Magnetic-resonance-guided focused ultrasound treatment of non-spinal osteoid osteoma in children: multicentre experience

Arrigoni, Francesco; Napoli, Alessandro; Bazzocchi, Alberto; Zugaro, Luigi; Scipione, Roberto; Bruno, Federico; Palumbo, Pierpaolo; Anzidei, Michele; Mercatelli, Daniele; Gravina, Giovanni Luca; Zoccali, Carmine; Ghanouni, Pejman; Barile, Antonio; Catalano, Carlo; Masciocchi, Carlo

doi:10.1007/s00247-019-04426-0

Cited by 38 publications

(36 citation statements)

References 24 publications

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“…CT-guided RFA is a safe and effective treatment for OO, resulting in a decrease in pathological MRI findings and excellent clinical results [16][17][18]. Moreover, promising results regarding high-frequency ultrasound treatment have also been achieved [31]. In the case of an intraarticular OO in a critical location with respect to the articular cartilage, protective measures, e. g. creation of artificial joint effusion, could reduce the risk of post-treatment articular defects.…”

Section: Discussionmentioning

confidence: 99%

Intraarticular Osteoid Osteoma: MRI Characteristics and Clinical Presentation Before and After Radiofrequency Ablation Compared to Extraarticular Osteoid Osteoma

Thomas

Weber

Lehner

et al. 2020

Rofo

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Purpose To determine MRI characteristics and the clinical presentation of intraarticular osteoid osteomas (OO) before and after treatment with CT-guided radiofrequency ablation (RFA) compared with extraarticular osteoid osteomas. Materials and Methods In a retrospective study, n = 21 patients with an intraarticular OO were matched with a control group of n = 21 patients with an extraarticular OO at a comparable anatomical position. All patients underwent CT-guided RFA and preinterventional MRI. In n = 31 cases, follow-up MR imaging was available. MR images were analyzed for morphologic features: effusion and synovitis, bone marrow edema (BME), soft tissue edema, periosteal reaction as well as T1 / T2 signal and contrast enhancement of the nidus. Recorded clinical parameters included the initial diagnosis, the course of pain symptoms after RFA and the incidence of complications. Results The nidus was detectable in all patients on MRI. BME had the highest sensitivity in both intra- and extraarticular OO (100 %). Effusion and synovitis were only observed in the intraarticular OO group (n = 21) with a perfect sensitivity and specificity (100 %) and a high negative predictive value (85 %). Soft tissue edema was significantly more present in patients with intraarticular OO (p = 0.0143). No significant differences were present regarding periosteal reaction, T1/T2 signal and contrast enhancement of the nidus (p > 0.05). BME, contrast enhancement, soft tissue edema, periosteal reaction, effusion and synovitis, if preexisting, always decreased after RFA. In 66.7 % of patients with intraarticular OO, a false initial diagnosis was made (extraarticular: 19 %). All patients were free of pain after intervention. Complications following the RFA procedure did not occur. Conclusion MRI demonstrates the nidus and thus the OO in all cases regardless of the location. The characteristic MRI morphology of an intraarticular OO includes synovitis and joint effusion, which are always present and differentiate with perfect sensitivity/specificity from an extraarticular OO. In both intra- and extraarticular OOs pathologic MRI changes at least decreased or completely normalized and the clinical results after RFA were excellent. Key Points: Citation Format

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Section: Discussionmentioning

confidence: 99%

Intraarticular Osteoid Osteoma: MRI Characteristics and Clinical Presentation Before and After Radiofrequency Ablation Compared to Extraarticular Osteoid Osteoma

Thomas

Weber

Lehner

et al. 2020

Rofo

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“…Magnetic resonance-guided focused ultrasound (MRgFUS), also known as high-intensity focused ultrasound (HIFU), is a noninvasive ablation technique that has been successfully used for the treatment of uterine fibroids, bone metastases, and essential tremor [1,2]. More recently, focused ultrasound ablation has been investigated for indications such as treatment of focal breast lesions, osteoid osteomas, and desmoid tumors [3,4].…”

