Interventional Radiology With Laser in Bone and Joint

This article reviews current trends in the treatment of osteoid osteoma with an emphasis on the evolving use of radiofrequency thermoablation as a primary definitive treatment and for recurrent and residual lesions. In so doing, the article reviews merits and relative disadvantages of both surgical and non-surgical imaging-guided techniques in treatment. Radiofrequency ablation of osteoid osteoma is a highly effective, efficient, minimally invasive and safe method of treating osteoid osteoma. Clinical success range from 76 to 100%. Surgery remains the standard treatment in cases where histology of the lesion is in doubt, neurovascular structures are within 1.5 cm or in repeated failure of any other minimally invasive ablative technique or percutaneous resection. Clinical success of surgery ranges from 88 to 100%. Laser interstitial thermal therapy shares many of the advantages and much of the success of radiofrequency thermoablation but has not been as available. Clinical success ranges from 87 to 100%. Cryotherapy, ethanol therapy and imaging-guided excision remain second-line therapies. Clinical success ranges from 77 to 100% for imaging-guided resection and 100% for ethanol therapy.

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“…Eighty-seven to 100% of patients treated with laser interstitial therapy had a successful treatment (Table 5) [49,50,51,52].…”

Section: Ct-guided Percutaneous Resection and Ethanol Injectionmentioning

confidence: 99%

“…Complications included 2 minor skin burns, 1 lost nail, 1 case of mild transient reflex sympathetic dystrophy and headache for 1 week after treatment of a spinal lesion [48,49,50,51,52,53].…”

Section: Ct-guided Percutaneous Resection and Ethanol Injectionmentioning

confidence: 99%

Current trends in treatment of osteoid osteoma with an emphasis on radiofrequency ablation

2004

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“…These disadvantages have encouraged the introduction of less invasive therapeutic methods, such as percutaneous excision, laser coagulation, and thermocoagulation (2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Because of good short-term results, thermocoagulation was accepted as the prevailing technique at our institution several years ago.…”

Section: © Rsna 2002mentioning

confidence: 99%

Osteoid Osteoma: Clinical Results with Thermocoagulation

Vanderschueren¹,

Taminiau²,

Obermann³

et al. 2002

Radiology

188

121

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“…In addition to conservative long-term treatment with nonsteroid anti-inflammatory drugs-which is problematic due to the side effects-the surgical resection of the nidus and several recently introduced minimally invasive therapies are treatment options for OO (4)(5)(6). Computed tomography (CT)-guided percutaneous radiofrequency ablation (RFA) has been the most commonly used method since its introduction in 1992 (7), with success rates of 67%-100% (8)(9)(10)(11).…”

mentioning

confidence: 99%

CT-guided radiofrequency ablation of osteoid osteoma: correlation of clinical outcome and imaging features

Rehnitz¹,

Sprengel²,

Lehner³

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to retrospectively evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) findings of patients with osteoid osteoma treated with CT-guided radiofrequency ablation (RFA) along with the clinical outcome and long-term success. MATERIALS AND METHODSSeventy-three CT-guided RFA procedures were performed in 72 patients. The long-term success was assessed using a questionnaire including several visual analog scale scores. The CT evaluation included pre-and immediate postprocedural imaging of all 72 patients, and MRI was performed in 18 patients with follow-up imaging (mean, 3.4±2.2 months). The evaluation criteria included nidus morphology and a correlation with markers of clinical success. RESULTSThe primary technique effectiveness rate was 71/72 (99%). One relapse was successfully retreated, leading to a secondary technique effectiveness rate of 72/72 (100%). The longterm follow-up (mean, 51.2±31.2 months; range, 3-109 months) revealed a highly significant reduction of all assessed limitation scores (P < 0.001). The CT morphology was typical in all cases and did not change during the short-term follow-up. The follow-up MRI patterns varied considerably, including persistent nidus contrast enhancement in one-third (6/18) and persistent marrow edema in half (9/18) of the patients. None of the investigated MRI and CT patterns correlated with the clinical outcome. CONCLUSIONThe long-term outcome of CT-guided RFA of osteoid osteoma is excellent. There is no correlation of the CT and MRI patterns with the clinical outcome. Thus, the treatment decisions should not be solely based on the imaging findings. Investigators should also be aware of the variety of imaging patterns after RFA.

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Interventional Radiology With Laser in Bone and Joint

Cited by 40 publications

References 32 publications

Current trends in treatment of osteoid osteoma with an emphasis on radiofrequency ablation

Current trends in treatment of osteoid osteoma with an emphasis on radiofrequency ablation

Osteoid Osteoma: Clinical Results with Thermocoagulation

CT-guided radiofrequency ablation of osteoid osteoma: correlation of clinical outcome and imaging features

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