Skip to main content
SpringerLink
Log in

CT-guided percutaneous cryoablation of osteoid osteoma in children: an initial study

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

The purpose of this study was to evaluate the safety and efficacy of CT-guided percutaneous cryoablation for osteoid osteoma in children.

Materials and methods

This study was approved by the institutional ethics committee. From January 2007 to July 2008, six children (four boys, two girls, mean age 12.6 years old) with osteoid osteoma were treated with CT-guided percutaneous cryoablation. The procedures were carried out under conscious sedation and local anesthesia. CT guidance was used for procedural planning, instrument guidance, and monitoring. An argon-based cryoablation system was used. Each cryoablation included two freezing-thawing cycles. Follow-up was performed to assess technical and clinical outcome for a minimum of 12 months. A visual analog scale (VAS) was used to assess severity of pain pre- and post-procedure, and mean VAS for the group was compared pre- and post-procedure with a t-test. The mean clinical follow-up period was 28.7 months (ranging from 18 to 36 months).

Results

Cryoablation was technically and clinically successful for all patients. No major immediate or delayed complications were observed. Significant pain relief (P <0.05) was observed in all patients after operation. Mean VAS were 6.57 ± 0.55 pre-procedure and 0.57 ± 0.10 1 month post-procedure. Patients were allowed to fully bear their weight and function without limitation within 3 days after the procedure. Pain recurrence was not observed in any patient.

Conclusion

Percutaneous cryoablation is safe and effective for the treatment of osteoid osteomas in children. Notably, this procedure can be accomplished without general anesthesia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3a–c
Fig. 4
Fig. 5a, b

Similar content being viewed by others

References

  1. Kransdorf MJ, Stull MA, Gilkey FW, Moser Jr RP. Osteoid osteoma. Radiographics. 1991;11(4):671–96.

    Article  CAS  Google Scholar 

  2. Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gebhardt MC, Mankin HJ. Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment. J Bone Joint Surg Am. 1998;80(6):815–21.

    Article  CAS  Google Scholar 

  3. Gangi A, Alizadeh H, Wong L, Buy X, Dietemann JL, Roy C. Osteoid osteoma: percutaneous laser ablation and follow-up in 114 patients. Radiology. 2007;242(1):293–301.

    Article  Google Scholar 

  4. Towbin R, Kaye R, Meza MP, Pollock AN, Yaw K, Moreland M. Osteoid osteoma: percutaneous excision using a CT-guided coaxial technique. AJR Am J Roentgenol. 1995;164(4):945–9.

    Article  CAS  Google Scholar 

  5. Sierre S, Innocenti S, Lipsich J, Lanfranchi L, Questa H, Moguillansky S. Percutaneous treatment of osteoid osteoma by CT-guided drilling resection in pediatric patients. Pediatr Radiol. 2006;36(2):115–8.

    Article  Google Scholar 

  6. Peyser A, Applbaum Y, Simanovsky N, Safran O, Lamdan R. CT-guided radiofrequency ablation of pediatric osteoid osteoma utilizing a water-cooled tip. Ann Surg Oncol. 2009;16(10):2856–61.

    Article  Google Scholar 

  7. Moser T, Giacomelli MC, Clavert JM, Buy X, Dietemann JL, Gangi A. Image-guided laser ablation of osteoid osteoma in pediatric patients. J Pediatr Orthop. 2008;28:265–70.

    Article  Google Scholar 

  8. Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ. Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology. 2003;229(1):171–5.

    Article  Google Scholar 

  9. Cioni R, Armillotta N, Bargellini I, Zampa V, Cappelli C, Vagli P, et al. CT-guided radiofrequency ablation of osteoid osteoma: long-term results. Eur Radiol. 2004;14(7):1203–8.

    Article  Google Scholar 

  10. Sung KS, Seo JG, Shim JS, Lee YS. Computed-tomography-guided percutaneous radiofrequency thermoablation for the treatment of osteoid osteoma—2 to 5 years follow-up. Int Orthop. 2009;33(1):215–8.