Section: Introductionmentioning

confidence: 99%

T2 mapping as a predictor of nonperfused volume in MRgFUS treatment of desmoid tumors

Morochnik

Ozhinsky

Rieke

et al. 2019

International Journal of Hyperthermia

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Objective: The objective of this study was to develop an alternative method of non-contrast monitoring of tissue ablation during focused ultrasound treatment. Desmoid tumors are benign but locally aggressive soft tissue tumors that arise from fibroblast cells. Magnetic resonance-guided focused ultrasound (MRgFUS) has emerged as an alternative to conventional therapies, showing promising results in reduction of tumor volume without significant side effects. The gold-standard assessment of the reduction of viable tumor volume post-treatment is non-perfused volume (NPV) and evaluation of NPV is typically performed with post-treatment gadolinium enhanced MR imaging. However, as gadolinium cannot be repeatedly administered during treatments, there is a need for alternative non-contrast monitoring of the tissue to prevent over and under treatment. Methods: Double-echo and multi-echo images were acquired before, during and after the MRgFUS treatment. T2 maps were generated with an exponential fit and T2 maps were compared to post-treatment post-contrast images. Results: In all five MRgFUS treatment sessions, T2 mapping showed excellent qualitative agreement with the post-contrast NPV. Conclusions: T2 mapping may be used to visualize the extent of ablation with focused ultrasound and can be used as a predictor of NPV prior to the administration of contrast during the post-treatment assessment.

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“…[17][18][19][20] The role of IR in the MSK field has grown significantly in the last few years. IR techniques currently represent the gold standard for the treatment of lesions such as osteoid osteoma (OO) 21,22 or osteoblastoma (OB). 23 They are a valid alternative to surgery in the presence of unicameral bone cysts (UBCs), aneurysmal bone cysts (ABCs), 24 and vascular malformations.…”

mentioning

confidence: 99%

“…The radiologic diagnosis is accurate when bone scintigraphy, radiography, computed tomography (CT), and magnetic resonance (MR) imaging are used in combination. 21,26 In the past, surgical resection or curettage were the only therapeutic alternatives to conservative treatment. Surgery has a reported success rate ranging from 88% to 97%.…”

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confidence: 99%

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Musculoskeletal Interventional Radiology in the Pediatric Population: State of the Art

Arrigoni

Izzo

Bruno

et al. 2021

Semin Musculoskelet Radiol

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Interventional radiology procedures have been proven to be as effective as traditional surgery but usually are characterized by lower morbidity rates. In this article, the most diffuse IR treatments for pediatric lesions are reviewed with the aim of describing main advantages and drawbacks. Ablation procedures (in particular RFA and MRgFUS) are widely used for the management of osteoid osteoma and osteoblastoma whereas intracystic injection of methylprednisolone acetate is performed for simple bone cysts. Sclerosing agents and where possible, selective arterial embolization are used for treatment of aneurysmal bone cysts and other vascular malformations. In the management of malignant muscoloskeletal tumors, the role interventional radiology is mainly represented by percutaneous biopsies, and by adiuvant selective embolizations in presence of hypervascular lesions to be submitted to surgery.

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Magnetic-resonance-guided focused ultrasound treatment of non-spinal osteoid osteoma in children: multicentre experience

Cited by 38 publications

References 24 publications

Intraarticular Osteoid Osteoma: MRI Characteristics and Clinical Presentation Before and After Radiofrequency Ablation Compared to Extraarticular Osteoid Osteoma

Intraarticular Osteoid Osteoma: MRI Characteristics and Clinical Presentation Before and After Radiofrequency Ablation Compared to Extraarticular Osteoid Osteoma

T2 mapping as a predictor of nonperfused volume in MRgFUS treatment of desmoid tumors

Musculoskeletal Interventional Radiology in the Pediatric Population: State of the Art

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