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Arpaia V, Vicenzo E, Belfiore MP, Pirolo L, Varriale E, Ferrante A, Belfiore G, Sandomenico F. Osteoid osteoma of third metatarsal bone treated with radiofrequency ablation: Case report, imaging findings and review of the literature. Radiol Case Rep 2024; 19:4636-4643. [PMID: 39220793 PMCID: PMC11363722 DOI: 10.1016/j.radcr.2024.07.070] [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: 04/12/2024] [Revised: 07/12/2024] [Accepted: 07/13/2024] [Indexed: 09/04/2024] Open
Abstract
Osteoid Osteoma (OO) is a frequent benign bone tumor that commonly affects males between 5 and 25. It usually arises from appendicular skeleton involving typically femur and tibia. OOs arising from small bones of hands and feet are very uncommon and metatarsal lesions account for only 1.7%. We report a case of a 20 year-old boy with a long history of nocturnal left foot pain with a good clinical response to assumption of salicylates or nonsteroidal anti-inflammatory drugs (NSAIDs). Plain radiograph of his left showed unconclusive results. Therefore, he underwent a contrast enhanced CT (CECT) scan with multiplanar reconstruction (MPR) that showed a bony lesion in the left third metatarsal bone that was compatible with a nidus even in absence of clear peri-nidal sclerosis. Therefore, other ancillary techniques such as MRI and bone scintigraphy were performed. Conclusive diagnosis was OO of third left metatarsal bone. Our patient underwent a mini-invasive treatment with radiofrequency (RF) ablation. After recovery, our patient had no post-operative complications and showed optimal clinical conditions with complete remission of left foot pain and no change or impairment in walking. In this essay, we discuss key imaging findings of OO of small bones and its treatment with radiofrequency ablation. We describe method of execution and illustrate advantages of this mini-invasive technique. We also perform a review of the literature.
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Affiliation(s)
- Valerio Arpaia
- Department of Diagnostic Imaging and Radiotherapy, Azienda Ospedaliera Universitaria “Federico II”, Via Pansini 5, 80131, Naples, Italy
| | - Emilio Vicenzo
- Radiology Department, Buon Consiglio Fatebenefratelli Hospital, Via Manzoni 220, 80123, Naples, Italy
| | - Maria Paola Belfiore
- Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Piazza Miraglia 2, 80110, Naples, Italy
| | - Luigi Pirolo
- Radiology Department, Buon Consiglio Fatebenefratelli Hospital, Via Manzoni 220, 80123, Naples, Italy
| | - Elisa Varriale
- Oncology Unit, Medicine Department, Buon Consiglio Fatebenefratelli Hospital, Via Manzoni 220, 80123, Naples, Italy
| | - Anna Ferrante
- Oncology Unit, Medicine Department, Buon Consiglio Fatebenefratelli Hospital, Via Manzoni 220, 80123, Naples, Italy
| | - Giuseppe Belfiore
- Radiology Department, “Casa di cura Dr. Prof. Luigi Cobellis” C.da Badia - 84078, Vallo della Lucania Salerno, Italy
| | - Fabio Sandomenico
- Radiology Department, Buon Consiglio Fatebenefratelli Hospital, Via Manzoni 220, 80123, Naples, Italy
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Mutlu IN, Cingoz M, Guzelbey T, Cingoz E, Kilickesmez O. Percutaneous CT-Guided Microwave Ablation for the Treatment of Osteoid Osteomas: A Single Center Experience. Acad Radiol 2024; 31:3725-3731. [PMID: 38490842 DOI: 10.1016/j.acra.2024.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 03/17/2024]
Abstract
RATIONALE AND OBJECTIVES The aim of the current study was to evaluate the feasibility and effectiveness of CT-guided microwave ablation (MWA) in the treatment of osteoid osteomas (OO). MATERIALS AND METHODS Data from 59 consecutive patients who underwent percutaneous CT-MWA for OO treatment were examined in the current retrospective study. The period of this study spanned from January 2021 to May 2023 at a single institution. The study involved an evaluation of clinical and radiological characteristics, procedural data, Visual Analog Scale (VAS) pain scores, complication incidences, as well as clinical and technical success rates. Statistical analyses were performed by using the Wilcoxon test with Bonferroni correction, Friedman, Spearman, Mann-Whitney U test. RESULTS 59 patients with an average age of 17.31 ± 8.53 years underwent CT-guided MWA for the treatment of OO. The procedure demonstrated a high success rate, with 96.6% of cases achieving both technical and clinical success. However, recurrence was observed in two patients (3.4%) at the three-month follow-up. These cases were successfully managed with a second MWA procedure. The median VAS pain scores reported by the patients was significantly improved post-procedure: from 8.64 ± 1.14 before treatment to 0.63 ± 0.98 in the first month, 0.41 ± 1.02 in the third month, and 0.15 ± 0.45 in the sixth month. Only one patient (1.7%) experienced a minor complication; no major complications were recorded in this study. CONCLUSION CT-guided percutaneous MWA is a minimally invasive and a highly effective and safe approach for the treatment of OO.
