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CardioVascular and Interventional Radiology

, Volume 34, Issue 3, pp 579–584 | Cite as

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

  • Andreas H. MahnkenEmail author
  • Philipp Bruners
  • Heide Delbrück
  • Rolf W. Günther
Clinical Investigation

Abstract

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.

Keywords

Radiofrequency ablation Osteoid osteoma CT guidance Benign bone tumor Thermal ablation 

References

  1. 1.
    Unni KK (1996) Dahlin’s bone tumours: general aspects and data on 11,087 cases, 5th edn. Lippincott-Raven, Philadelphia, pp 121–142Google Scholar
  2. 2.
    Woertler K, Vestring T, Boettner F, Winkelmann W, Heindel W, Lindner N (2001) Osteoid osteoma: CT-guided percutaneous radiofrequency ablation and follow-up in 47 patients. J Vasc Interv Radiol 12:717–722PubMedCrossRefGoogle Scholar
  3. 3.
    Venbrux AC, Montague BJ, Murphy KPJ, Bobonis LA, Washington SB, Soltes AP et al (2003) Image guided percutaneous radiofrequency ablation for osteoid osteomas. J Vasc Interv Radiol 14:375–380PubMedGoogle Scholar
  4. 4.
    Mastrantuono D, Martorano D, Verna V, Mancini A, Faletti C (2005) Osteoid osteoma: our experience using radio-frequency (RF) treatment. Radiol Med (Torino) 109:220–228Google Scholar
  5. 5.
    Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ (2003) Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 229:171–175PubMedCrossRefGoogle Scholar
  6. 6.
    Vanderschueren GM, Taminiau AHM, Obermann WR, Bloem JL (2002) Osteoid osteoma: clinical results with thermocoagulation. Radiology 224:82–86PubMedCrossRefGoogle Scholar
  7. 7.
    Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings CJ, Gerbhardt MC, Mankin HJ (1998) Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment. J Bone Joint Surg 80:815–821PubMedGoogle Scholar
  8. 8.
    Martel J, Bueno A, Nieto-Morales ML, Ortiz EJ (2009) Osteoid osteoma of the spine: CT-guided monopolar radiofrequency ablation. Eur J Radiol 71:564–569PubMedCrossRefGoogle Scholar
  9. 9.
    Mahnken AH, Tacke JA, Wildberger JE, Günther RW (2006) Radiofrequency ablation of osteoid osteoma: initial results with a bipolar ablation device. J Vasc Interv Radiol 17:1465–1470PubMedCrossRefGoogle Scholar
  10. 10.
    Carrafiello G, Fontana F, Pellegrino C, Mangini M, Cabrini L, Mariani D et al (2009) Radiofrequency ablation of abdominal wall endometrioma. Cardiovasc Intervent Radiol 32:1300–1303PubMedCrossRefGoogle Scholar
  11. 11.
    Bruners P, Lipka J, Günther RW, Schmitz-Rode T, Mahnken AH (2008) Bipolar radiofrequency ablation: is the shape of the coagulation volume different in comparison to monopolar RF-ablation using variable active tip lengths? Minim Invasive Ther Allied Technol 17:267–274PubMedCrossRefGoogle Scholar
  12. 12.
    Akhlaghpoor S, Tomasian A, Arjmand Shabestari A, Ebrahimi M, Alinaghizadeh MR (2007) Percutaneous osteoid osteoma treatment with combination of radiofrequency and alcohol ablation. Clin Radiol 62:268–273PubMedCrossRefGoogle Scholar
  13. 13.
    Vanderschueren GM, Taminiau AHM, Obermann WR, van den Berg-Huysmans AA, Bloem JL (2004) Osteoid osteoma: factors for increased risk unsuccessful thermal coagulation. Radiology 233:757–762PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2010

Authors and Affiliations

  • Andreas H. Mahnken
    • 1
    • 2
    Email author
  • Philipp Bruners
    • 1
    • 2
  • Heide Delbrück
    • 3
  • Rolf W. Günther
    • 1
  1. 1.Department of Diagnostic RadiologyRWTH Aachen UniversityAachenGermany
  2. 2.Applied Medical EngineeringRWTH Aachen UniversityAachenGermany
  3. 3.Orthopedic ClinicRWTH Aachen UniversityAachenGermany

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