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Radiofrequency thermoablation of primary non-spinal osteoid osteoma: optimization of the procedure

  • Musculoskeletal
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Abstract

Osteoid osteoma is a small benign tumor that requires treatment due to the intense pain it causes. Surgical therapy has been the ablative technique of choice after a failure of medical therapy. Recently, numerous less invasive, alternative procedures have been proposed: drill trepanation with or without ethanol injections, cryoablation, and thermoablation with laser or radiofrequency. The aim of this review is to retrospectively assess the effect of radiofrequency (RF) thermoablation in the treatment of primary non-spinal osteoid osteoma. From June 2001 to July 2003, we treated 106 patients affected by osteoid osteoma with RF thermoablation. Five patients with spinal osteoid osteoma and four with a previously treated osteoma were excluded from the study. In this paper, we assess the results obtained in a selected group of 97 primary non-spinal osteoid osteoma. The lesions were predominantly in the metaphysics of the femur. Central nidus calcifications were frequent and there was no prevalence for which side they occurred. Primary success was achieved in 82 patients (85%), while we obtained secondary success in 15 patients (15%). In two patients (2%), pain persisted between the two treatments and failed to be resolved, even after the second treatment; therefore, surgical excision was performed and complete resolution was obtained. No complications were reported. In conclusion, our results confirm that the treatment of choice for non-spinal osteoid osteoma is RF thermoablation, offering several advantages over ablative techniques.

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References

  1. Jaffe HL (1935) Osteoid osteoma: a benign osteoblastic tumor composed of osteoid and atypical bone. Arch Surg 31:709–728

    Google Scholar 

  2. Pieterse AS, Vernon-Roberts B, Paterson DC, Cornish BL, Lewis PR (1983) Osteoid osteoma transforming to aggressive (low grade malignant) osteoblastoma: a case report and literature review. Histopatology 7(5):789–800

    Google Scholar 

  3. Golding JSR (1954) The natural history of osteoid osteoma with a report of twenty cases. J Bone Joint Surg 36-B(2):218–229

    Google Scholar 

  4. Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gebhardt MC, Mankin HJ (1998) Percutaneous radiofrequency coagulation of osteoid osteoma compared with operative treatment. J Bone Joint Surg Am 80:815–821

    CAS  PubMed  Google Scholar 

  5. Rosenthal DI, Springfield DS, Gebhardt MC, Rosemberg AE, Mankin HJ (1995) Osteoid osteoma percutaneous radio-frequency ablation. Radiology 197:451–454

    CAS  PubMed  Google Scholar 

  6. Barbiera F, Bartolotta TV, Lo Casto A, Pardo S, Rossello M, De Maria M (2002) Osteoma osteoide intrarticolare: imaging integrato in tre casi. Radiol Med 103:464–473

    Google Scholar 

  7. Liu PT, Chivers FS, Roberts CC, Schultz CJ, Beauchamp CP (2003) Imaging of osteoid osteoma with dynamic gadolinium-enhanced MR imaging. Radiology 227(3):691–700

    Google Scholar 

  8. Campanacci M (1999) Osteoid osteoma in bone and soft tissue tumors, 2nd edn. Springer, Berlin Heidelberg New York, pp 391–414

    Google Scholar 

  9. Assoun J, Railhac JJ, Bonnevialle P, Poey C, Salles de Gauzy J, Baunin C, Cahuzac JP, Clement JL, Coustets B, Railhac N (1993) Osteoid osteoma: percutaneous resection with CT guidance. Radiology 188:541–547

    Google Scholar 

  10. D’Erme M, Del Popolo P, Diotallevi R, Pasquali-Lasagni M (1995) CT-guided percutaneous treatment of osteoid osteoma. Radiol Med 90(1–2):84–87

    Google Scholar 

  11. Kohler R, Joffre P (1993) Treatment of osteoid osteoma by percutaneous drill resection with computed tomography control: a study of 12 cases. J Pediatr Orthop B 2:78–82

    Google Scholar 

  12. Labbè JL, Clement JL, Duparc B, Poey C, Railhac JJ (1995) Percutaneous extraction of vertebral osteoid osteoma under computed tomography guidance. Eur Spine J 4:368–371

    Google Scholar 

  13. Sans N, Galy-Fourcade D, Assoun J, Jarlaud T, Chiavassa H, Bonnevialle P, Railhac N, Giron J, Morera-Maupome H, Railhac JJ (1999) Osteoid osteoma: CT-guided percutaneous resection and follow-up in 38 patients. Radiology 212(3):687–692

    Google Scholar 

  14. Towbin R, Kaye R, Meza MP, Pollock AN, Yaw K, Moreland M (1995) Osteoid osteoma: percutaneous excision using a CT-guided coaxial technique. Am J Roentgenol 164(4):945–949

    Google Scholar 

  15. Voto SJ, Cook AJ, Weiner DS, Ewing JW, Arrington LE (1990) Treatment of osteoid osteoma by computed tomography guided excision in the pediatric patient. J Pediatr Orthop 10(4):510–513

    Google Scholar 

  16. 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(6):717–722

    CAS  PubMed  Google Scholar 

  17. Cool P, Williams DH, Pullicino V (2001) Interstitial laser photocoagulation for the treatment of osteoid osteoma. J Bone Joint Surg Br 83(3):462