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Affiliation(s)
- Ilhan Nahit Mutlu
- Department of Radiology, Basaksehir Cam And Sakura City Hospital, Basaksehir 34480, Istanbul, Turkey
| | - Mehmet Cingoz
- Department of Radiology, Basaksehir Cam And Sakura City Hospital, Basaksehir 34480, Istanbul, Turkey.
| | - Tevfik Guzelbey
- Department of Radiology, Basaksehir Cam And Sakura City Hospital, Basaksehir 34480, Istanbul, Turkey
| | - Eda Cingoz
- Department of Radiology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ozgur Kilickesmez
- Department of Radiology, Basaksehir Cam And Sakura City Hospital, Basaksehir 34480, Istanbul, Turkey
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Doelakeh ES, Weerarathna IN, Luharia A. Microwave Ablation for Osteoid Osteoma in a Young Patient: A Case Report. Cureus 2024; 16:e61332. [PMID: 38947687 PMCID: PMC11214646 DOI: 10.7759/cureus.61332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 05/29/2024] [Indexed: 07/02/2024] Open
Abstract
Osteoid osteoma (OO) is a common benign ossifying lesion that is most prevalent among youth. Usually, it attacks the diaphyseal or metaphyseal bones that are tubular. The common hallmark of muscle pain is the reported occurrence of night pain that is nearly always present, yields satisfactory responses from nonsteroidal anti-inflammatory medications, and may be joined by complaints regarding physical activities. Also, it shows typical signs of study procedures like computed tomography (CT) and magnetic resonance imaging (MRI). A nidus, which is the primary marker in the diagnostic formation of shadowed images, is a crucial sign of an OO. This source is usually portrayed as an oval lytic lesion, measuring 1 cm flat and surrounded by a region of reactive ossification. It is laborious to diagnose OO since the condition is frequently confused with many other ones, and testing and therapy may be delayed and complicated as a result. There are still few studies on OO diagnosis and distinguishing of surrogate conditions. Unfortunately, either ablation or resection can be said to be the cure. Improved detection of OO shows the possibility for prompt diagnosis, fewer patient discomfort and side effects, less cost involved in unnecessary treatments, and a rightly diagnosed condition.
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Affiliation(s)
| | - Induni N Weerarathna
- Biomedical Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anurag Luharia
- Radiology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Reis J, Koo KSH, Shivaram GM, Shaw DW, Iyer RS. Time-Driven Activity-Based Cost Comparison of Osteoid Osteoma Ablation Techniques. J Am Coll Radiol 2024; 21:567-575. [PMID: 37473855 DOI: 10.1016/j.jacr.2023.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/27/2023] [Accepted: 02/07/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE Compare the cost of performing an osteoid osteoma ablation using cone beam CT (CBCT) with overlay fluoroscopic guidance to ablation using conventional CT (CCT) guidance and microwave ablation (MWA) to radiofrequency ablation (RFA). METHODS An 11-year retrospective study was performed of all patients undergoing osteoid osteoma ablation. Ablation equipment included a Cool tip RFA probe (Covidien, Minneapolis, Minnesota) or a Neuwave PR MWA probe (Ethicon, Rariton, New Jersey). The room times as well as immediate recovery time were recorded for each case. Cost analysis was then performed using time-driven activity-based costing for rate-dependent variables including salaries, equipment depreciation, room time, and certain supplies. Time-independent costs included the disposable interventional radiology supplies and ablation systems. Costs were reported for each service providing care and using conventional cost accounting methods with variable and fixed expenditures. RESULTS A total of 91 patients underwent 96 ablation procedures in either CBCT (n = 66) or CCT (n = 30) using either MWA (n = 51) or RFA (n = 45). The anesthesia induction (22.7 ± 8.7 min versus 15.9 ± 7.2 min, P < .001), procedure (64.7 ± 27.5 min versus 47.3 ± 15.3 min; P = .001), and room times (137.7 ± 33.7 min versus 103.9 ± 22.6. min; P < .001) were significantly longer for CBCT procedures. The procedure time did not differ significantly between MWA and RFA (62.1 ± 27.4 min versus 56.1 ± 23.3 min; P = .27). Multiple regression analysis demonstrated lower age (P = .046), CBCT use (P = .001), RFA use (P = .02), and nonsupine patient position (P = .01) significantly increased the total procedural cost. After controlling for these variables, the total cost of CBCT ($5,981.32 ± $523.93 versus $5,378.93 ± $453.12; P = .001) remained higher than CCT and the total cost of RFA ($5,981.32 ± $523.93 versus $5,674.43 ± $549.14; P = .05) approached a higher cost than MWA. CONCLUSION The use of CBCT with overlay fluoroscopic guidance for osteoid osteoma ablation resulted in longer in-room times and greater cost when compared with CCT. These cost considerations should be weighed against potential radiation dose advantage of CBCT when choosing an image guidance modality. Younger age, RFA use, and nonsupine patient position additionally contributed to higher costs.
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Affiliation(s)
- Joseph Reis
- Director of Interventional Radiology Enteric Access Service, Department of Radiology, Seattle Children's Hospital, Seattle, Washington; Co-Medical Director of Vascular Access Service, and Medical Director of Clinical Strategy in Radiology, Department of Radiology, Seattle Children's Hospital, Seattle, Washington; Section Chief of Pediatric Interventional Radiology, Department of Radiology, Seattle Children's Hospital, Seattle, Washington.
| | - Kevin S H Koo
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington; Vice Chair of Education, Department of Radiology, University of Washington School of Medicine; Panel Chair, ACR Appropriateness Criteria-Pediatrics; Chair, ACR Strategic Planning and Compliance Committee, Commission on Publications and Lifelong Learning
| | - Giri M Shivaram
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington; Vice Chair of Education, Department of Radiology, University of Washington School of Medicine; Panel Chair, ACR Appropriateness Criteria-Pediatrics; Chair, ACR Strategic Planning and Compliance Committee, Commission on Publications and Lifelong Learning
| | - Dennis W Shaw
- Director of Magnetic Resonance Imaging, Department of Radiology, Seattle Children's Hospital, Seattle, Washington
| | - Ramesh S Iyer
- Department of Radiology, Seattle Children's Hospital, Seattle, Washington; Vice Chair of Education, Department of Radiology, University of Washington School of Medicine; Panel Chair, ACR Appropriateness Criteria-Pediatrics; Chair, ACR Strategic Planning and Compliance Committee, Commission on Publications and Lifelong Learning
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Tomasian A, Cazzato RL, Sharma K, Gangi A, Jennings JW. Benign Bone Tumors: State of the Art in Minimally Invasive Percutaneous Interventions. Radiographics 2023; 43:e220041. [PMID: 36563097 DOI: 10.1148/rg.220041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Painful benign bone tumors most commonly affect pediatric patients and young adults. They may be associated with skeletal-related events such as intractable pain, pathologic fracture, neurologic deficit as a consequence of nerve or spinal cord compression, as well as growth disturbance. Consequently, they often result in diminished activity and adversely affect quality of life. There have been substantial recent advances in percutaneous minimally invasive image-guided interventions for treatment of painful benign bone tumors including thermal ablation (radiofrequency ablation, cryoablation, microwave ablation, laser photocoagulation, and high-intensity focused US ablation), chemical (alcohol) ablation, cementoplasty, and intralesional injections. The safety, efficacy, and durability of such interventions have been established in the recent literature and as such, the role of musculoskeletal interventional radiologists in the care of patients with benign bone lesions has substantially expanded. The treatment goal of minimally invasive musculoskeletal interventions in patients with benign bone tumors is to achieve definitive cure. The authors detail the most recent advances and available armamentarium in minimally invasive image-guided percutaneous interventions with curative intent for the management of benign bone tumors. © RSNA, 2022.
