1
|
Izzo A, Zugaro L, Fascetti E, Bruno F, Zoccali C, Arrigoni F. Management of Osteoblastoma and Giant Osteoid Osteoma with Percutaneous Thermoablation Techniques. J Clin Med 2021; 10:jcm10245717. [PMID: 34945013 PMCID: PMC8709302 DOI: 10.3390/jcm10245717] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/27/2021] [Accepted: 12/03/2021] [Indexed: 12/23/2022] Open
Abstract
Osteoblastoma (OB) is a rare, benign bone tumor, accounting for 1% of all primary bone tumors, which occurs usually in childhood and adolescence. OB is histologically and clinically similar to osteoid osteoma (OO), but it differs in size. It is biologically more aggressive and can infiltrate extraskeletal tissues. Therapy is required because of severe bone pain worsening at night. Moreover, non-steroid anti-inflammatory drugs (NSAIDs) are not a reasonable long-term treatment option in young patients. Surgical excision, considered the gold standard in the past, is no longer attractive today due to its invasiveness and the difficulty in performing a complete resection. The treatment of choice is currently represented by percutaneous thermoablation techniques. Among these, Radiofrequency ablation (RFA) is considered the gold standard treatment, even when the lesions are located in the spine. RFA is a widely available technique that has shown high efficacy and low complication rates in many studies. Other percutaneous thermoablation techniques have been used for the treatment of OB, including Cryoablation (CA) and laser-ablation (LA) with high success rates and low complications. Nevertheless, their role is limited, and further studies are necessary.
Collapse
Affiliation(s)
- Antonio Izzo
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.F.); (F.B.)
- Correspondence:
| | - Luigi Zugaro
- Department of Emergency and Interventional Radiology, San Salvatore Hospital, 67100 L’Aquila, Italy; (L.Z.); (F.A.)
| | - Eva Fascetti
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.F.); (F.B.)
| | - Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (E.F.); (F.B.)
| | - Carmine Zoccali
- Orthopaedics and Traumatology Unit, Policlinico Umberto I, Sapienza University of Rome, 00185 Roma, Italy;
| | - Francesco Arrigoni
- Department of Emergency and Interventional Radiology, San Salvatore Hospital, 67100 L’Aquila, Italy; (L.Z.); (F.A.)
| |
Collapse
|
2
|
Le Corroller T, Vives T, Mattei JC, Pauly V, Guenoun D, Rochwerger A, Champsaur P. Osteoid Osteoma: Percutaneous CT-guided Cryoablation Is a Safe, Effective, and Durable Treatment Option in Adults. Radiology 2021; 302:392-399. [PMID: 34812672 DOI: 10.1148/radiol.2021211100] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Cryoablation is playing an increasing role in the percutaneous treatment of bone tumors. However, despite its potential advantages over heat-based ablation techniques, the clinical safety and efficacy of cryoablation have not been established for osteoid osteoma treatment. Purpose To evaluate percutaneous CT-guided cryoablation for the treatment of osteoid osteoma in young patients and adults. Materials and Methods This retrospective study reviewed data from 50 consecutive patients who underwent percutaneous CT-guided cryoablation for the treatment of osteoid osteoma between January 2013 and June 2019 in a single institution. In 30 of 50 patients (60%), the procedure was carried out with the patient under local anesthesia and conscious sedation, with the cryoprobe covering the lesion from an extraosseous position, avoiding direct penetration of the nidus. Clinical and radiologic features, procedure-related data, visual analog scale (VAS) pain scores, complications, and overall success rate were evaluated. Statistical analyses were performed by using the nonparametric Friedman test and Wilcoxon signed rank test for repeated measures. Results Fifty patients (median age, 24 years; interquartile range [IQR], 19-38 years; 31 men) underwent CT-guided cryoablation for the treatment of osteoid osteoma, with a 96% (48 of 50 patients) overall clinical success rate. Of the two patients without clinical success, one patient had incomplete pain relief and the other experienced a recurrence of osteoid osteoma at 11 months, which was successfully treated with a second cryoablation procedure. The median VAS pain score was 8 (IQR, 7-8) before the procedure and 0 (IQR, 0-1; P < .001) after the procedure at both primary (6 weeks) and secondary (18-90 months) follow-up. Three of the 50 patients had minor complications (6%); no major complications were reported. Conclusion Osteoid osteoma was safely, effectively, and durably treated with CT-guided percutaneous cryoablation. In the majority of patients, treatment could be performed without general anesthesia, with the cryosphere covering the nidus from an extraosseous position. © RSNA, 2021.
Collapse
Affiliation(s)
- Thomas Le Corroller
- From the Department of Radiology, Hôpitaux Sud, Assistance Publique - Hôpitaux de Marseille, Marseille, France (T.L.C., T.V., D.G., P.C.); Aix Marseille Université, CNRS, ISM UMR 7287, Marseille, France (T.L.C., D.G., P.C.); Department of Orthopedic Surgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France (J.C.M., A.R.); and Aix Marseille Université, Unité de Recherche EA 3279, Santé Publique et Maladies Chroniques, Marseille, France (V.P.)
| | - Thomas Vives
- From the Department of Radiology, Hôpitaux Sud, Assistance Publique - Hôpitaux de Marseille, Marseille, France (T.L.C., T.V., D.G., P.C.); Aix Marseille Université, CNRS, ISM UMR 7287, Marseille, France (T.L.C., D.G., P.C.); Department of Orthopedic Surgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France (J.C.M., A.R.); and Aix Marseille Université, Unité de Recherche EA 3279, Santé Publique et Maladies Chroniques, Marseille, France (V.P.)
