Abstract | OBJECTIVES: To present the results of biopsy and computed tomography (CT) guided radiofrequency ablation (RFA) for non-spinal osteoid osteomas, and compare the results before and after procedural modifications. METHODS: We retrospectively studied 557 patients with non-spinal osteoid osteomas treated with biopsy and CT-guided RFA. In 68 patients we used 3-mm CT at 2-mm intervals, 19 G/5-mm active tip electrodes, and one 4-minute ablation at 90-93°C. In 489 patients we used contiguous 1-mm CT, 20 G/5-15-mm electrodes, ablation maintaining 60°C for 2 min followed by 14-15 min at 90-93°C, and multiple ablations in the same session for large and multiform lesions. RESULTS: 533/557 patients (96%) remained asymptomatic and 24/557 (4%) had recurrence; repeat RFA was successful in 22/24 patients (92%). Biopsy was non-diagnostic in 82%. With the modifications performed, success improved from 79% to 98%, recurrences reduced from 21% to 2% and complications from 5.9% to 0.2% (p < 0.001). All patients with large and multiform lesions treated with one ablation had recurrence, compared to no patient with similar lesions and multiple ablations in the same session. CONCLUSION:
Electrode parameters, duration of ablation, morphology and size of osteoid osteomas are important for RFA. The above modifications are recommended for improved outcome.
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Authors | Eugenio Rimondi, Andreas F Mavrogenis, Giuseppe Rossi, Rosanna Ciminari, Cristina Malaguti, Cristina Tranfaglia, Daniel Vanel, Pietro Ruggieri |
Journal | European radiology
(Eur Radiol)
Vol. 22
Issue 1
Pg. 181-8
(Jan 2012)
ISSN: 1432-1084 [Electronic] Germany |
PMID | 21842430
(Publication Type: Evaluation Study, Journal Article)
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Topics |
- Adolescent
- Adult
- Aged
- Biopsy
- Bone Neoplasms
(diagnostic imaging, pathology, surgery)
- Catheter Ablation
(methods)
- Child
- Child, Preschool
- Female
- Humans
- Male
- Middle Aged
- Osteoma, Osteoid
(diagnostic imaging, pathology, surgery)
- Retrospective Studies
- Surgery, Computer-Assisted
(methods)
- Tomography, X-Ray Computed
- Treatment Outcome
- Young Adult
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