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Affiliation(s)
- Anderanik Tomasian
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
| | - Roberto Luigi Cazzato
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
| | - Karun Sharma
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
| | - Afshin Gangi
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
| | - Jack W Jennings
- From the Department of Radiological Sciences, University of California, Irvine, 101 The City Dr S, Orange, CA 92868 (A.T.); Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France (R.L.C., A.G.); Department of Radiology, Children's National Hospital, Washington, DC (K.S.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.W.J.)
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Radiofrequency ablation is as safe and effective as surgical excision for spinal osteoid osteoma: a systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:210-220. [PMID: 36214895 DOI: 10.1007/s00586-022-07411-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Osteoid osteoma (OO) is a primary benign tumor that affects mainly young patients. Ten percent of all OO are located in the vertebral column. Treatment of spinal OO is challenging and there is no consensus in the literature on the best operative approach. PURPOSE The aim of this systematic review and meta-analysis was to determine safety and efficacy of radiofrequency ablation (RFA) versus surgical excision for the treatment of spinal OO. METHODS A literature search was performed on PubMed, Web of Science, and Embase from inception up to 22 March 2022. Studies addressing surgical excision or RFA for the treatment of spinal OO were included. The main outcomes evaluated were pain before and after intervention, the treatments success rate, defined as complete pain relief with no recurrence until the last follow-up, and the number and type of complications. RESULTS Thirty-one studies (749 patients) were included. For patients who underwent surgical excision, 19 studies reported a mean treatment success rate of 85.6%, while in the RFA treatment group, 18 studies reported a mean success rate of 88.6%. At last follow-up, the pooled mean difference in pain scores from baseline on a 0-10 scale was 5.8 points in the surgical excision group and 6.7 points in the RFA group. Recurrences were observed in 5.6% of the patients who underwent surgical excision and in 6.7% of the patients treated with RFA. The complication rate was 7.8% in the surgical excision group and 4.4% in the RFA group. CONCLUSIONS This meta-analysis found high global success rates for both surgical and RFA treatments. Both treatments were efficient in pain relief and presented a low rate of recurrences. The complication rate was low for both treatments. Compared to surgical excision, RFA is a less invasive procedure which proved to be a safe and as effective option for the treatment of spinal OO.
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Shu M, Ke J. The surgical management of osteoid osteoma: A systematic review. Front Oncol 2022; 12:935640. [PMID: 35936708 PMCID: PMC9355277 DOI: 10.3389/fonc.2022.935640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background Osteoid osteoma (OO) comprises approximately 11%-14% of benign bone tumors. The main symptom of OO is localized pain accompanied by nighttime aggravation. Surgical treatment is frequently used in clinic, including open surgery and percutaneous ablation, the latter including radiofrequency ablation, cryoablation, and microwave ablation, but there is no consensus on when and how to choose the best treatment for OO. Purpose We did a systematic review of the literature on existing surgical treatments of OO to assess the safety and efficacy of surgical treatments of OO and to evaluate the surgical options for different locations of OO. Methods The inclusion criteria in the literature are 1. Patients diagnosed with osteoid osteoma and treated surgically; 2. Include at least five patients; 3. Perioperative visual analogue scale (VAS), postoperative complications, and recurrence were recorded; 4. Literature available in PubMed from January 2014 to December 2021. Results In the cohort, 1565 patients (mainly adolescents) with OO received 1615 treatments. And there are 70 patients with postoperative recurrence and 93 patients with postoperative complications (minor: major=84:9). The results of Kruskal-Wallis examination of each experimental index in this experiment were clinical success rate H=14.818, p=0.002, postoperative short-term VAS score H=212.858, p<0.001, postoperative long-term VAS score H=122.290, p<0.001, complication rate H=102.799, p<0.001, recurrence rate H=17.655, p<0.001, the technical success rate was H=45.708, p<0.001, according to the test criteria of α=0.05, H0 was rejected. The overall means of the outcome index in each group were not completely equal. Conclusion Percutaneous ablation and open surgery are safe and reliable for OOs, and the technical success rate of percutaneous ablation is higher than that of open surgery. Open surgery and cryoablation can be selected for OOs close to the nerve and atypical sites, while radiofrequency ablation and microwave ablation can be selected for OOs in most other sites.