    Article  Google Scholar 

  11. Donkol RH, Al-Nammi A, Moghazi K. Efficacy of percutaneous radiofrequency ablation of osteoid osteoma in children. Pediatr Radiol. 2008;38(2):180–5.

    Article  Google Scholar 

  12. Vanderschueren GM, Taminiau AH, Obermann WR, van den Berg-Huysmans AA, Bloem JL. Osteoid osteoma: factors for increased risk of unsuccessful thermal coagulation. Radiology. 2004;233(3):757–62.

    Article  Google Scholar 

  13. Rubinsky B. Cryosurgery. Annu Rev Biomed Eng. 2000;2:157–87.

    Article  CAS  Google Scholar 

  14. Baust JG, Gage AA, Clarke D, et al. Cryosurgery—a putative approach to molecular-based optimization. Cryobiology. 2004;48(2):190–204.

    Article  CAS  Google Scholar 

  15. Gage AA, Baust J. Mechanisms of tissue injury in cryosurgery. Cryobiology. 1998;37(3):171–86.

    Article  CAS  Google Scholar 

  16. Callstrom MR, Atwell TD, Charboneau JW, Farrell MA, Goetz MP, Rubin J, et al. Painful metastases involving bone: percutaneous image-guided cryoablation—prospective trial interim analysis. Radiology. 2006;241(2):572–80.

    Article  Google Scholar 

  17. Tuncali K, Morrison PR, Winalski CS, Carrino JA, Shankar S, Ready JE, et al. MRI-guided percutaneous cryotherapy for soft-tissue and bone metastases: initial experience. AJR Am J Roentgenol. 2007;189(1):232–9.

    Article  Google Scholar 

  18. Skjeldal S, Lilleås F, Follerås G, Stenwig AE, Samset E, Tillung T, et al. Real time MRI-guided excision and cryo-treatment of osteoid osteoma in os ischii—a case report. Acta Orthop Scand. 2000;71(6):637–8.

    Article  CAS  Google Scholar 

  19. Liu DM, Kee ST, Loh CT, McWilliams J, Ho SG, Brower JS, et al. Cryoablation of osteoid osteoma: two case reports. J Vasc Interv Radiol. 2010;21(4):586–9.

    Article  Google Scholar 

  20. Lee MH, Ahn JM, Chung HW, Lim HK, Suh JG, Kwag HJ, et al. Osteoid osteoma treated with percutaneous radiofrequency ablation: MR imaging follow-up. Eur J Radiol. 2007;64(2):309–14.

    Article  Google Scholar 

  21. Callstrom MR, Kurup AN. Percutaneous ablation for bone and soft tissue metastases—why cryoablation? Skeletal Radiol. 2009;38(9):835–9.

    Article  Google Scholar 

  22. Moser T, Buy X, Goyault G, Tok CH, Irani F, Gangi A. Image-guided ablation of bone tumors: review of current techniques. J Radiol. 2008;89(4):461–71.

    Article  CAS  Google Scholar 

  23. Ullrick SR, Hebert JJ, Davis KW. Cryoablation in the musculoskeletal system. Curr Probl Diagn Radiol. 2008;37(1):39–48.

    Article  Google Scholar 

  24. Bischof JC. Quantitative measurement and prediction of biophysical response during freezing in tissues. Annu Rev Biomed Eng. 2000;2:257–88.

    Article  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Chinese PLA General Hospital, Fuxing Road 28, Beijing, 100853, China

    Bin Wu, Yue-Yong Xiao & Xiao Zhang

  2. Department of Radiology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Lei Zhao

  3. Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    John A. Carrino

Authors
  1. Bin Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yue-Yong Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiao Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lei Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John A. Carrino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yue-Yong Xiao.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wu, B., Xiao, YY., Zhang, X. et al. CT-guided percutaneous cryoablation of osteoid osteoma in children: an initial study. Skeletal Radiol 40, 1303–1310 (2011). https://doi.org/10.1007/s00256-011-1119-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-011-1119-1

Keywords

Search

Navigation