    Google Scholar 

  18. De Berg JC, Pattynama PMT, Oerman WR, Bode PJ, Vielvoye GJ, Taminiau AHM (1995) Percutaneous computed-tomography-guided thermocoagulation for osteoid osteomas. Lancet 346:350–351

    Google Scholar 

  19. Gangi A, Dietemann JL, Gasser B, Mortazavi R, Brunner P, Mourou MY, Dosch JC, Durckel J, Marescaux J, Roy C (1997) Interstitial laser photocoagulation of osteoid osteomas with use CT guidance. Radiology 203:843–848

    Google Scholar 

  20. Gangi A, Dietemann JL, Guth S, Vinclair L, Sibilia J, Mortazavi R, Steib JP, Rey C (1998) Percutaneous laser photocoagulation of spinal osteoid osteomas under CT guidance. Am J Neuroradiol 19:1955–1958

    Google Scholar 

  21. Barei DP, Moreau G, Scarborough MT, Neel MD (2000) Percutaneous radiofrequency ablation of osteoid osteoma. Clin Orthop Relat Res 373:115–124

    Google Scholar 

  22. Gallazzi MB, Arborio G, Garbagna PG, Perrucchini G, Daolio PA (2001) Termocoagulazione percutanea degli osteomi osteoidi mediante radiofrequenza: tecnica e risultati preliminari. Radiol Med 102:329–334

    Google Scholar 

  23. Lindner NJ, Ozaki T, Roedl R, Gosheger G, Winkelmann W, Wortler K (2001) Percutaneous radiofrequency ablation in osteoid osteoma. J Bone Joint Surg Br 83(3):391–396

    Google Scholar 

  24. Goldberg SN, Gazelle GS, Dawson SL, Rittman WJ, Mueller PR, Rosenthal DI (1995) Tissue ablation with radiofrequency: effect of probe size, gauge, duration and temperature on lesion volume. Acad Radiol 2:399–404

    Google Scholar 

  25. Livraghi T, Golberg SN, Monti F, Bizzini A, Lazzaroni S, Meloni F, Pellicano S, Solbiati L, Gazelle GS (1997) Saline enhanced radio-frequency tissue ablation in the treatment of liver metastases. Radiology 202:205–210

    CAS  PubMed  Google Scholar 

  26. Goldberg SN, Stein M, Gazelle GS, Kruskal JB, Clouse ME (1999) Percutaneous radiofrequency tissue ablation: optimization of pulsed-RF technique to increase coagulation necrosis. J Vasc Interv Radiol 10:907–916

    Google Scholar 

  27. Rosenthal DI, Alexander A, Rosenberg AE, Springfield D (1992) Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology 183:29–33

    Google Scholar 

  28. Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ (2003) Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 229:171–175

    Google Scholar 

  29. Denys AL, De Baere T, Kuoch V, Dupas B, Chevallier P, Madoff DC, Schnyder P, Doenz F (2003) Radio-frequency tissue ablation of the liver: in vivo and ex vivo experiments with four different systems. Eur Radiol 13(10):2346–2352

    Article  PubMed  Google Scholar 

  30. Campanacci M, Ruggieri P, Gasbarrini A, Ferraro A, Campanacci L (1991) Osteoid osteoma direct visual identification and intralesional excision of the nidus with minimal removal of bone. J Bone Joint Surg Br 81:814–820

    Google Scholar 

  31. Pinto CH, Taminiau AHM, Vanderschueren GM, Hogendoorn CW, Bloem JL, Oberman WR (2002) Technical considerations in CT-guided radiofrequency thermal ablation of osteoid osteoma: tricks of the trade. Am J Roentgenol 179:1633–1642

    PubMed  Google Scholar 

  32. Cioni R, Armillotta N, Bargellini I, Zampa V, Cappelli C, Vagli P, Boni G, Marchetti S, Consoli V, Bartolozzi C (2004) CT-guided radiofrequency ablation of osteoid osteoma: long-term results. Eur Radiol 14(7):1203–1208

    Google Scholar 

  33. Cantwell CP, Obyrne J, Eustace S (2003) Current trends in treatment of osteoid osteoma with an emphasis on radiofrequency ablation. Eur Radiol 14(4):607–617

    Google Scholar 

  34. Vanderschueren GM, Taminiau AH, Obermann WR, Bloem JL (2002) Osteoid osteoma: clinical results with thermocoagulation. Radiology 224(1):82–86

    PubMed  Google Scholar 

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Authors and Affiliations

  1. V Divisione, Istituti Ortopedici Rizzoli, Via Pupilli 1, Bologna, 40136, Italy

    Giuseppe Bianchi, A. Del Baldo & M. Mercuri

  2. Radiology Department, Istituti Ortopedici Rizzoli, Via Pupilli 1, Bologna, 40136, Italy

    E. Rimondi, M. C. Malaguti, R. Ciminari & U. Albisinni

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  1. E. Rimondi
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  2. Giuseppe Bianchi
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  3. M. C. Malaguti
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  4. R. Ciminari
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Correspondence to Giuseppe Bianchi.

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Rimondi, E., Bianchi, G., Malaguti, M.C. et al. Radiofrequency thermoablation of primary non-spinal osteoid osteoma: optimization of the procedure. Eur Radiol 15, 1393–1399 (2005). https://doi.org/10.1007/s00330-004-2616-6

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  • DOI: https://doi.org/10.1007/s00330-004-2616-6

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