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Affiliation(s)
- Man Shu
- Department of Orthopaedics, General Hospital of Southern Theater Command, Southern Medical University, Guangzhou, China
| | - Jin Ke
- Department of Orthopaedics, ZhuJiang Hospital of Southern Medical University, Southern Medical University, Guangzhou, China
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Parisot L, Grillet F, Verdot P, Danner A, Brumpt E, Aubry S. CT-guided microwave ablation of osteoid osteoma: Long-term outcome in 28 patients. Diagn Interv Imaging 2022; 103:427-432. [PMID: 35523700 DOI: 10.1016/j.diii.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to assess the long-term efficacy of CT-guided microwave ablation (MWA) in the treatment of osteoid osteoma. Secondary objectives were to assess early outcome and side-effects of MWA. MATERIALS AND METHODS Twenty-eight consecutive patients (18 men, 10 women) with a median age of 19.5 years (IQR: 16, 25.5) with a total of 28 non-spinal osteoid osteoma treated by CT-guided MWA were retrospectively included. The ablations were performed with a median power and duration of 60 Watt and 1 min 30 s, respectively. Pain referred to osteoid osteoma was assessed at predefined time points using a 0-10 numeric rating scale. At one month, contrast-enhanced follow-up MRI was performed to evaluate the nidus vascularization and the volume of necrosis induced by MWA. Clinical success was defined by the absence of osteoid osteoma-related pain, and technical success was defined by the presence of necrosis of the nidus on the one-month post-MWA MRI. RESULTS Long term success rate was 93% (26/28) after a follow-up of 55.5 months (IQR: 25.75, 74.5) and technical success rate was 96 % (25/26). One late failure was observed after a patient had been declared cured at one month but the formal proof of a late recurrence of osteoid osteoma could not be brought. Three minor complications were reported including mild reversible superficial radial nerve injury with a skin burn (grade 2) in one patient and moderate skin burn only in two patients. CONCLUSION Our results suggest that CT-guided MWA is an effective option for a minimally-invasive treatment of osteoid osteoma with a low rate of complication and no late recurrence.
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Affiliation(s)
- Lucie Parisot
- Department of Radiology, CHU de Besancon, 25030 Besancon, France
| | - Franck Grillet
- Department of Radiology, CHU de Besancon, 25030 Besancon, France; Department of Radiology, Centre Leon Bérard, 69008 Lyon, France
| | - Pierre Verdot
- Department of Radiology, CHU de Besancon, 25030 Besancon, France
| | - Alexis Danner
- Department of Radiology, CHU de Besancon, 25030 Besancon, France
| | - Eléonore Brumpt
- Department of Radiology, CHU de Besancon, 25030 Besancon, France; Nanomedicine laboratory EA4662. University of Franche-Comté, 25000 Besancon, France
| | - Sébastien Aubry
- Department of Radiology, CHU de Besancon, 25030 Besancon, France; Nanomedicine laboratory EA4662. University of Franche-Comté, 25000 Besancon, France.
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Bianchi G, Zugaro L, Palumbo P, Candelari R, Paci E, Floridi C, Giovagnoni A. Interventional Radiology’s Osteoid Osteoma Management: Percutaneous Thermal Ablation. J Clin Med 2022; 11:jcm11030723. [PMID: 35160184 PMCID: PMC8836989 DOI: 10.3390/jcm11030723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 01/27/2023] Open
Abstract
Osteoid osteoma (OO) is one of the most common benign bone tumors with specific clinical and radiological characteristics. Analgesic therapy and surgical treatment have been considered the only therapy for a long time. Recently, safe and effective new therapeutic options have been introduced, among which percutaneous thermal ablation techniques. This review aims to describe the recent updates in the field of percutaneous thermal ablation techniques in the treatment of OO, assessing the outcomes in terms of efficacy, complications, and recurrence rate.
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Affiliation(s)
- Giampaolo Bianchi
- Diagnostic and Interventional Radiology, SS. Filippo e Nicola Hospital, 67051 Avezzano, Italy
- Correspondence:
| | - Luigi Zugaro
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (L.Z.); (P.P.)
