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Pediatric Percutaneous Osteoid Osteoma Ablation: Cone-Beam CT with Fluoroscopic Overlay Versus Conventional CT Guidance

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Abstract

Purpose

To compare technical success, clinical success, complications, radiation dose, and total room utilization time for osteoid osteoma thermal (radiofrequency or microwave) ablation using cone-beam computed tomography (CBCT) with two-axis fluoroscopic navigational overlay versus conventional computed tomography (CT) guidance.

Materials and Methods

A retrospective review was performed to identify all osteoid osteoma ablations performed over a 5.5-year period at a single tertiary care pediatric hospital. Twenty-five ablations (15 radiofrequency and 10 microwave) in 23 patients undergoing fluoroscopic CBCT-guided osteoid osteoma ablation were compared to 35 ablations (35 radiofrequency) in 32 patients undergoing ablation via conventional CT guidance. Dose area product and dose length product were recorded for CBCT and conventional CT, respectively, and converted to effective doses. Technical success, clinical success (cessation of pain and medication use 1 month after ablation), complications, radiation dose, and total room utilization time were compared.

Results

All procedures were technically successful. Twenty-two of 25 (88.0%) CBCT and 31 of 35 (88.6%) conventional CT-guided ablations achieved immediate clinical success. There were two minor complications in each group and no major complications. Mean effective radiation dose was significantly lower for CBCT compared to CT guidance (0.12 vs. 0.39 mSv, p = 0.02). Mean total room utilization time for CBCT was longer (133.5 vs. 97.5 min, p = 0.0001).

Conclusions

Fluoroscopic CBCT guidance for percutaneous osteoid osteoma ablation yields similar technical and clinical success, reduced radiation dose, and increased total room utilization time compared to conventional CT guidance.

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Authors and Affiliations

  1. Department of Radiology, University of Washington, Seattle, WA, USA

    Brandon C. Perry & Kalpana M. Kanal

  2. Department of Radiology, Section of Interventional Radiology, Seattle Children’s Hospital, 4800 Sand Point Way NE, M/S R-5417, Seattle, WA, 98105, USA

    Eric J. Monroe & Giridhar Shivaram

  3. University of Washington School of Medicine, Seattle, WA, USA

    Tyler McKay

Authors
  1. Brandon C. Perry
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  2. Eric J. Monroe
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  3. Tyler McKay
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Corresponding author

Correspondence to Giridhar Shivaram.

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Conflict of interest

Brandon C. Perry, Eric J. Monroe, Tyler McKay, Kalpana M. Kanal, and Giridhar Shivaram report no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Perry, B.C., Monroe, E.J., McKay, T. et al. Pediatric Percutaneous Osteoid Osteoma Ablation: Cone-Beam CT with Fluoroscopic Overlay Versus Conventional CT Guidance. Cardiovasc Intervent Radiol 40, 1593–1599 (2017). https://doi.org/10.1007/s00270-017-1685-2

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  • DOI: https://doi.org/10.1007/s00270-017-1685-2

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