| | - Jean-Camille Mattei
- From the Department of Radiology, Hôpitaux Sud, Assistance Publique - Hôpitaux de Marseille, Marseille, France (T.L.C., T.V., D.G., P.C.); Aix Marseille Université, CNRS, ISM UMR 7287, Marseille, France (T.L.C., D.G., P.C.); Department of Orthopedic Surgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France (J.C.M., A.R.); and Aix Marseille Université, Unité de Recherche EA 3279, Santé Publique et Maladies Chroniques, Marseille, France (V.P.)
| | - Vanessa Pauly
- From the Department of Radiology, Hôpitaux Sud, Assistance Publique - Hôpitaux de Marseille, Marseille, France (T.L.C., T.V., D.G., P.C.); Aix Marseille Université, CNRS, ISM UMR 7287, Marseille, France (T.L.C., D.G., P.C.); Department of Orthopedic Surgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France (J.C.M., A.R.); and Aix Marseille Université, Unité de Recherche EA 3279, Santé Publique et Maladies Chroniques, Marseille, France (V.P.)
| | - Daphné Guenoun
- From the Department of Radiology, Hôpitaux Sud, Assistance Publique - Hôpitaux de Marseille, Marseille, France (T.L.C., T.V., D.G., P.C.); Aix Marseille Université, CNRS, ISM UMR 7287, Marseille, France (T.L.C., D.G., P.C.); Department of Orthopedic Surgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France (J.C.M., A.R.); and Aix Marseille Université, Unité de Recherche EA 3279, Santé Publique et Maladies Chroniques, Marseille, France (V.P.)
| | - Alexandre Rochwerger
- From the Department of Radiology, Hôpitaux Sud, Assistance Publique - Hôpitaux de Marseille, Marseille, France (T.L.C., T.V., D.G., P.C.); Aix Marseille Université, CNRS, ISM UMR 7287, Marseille, France (T.L.C., D.G., P.C.); Department of Orthopedic Surgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France (J.C.M., A.R.); and Aix Marseille Université, Unité de Recherche EA 3279, Santé Publique et Maladies Chroniques, Marseille, France (V.P.)
| | - Pierre Champsaur
- From the Department of Radiology, Hôpitaux Sud, Assistance Publique - Hôpitaux de Marseille, Marseille, France (T.L.C., T.V., D.G., P.C.); Aix Marseille Université, CNRS, ISM UMR 7287, Marseille, France (T.L.C., D.G., P.C.); Department of Orthopedic Surgery, Hôpital Nord, Assistance Publique - Hôpitaux de Marseille, Marseille, France (J.C.M., A.R.); and Aix Marseille Université, Unité de Recherche EA 3279, Santé Publique et Maladies Chroniques, Marseille, France (V.P.)
| |
Collapse
|
3
|
Serrano E, Zarco F, Gill AE, Hawkins CM, Macías N, Inarejos Clemente EJ, Torner F, Barber I, Corominas D, González EL, López-Rueda A, Gómez FM. Percutaneous cryoablation of chondroblastoma and osteoblastoma in pediatric patients. Insights Imaging 2021; 12:106. [PMID: 34313884 PMCID: PMC8314258 DOI: 10.1186/s13244-021-01036-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To review the safety and efficacy of percutaneous cryoablation for the treatment of chondroblastoma and osteoblastoma in the pediatric and adolescent population. MATERIALS AND METHODS A retrospective review from 2016 to 2020 was performed to evaluate clinical and imaging response to percutaneous cryoablation in 11 symptomatic patients with diagnosis of chondroblastoma and osteoblastoma treated from two pediatric hospitals with at least 12-month follow-up. Technical success (correct needle placement and potential full coverage of the tumor with the planned ablation zone) and clinical success (relief of the symptoms) were evaluated. The primary objective was to alleviate pain related to the lesion(s). Immediate and late complications were recorded. Patients were followed in clinic and with imaging studies such as MRI or CT for a minimum of 6 months. RESULTS A total of 11 patients were included (mean 14 years, age range 9-17; male n = 8). Diagnoses were osteoblastoma (n = 4) and chondroblastoma (n = 7). Locations were proximal humerus (n = 1), femur condyle (n = 1), and proximal femur (n = 1) tibia (n = 3), acetabulum (n = 3), thoracic vertebra (n = 1) and lumbar vertebra (n = 1). Cryoablation was technically successful in all patients. Clinical success (cessation of pain) was achieved in all patients. No signs of recurrence were observed on imaging follow-up in any of the patients. One of the patients developed periprocedural right L2-L3 transient radiculopathy as major immediate complication. CONCLUSIONS Percutaneous image-guided cryoablation can be considered potentially safe and effective treatment for chondroblastoma and osteoblastoma in children and adolescents.
Collapse
Affiliation(s)
- Elena Serrano
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Federico Zarco
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Anne E Gill
- Department of Interventional Radiology, Children's Healthcare of Atlanta, Egleston Hospital, Atlanta, Georgia
| | - C Matthew Hawkins
- Department of Interventional Radiology, Children's Healthcare of Atlanta, Egleston Hospital, Atlanta, Georgia
| | - Napoleón Macías
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | | | - Ferran Torner
- Pediatric Orthopaedics and Traumatology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Ignasi Barber
- Department of Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Daniel Corominas
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Enrique Ladera González
- Department of Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Antonio López-Rueda
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain.,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Fernando M Gómez
- Department of Interventional Radiology, Hospital Clínic Barcelona, Barcelona, Spain. .,Department of Interventional Radiology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
| |
Collapse
|