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (L.Z.); (P.P.)
| | - Roberto Candelari
- Interventional Radiology, Department of Radiology, Az. Osp-Univ OORR-Torrette, 60100 Ancona, Italy; (R.C.); (E.P.)
| | - Enrico Paci
- Interventional Radiology, Department of Radiology, Az. Osp-Univ OORR-Torrette, 60100 Ancona, Italy; (R.C.); (E.P.)
| | - Chiara Floridi
- Department of Radiology, University Hospital “Umberto I-Lancisi-Salesi”, 60100 Ancona, Italy;
| | - Andrea Giovagnoni
- Department of Radiological Sciences, Ospedali Riuniti, Marche Polytechnic University, 60100 Ancona, Italy;
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Westlake B, Mazzi J, Tedesco N. Osteoid Osteoma Treatment with Microwave Ablation: A Report of Two Cases. ACTA ACUST UNITED AC 2021; 57:medicina57050470. [PMID: 34064587 PMCID: PMC8151136 DOI: 10.3390/medicina57050470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/25/2021] [Accepted: 05/04/2021] [Indexed: 11/16/2022]
Abstract
Osteoid osteomas are one of the most common bone tumors. Although benign in nature, they can cause significant pain and distress to the afflicted patient. The main goal of treatment is to relieve pain. Historically, these tumors were treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or surgery. Percutaneous ablative techniques have since gained popularity because of their efficacy and low risk profiles. Radiofrequency ablation was the first of these technologies used in the treatment of these tumors. More recently, microwave ablation has gained popularity. However, the literature is sparse regarding the safety and efficacy of this treatment. Here, we discuss our experience with microwave ablation in the treatment of osteoid osteomas in two patients and review the current literature on this technique. Microwave ablation in the treatment of osteoid osteoma seems to be a safe and effective treatment for this tumor.
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Affiliation(s)
- Babe Westlake
- Department of Orthopedic Surgery, Good Samaritan Regional Medical Center, Corvallis, OR 97330, USA;
- Correspondence:
| | - Jessica Mazzi
- Western University of Health Sciences COMP-NW, Lebanon, OR 97355, USA;
| | - Nicholas Tedesco
- Department of Orthopedic Surgery, Good Samaritan Regional Medical Center, Corvallis, OR 97330, USA;
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Parmeggiani A, Martella C, Ceccarelli L, Miceli M, Spinnato P, Facchini G. Osteoid osteoma: which is the best mininvasive treatment option? EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2021; 31:1611-1624. [PMID: 33839926 PMCID: PMC8578134 DOI: 10.1007/s00590-021-02946-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/21/2021] [Indexed: 01/21/2023]
Abstract
Osteoid osteoma is the third most common benign bone tumor, with well-known clinical presentation and radiological features. Although surgical excision has been the only therapeutic option for a long time, to date it has been replaced by minimally invasive techniques, which proved satisfactory success rates and low complication occurrence. Therefore, the purpose of this literature review was to describe the main updates of these recent procedures in the field of interventional radiology, with particular attention paid to the results of the leading studies relating to the efficacy, complications, and recurrence rate. Nevertheless, this study aimed to analyze the peculiarities of each reported technique, with specific focus on the possible improvements and pitfalls. Results proved that all mininvasive procedures boast a high success rate with slight number of complications and a low recurrence rate. Radiofrequency ablation is still considered the gold standard procedure for percutaneous treatment of osteoid osteoma, and it has the possibility to combine treatment with a biopsy. Interstitial laser ablation's advantages are the simplicity of use and a lower cost of the electrodes, while cryoablation allows real-time visualization of the ablated zone, increasing the treatment safety. Magnetic resonance-guided focused ultrasound surgery is the most innovative non-invasive procedure, with the unquestionable advantage to be radiation free.
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Affiliation(s)
- Anna Parmeggiani
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G.C.Pupilli, 1-40136, Bologna, Italy.
