Percutaneous Radiofrequency Ablation of Osteoid Osteomas with Use of Real-Time Needle Guidance for Accurate Needle Placement: A Pilot Study

Busser, W.; Hoogeveen, Yvonne L.; Veth, R.P.H.; Schreuder, H.W.B.; Balguid, Angelique; Renema, Willem; Schultze-Kool, L.

doi:10.1007/s00270-010-9950-7

Cited by 34 publications

(32 citation statements)

References 14 publications

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“…Some authors have reported achieved accuracies using CBCT guidance in small patient groups to be ,5 mm in most of their cases [9][10][11]13]; however, these groups are small and there is no or little information on the used needle paths. Nonetheless, this suggests that accuracies of around 3 mm can be reached in clinical practice also, irrespective of the complexity of the needle path and the user experience level.…”

Section: Discussionmentioning

confidence: 99%

“…A deviation of about 7 mm as observed in the case of the double angulated procedures using CT guidance, however, can be expected to impact the treatment outcome. For instance, the targeted small high contrast nidus in radiofrequency ablations of osteoid osteoma is most often ,10 mm [11]. Here, as the ablation zone is approximately 2 cm around the needle tip, a deviation from the target point of .5 mm will result in partial treatment, or even worse, missing the nidus completely.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors described the use of this CBCT with navigational tools in various types of procedures [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Braak et al [8] described the effective patient dose of CBCT guidance procedures to be reduced by 13-42% compared with CT guidance for abdominal and thoracic procedures.…”

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confidence: 99%

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Cone beam CT guidance provides superior accuracy for complex needle paths compared with CT guidance

Busser¹,

Braak²,

Fütterer³

et al. 2013

BJR

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Objective: To determine the accuracy of cone beam CT (CBCT) guidance and CT guidance in reaching small targets in relation to needle path complexity in a phantom. Methods: CBCT guidance combines three-dimensional CBCT imaging with fluoroscopy overlay and needle planning software to provide real-time needle guidance. The accuracy of needle positioning, quantified as deviation from a target, was assessed for inplane, angulated and double angulated needle paths. Four interventional radiologists reached four targets along the three paths using CBCT and CT guidance. Accuracies were compared between CBCT and CT for each needle path and between the three approaches within both modalities. The effect of user experience in CBCT guidance was also assessed. Results: Accuracies for CBCT were significantly better than CT for the double angulated needle path (2.2 vs 6.7 mm, p,0.001) for all radiologists. CBCT guidance showed no significant differences between the three approaches. For CT, deviations increased with increasing needle path complexity from 3.3 mm for the inplane placements to 4.4 mm (p50.007) and 6.7 mm (p,0.001) for the angulated and double angulated CT-guided needle placements, respectively. For double angulated needle paths, experienced CBCT users showed consistently higher accuracies than trained users [1.8 mm (range 1.2-2.2) vs 3.3 mm (range 2.1-7.2) deviation from target, respectively; p50.003]. Conclusion: In terms of accuracy, CBCT is the preferred modality, irrespective of the level of user experience, for more difficult guidance procedures requiring double angulated needle paths as in oncological interventions. Advances in knowledge: Accuracy of CBCT guidance has not been discussed before. CBCT guidance allows accurate needle placement irrespective of needle path complexity. For angulated and double-angulated needle paths, CBCT is more accurate than CT guidance.Needle guidance for puncture or other minimally invasive procedures is increasing in standard interventional radiology practice. In local therapy procedures, such as percutaneous ablations, accurate placement of one or more needles is important in order to provide effective treatment [1]. This is especially the case in treatment or biopsy procedures of small lesions, in which the tip of the needle needs to be placed within a range of millimetres of the target point. Therefore, image guidance plays a significant role in accurate percutaneous needle placement [2].Currently, most needle placement procedures are performed using CT guidance, fluoroscopy or ultrasound [3]. CT images provide good visualisation of the target and surrounding tissues. For needle guidance, however, CT has limitations mainly because it does not allow real-time feedback on needle progression. For semi-real-time imaging within the CT scanner, CT-fluoroscopy can be used at the expense of a higher radiation dose to the patient and operator [4]. Acquiring CT fluoroscopy images to check needle position takes approximately 1 s, time in which the needle cannot be progressed.Fluorosc...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cone beam CT guidance provides superior accuracy for complex needle paths compared with CT guidance

Busser¹,

Braak²,

Fütterer³

et al. 2013

BJR

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“…OO are mainly found in distal femur and tibia but can occur in almost any bone [3]. Characteristic radiological signs are central, radiotransparent, partly ossifying nidus surrounded by a reactive ossification [4].…”

Section: Introductionmentioning

confidence: 99%

CT-guided radiofrequency ablation of osteoid osteoma using a novel battery-powered drill

et al. 2014

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“…Theoretically, RFA induced the tumor tissue, paravertebral venous plexus or venous plexus within the vertebral body to coagulate to form a 'reactive zone', which can reduce the risk of bone cement leakage, making the bone cement more evenly distributed within the tumor tissues (34). The combination of RFA and PVP technology can largely overcome their own limitations and enhance the complementarity between them (35).…”

Section: Radiofrequency Ablation Combined With Pvp Technologymentioning

confidence: 99%

Advances in the clinical research of the minimally invasive treatment for the posterior edge of vertebral-body defects by spinal metastases

et al. 2015

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Abstract.Spinal metastasis is one of the commonly observed complications in the advanced stages of cancer patients, and is a serious threat to human life and health. Malignant tumor invasion usually leads to defects in the posterior margins of the vertebral body, which caused significant cancer pains to patients and increased the risk of surgery. Currently, minimally invasive treatments of vertebral defects caused by spinal metastases include percutaneous vertebroplasty (PVP) combined with radiofrequency ablation and PVP combined with 125 I seed implantation. These minimally invasive techniques have particular superiority to control pain in patients with spinal metastases, improve nerve function, reduce the incidence of fractures and surgical risk, and improve the quality of life. The present study reviewed the progress in clinical research on vertebral defects caused by spinal metastases, and the mechanisms and minimally invasive treatment.

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Percutaneous Radiofrequency Ablation of Osteoid Osteomas with Use of Real-Time Needle Guidance for Accurate Needle Placement: A Pilot Study

Cited by 34 publications

References 14 publications

Cone beam CT guidance provides superior accuracy for complex needle paths compared with CT guidance

Cone beam CT guidance provides superior accuracy for complex needle paths compared with CT guidance

CT-guided radiofrequency ablation of osteoid osteoma using a novel battery-powered drill

Advances in the clinical research of the minimally invasive treatment for the posterior edge of vertebral-body defects by spinal metastases

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