and Imaging Outcomes of Radiofrequency Ablation of Osteoid Osteoma