| | - Claudia Martella
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G.C.Pupilli, 1-40136, Bologna, Italy
| | - Luca Ceccarelli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G.C.Pupilli, 1-40136, Bologna, Italy.,U.O. Di Radiologia, Ospedale degli Infermi, Azienda AUSL Della Romagna, Faenza, Italy
| | - Marco Miceli
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G.C.Pupilli, 1-40136, Bologna, Italy
| | - Paolo Spinnato
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G.C.Pupilli, 1-40136, Bologna, Italy
| | - Giancarlo Facchini
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G.C.Pupilli, 1-40136, Bologna, Italy
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Wacheul E, Leemrijse T, Galant C, Malghem J, Lecouvet FE. Soft tissue recurrence of an osteoid osteoma: an exceptional observation. Skeletal Radiol 2021; 50:827-833. [PMID: 32964242 DOI: 10.1007/s00256-020-03609-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/01/2020] [Accepted: 09/10/2020] [Indexed: 02/02/2023]
Abstract
We report the observation of the soft tissue recurrence of an osteoid osteoma (OO) in a 26-year-old man initially complaining of post-traumatic pain and swelling of the right ankle. A first arthroscopic resection was performed after the misdiagnosis of "bone irregularities" observed on computed tomography (CT) and magnetic resonance imaging (MRI). The diagnosis of OO was made by histological analysis of the resection material. The patient became asymptomatic for 5 years until the symptoms progressively recurred. Follow-up MRI and CT studies demonstrated a nodular bony focus within the periarticular soft tissues of the ankle. The lesion was removed, and histological analysis confirmed the diagnosis of a whole viable OO. This observation likely resulted from the displacement of the initial lesion during the initial arthroscopic procedure. This case report highlights the possibility of recurrence of OO in the soft tissues.
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Affiliation(s)
- Emilie Wacheul
- Department of Pathology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | | | - Christine Galant
- Department of Pathology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate, 10, 1200, Brussels, Belgium
| | - Jacques Malghem
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), 10 Avenue Hippocrate, 10/2942, 1200, Brussels, Belgium
| | - Frédéric E Lecouvet
- Department of Radiology, Institut de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), 10 Avenue Hippocrate, 10/2942, 1200, Brussels, Belgium.
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Meng L, Zhang X, Xu R, Wu B, Zhang X, Wei Y, Li J, Shan H, Xiao Y. A preliminary comparative study of percutaneous CT-guided cryoablation with surgical resection for osteoid osteoma. PeerJ 2021; 9:e10724. [PMID: 33520471 PMCID: PMC7812921 DOI: 10.7717/peerj.10724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/16/2020] [Indexed: 12/28/2022] Open
Abstract
Background The traditional treatment for osteoid osteoma is the nidus’ surgical resection, which was difficult to eradicate with more invasive and complications because of osteosclerosis surrounding the nidus. This study aimed to analyze the efficacy and safety of percutaneous CT-guided cryoablation of osteoid osteoma at different sites (especially refractory sites such as the spine). Methods Fifteen patients with osteoid osteoma who underwent cryoablation at our institution were analyzed retrospectively on their imaging data and clinical visual analog scale (VAS) pain scores before and after the procedure. Fifty-three patients underwent surgical resection during the period were also included in this study as a control group. Treatment efficacy was assessed primarily by comparing the differences in VAS scores at different time points in each group of patients by paired-sample t-test. Differences in length of hospital stay and complications between the two groups were also compared. Results The technical success rate was 100% in both the cryoablation and surgical resection group. Cryoablation had a significantly shorter hospitalization time than surgery (p = 0.001). Clinically, the post-operative VAS scores were all significantly improved compared to the pre-operative period, and the clinical cure was achieved in both groups. Surgical operations had more complications than cryoablation, although there was no significant difference. In the group of cryoablation, only one patient had mild numbness of the left lower extremity, which relieved itself; two patients had mild post-operative pain. No patients in the cryoablation group experienced recurrence during the follow-up period. In the surgery group, three of the patients experienced massive bleeding (>500 ml), and two underwent transfusion therapy. Only one patient in the surgical resection group experienced a recurrence at 29 months postoperatively and underwent a second resection. All patients had local scars on the skin after surgical resection. Conclusion Cryoablation is a minimally invasive, safe, and effective treatment strategy for osteoid osteoma, and is fully comparable to surgical resection.
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Affiliation(s)
- Liangliang Meng
- Medical School of Chinese PLA, Beijing, China.,Department of Radiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China.,Department of Radiology, Chinese PAP Beijing Corps Hospital, Beijing, China
| | - Xiao Zhang
- Department of Radiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Ruijiang Xu
- Department of Pediatric Surgery, Chinese PLA General Hospital, Beijing, China
| | - Bin Wu
- Department of Radiology, Chinese PAP Beijing Corps Hospital, Beijing, China
| | - Xiaobo Zhang
- Department of Radiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Yingtian Wei
- Department of Radiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Jing Li
- Department of Radiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Husheng Shan
- Department of Radiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Yueyong Xiao
- Department of Radiology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
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