Annals of Surgical Oncology

, Volume 14, Issue 2, pp 591–596 | Cite as

Osteoid Osteoma: CT-Guided Radiofrequency Ablation Using a Water-Cooled Probe

  • A. Peyser
  • Y. Applbaum
  • A. Khoury
  • M. Liebergall
  • K. Atesok



The purpose of this study was to assess the safety and efficacy of computed tomography (CT) guided percutaneous radiofrequency (RF) ablation of osteoid osteoma by using the water-cooled probe.


During the period from July 2002 to February 2006, fifty-one patients with osteoid osteomas localized in femur (29), tibia (10), calcaneus (2), talus (2), metatarsus (2), humerus (1), sacrum (1), scapula (1), olecranon (1), patella (1) and thoracic vertebra (1) were treated with CT-guided RF ablation using the Cooltip™ Tyco Healthcare probe. Mean age was 20 (range, 3.5–57 years) and male to female ratio was 36/15. Mean follow-up period was reported 2 years (range, 9–51 months). The procedures were carried out under general anesthesia and the patients were discharged from the hospital within 24 h.


Technical failure was reported in only one procedure. Pain disappeared postoperatively in all the patients within 2–3 days and no patients needed analgesic treatment after a week. All patients were allowed fully weight bear and function without limitation after the procedure. Recurrence of the pain was observed in one patient who was treated successfully with a second ablation. Our primary and secondary clinical success rates were 98 and 100% respectively. In one case, wound infection was observed after the procedure as the only post-operative complication in our series.


CT-guided percutaneous RF ablation of osteoid osteomas using the water-cooled probe is a safe, effective and minimally invasive procedure with high success rate and lack of relapses.


Osteoid osteoma CT Radiofrequency ablation Water-cooled probe 


  1. 1.
    Assoun J, Railhac JJ, Bonnevialle P, et al. Osteoid osteoma: percutaneous resection with CT guidance. Radiology 1993; 188:541–7PubMedGoogle Scholar
  2. 2.
    Barei DP, Moreau G, Scarborough MT, et al. Percutaneous radiofrequency ablation of osteoid osteoma. Clin Orthop 2000; 373:115–24PubMedCrossRefGoogle Scholar
  3. 3.
    Campanacci M, Ruggieri P, Gasbarrini A, et al. Osteoid osteoma direct visual identification and intralesional excision of the nidus with minimal removal of bone. J Bone Joint Surg Br 1999; 81:814–20PubMedCrossRefGoogle Scholar
  4. 4.
    Cantwell CP, Kerr J, O’byrne J, et al. MRI features after radiofrequency ablation of osteoid osteoma with cooled probes and impedance-control energy delivery. AJR Am J Roentgenol 2006; 186:1220–7PubMedCrossRefGoogle Scholar
  5. 5.
    Cantwell CP, O’byrne J, Eustace S. Radiofrequency ablation of osteoid osteoma with cooled probes and impedance-control energy delivery. AJR Am J Roentgenol 2006; 186:244–8CrossRefGoogle Scholar
  6. 6.
    Cioni R, Armillotta N, Bargellini I, et al. CT-guided radiofrequency ablation of osteoid osteoma: long term results. Eur Radiol 2004; 14:1203–8PubMedCrossRefGoogle Scholar
  7. 7.
    De Berg JC, Pattynama PMT, Obermann WR, et al. Percutaneous computed tomography-guided thermocoagulation for osteoid osteomas. Lancet 1995; 346:350–1PubMedCrossRefGoogle Scholar
  8. 8.
    Ehara SR, Rosenthal DI, Aoki J, et al. Peritumoral edema in osteoid osteoma on magnetic resonance imaging. Skeletal Radiol 1999; 28:265–70PubMedCrossRefGoogle Scholar
  9. 9.
    Ghanem I. The management of osteoid osteoma: updates and controversies. Curr Opin Pediatr 2006; 18:36–41PubMedCrossRefGoogle Scholar
  10. 10.
    Ghanem I, Collet LM, Kharrat K, et al. Percutaneous radiofrequency coagulation of osteoid osteoma in children and adolescents. J Pediatr Orthop B 2003; 12:244–52PubMedCrossRefGoogle Scholar
  11. 11.
    Kneisl JS, Simon MA. Medical management compared with operative treatment for osteoid osteoma. J Bone Joint Surg Am 1992; 74-A:179–85Google Scholar
  12. 12.
    Lindner NJ, Ozaki T, Roedl R, et al. Percutaneous radiofrequency ablation in osteoid osteoma. J Bone Joint Surg [Br] 2001; 83-B:391–6CrossRefGoogle Scholar
  13. 13.
    Makley JT, Dunn MJ. Prostoglandin synthesis by osteoid osteoma. Lancet 1982; 2(8288):42PubMedCrossRefGoogle Scholar
  14. 14.
    Martel VJ, Bueno A, Ortiz E. Percutaneous radiofrequency treatment of osteoid osteoma using cool-tip electrodes. Eur J Radiol 2005; 56(3):403–8PubMedCrossRefGoogle Scholar
  15. 15.
    Pinto CH, Taminiau AHM, Vanderschueren GM, et al. Technical considerations in CT-guided radiofrequency thermal ablation of osteoid osteoma: tricks of the trade. AJR Am J Roentgenol 2002; 179:1633–42PubMedGoogle Scholar
  16. 16.
    Rosenthal DI, Alexander A, Rosenberg AE, et al. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology 1992; 183:29–33PubMedGoogle Scholar
  17. 17.
    Rosenthal DI, Hornicek FJ, Torriani M, et al. Osteoid osteoma: Percutaneous treatment with radiofrequency energy. Radiology 2003; 229:171–5PubMedCrossRefGoogle Scholar
  18. 18.
    Rosenthal DI, Hornieck FJ, Wolfe MW, et al. Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment. J Bone Joint Surg Am 1998; 80:815–21PubMedGoogle Scholar
  19. 19.
    Schulman L, Dorfman HD. Nerve fibres in osteoid osteoma. J Bone Joint Surg 1970; 52A:1351Google Scholar
  20. 20.
    Solbiati L, Goldberg SN, Ierace T, et al. Hepatic metastases: percutaneous radio- frequency ablation with cooled-tip electrodes. Radiology 1997; 205(2):367–73PubMedGoogle Scholar
  21. 21.
    Vanderschueren GM, Taminiau AHM, Obermann VR, et al. Osteoid osteoma: factors for increased risk of unsuccessful thermal coagulation. Radiology 2004; 233:757–62PubMedCrossRefGoogle Scholar
  22. 22.
    Venbrux AC, Montague BJ, Murphy KPJ, et al. Image-guided percutaneous radiofrequency ablation for osteoid osteoma. J Vasc Interv Radiol 2003; 14:375–80PubMedGoogle Scholar
  23. 23.
    Woertler K, Vestring T, Boettner F, et al. Osteoid osteoma: CT-guided percutaneous radiofrequency ablation and follow-up in 47 patients. J Vasc Interv Radiol 2001; 12:717–22PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2006

Authors and Affiliations

  • A. Peyser
    • 1
  • Y. Applbaum
    • 2
  • A. Khoury
    • 1
  • M. Liebergall
    • 1
  • K. Atesok
    • 1
  1. 1.Department of Orthopaedic SurgeryThe Hadassah-Hebrew University Medical CenterJerusalemIsrael
  2. 2.Department of RadiologyThe Hadassah-Hebrew University Medical CenterJerusalemIsrael

Personalised recommendations