Adam N Wallace1, Anderanik Tomasian2, Randy O Chang3, Jack W Jennings2. 1. Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Saint Louis, MO, 63110, USA. wallacea@mir.wustl.edu. 2. Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Saint Louis, MO, 63110, USA. 3. Washington University School of Medicine, 660 South Euclid Avenue, Saint Louis, MO, 63110, USA.
Abstract
BACKGROUND: Percutaneous CT-guided radiofrequency ablation is a safe and effective minimally invasive treatment for osteoid osteomas. This technical case series describes the use of a recently introduced ablation system with a probe that can be curved in multiple directions, embedded thermocouples for real-time monitoring of the ablation volume, and a bipolar design that obviates the need for a grounding pad. METHODS: Medical records of all patients who underwent radiofrequency ablation of an osteoid osteoma with the STAR Tumor Ablation System (DFINE; San Jose, CA) were reviewed. The location of each osteoid osteoma, nidus volume, and procedural details were recorded. Treatment efficacy and long-term complications were assessed at clinical follow-up. RESULTS: During the study period, 18 osteoid osteomas were radiofrequency ablated with the multidirectional bipolar system. Lesion locations included the femur (50%; 9/18), tibia (22%; 4/18), cervical spine (11%; 2/18), calcaneus (5.5%; 1/18), iliac bone (5.5%; 1/18), and fibula (5.5%; 1/18). The median nidus volume of these cases was 0.33 mL (range 0.12-2.0 mL). All tumors were accessed via a single osseous channel. Median cumulative ablation time was 5 min and 0 s (range 1 min and 32 s-8 min and 50 s). All patients with clinical follow-up reported complete symptom resolution. No complications occurred. CONCLUSION: Safe and effective CT-guided radiofrequency ablation of osteoid osteomas can be performed in a variety of locations using a multidirectional bipolar system.
BACKGROUND: Percutaneous CT-guided radiofrequency ablation is a safe and effective minimally invasive treatment for osteoid osteomas. This technical case series describes the use of a recently introduced ablation system with a probe that can be curved in multiple directions, embedded thermocouples for real-time monitoring of the ablation volume, and a bipolar design that obviates the need for a grounding pad. METHODS: Medical records of all patients who underwent radiofrequency ablation of an osteoid osteoma with the STAR Tumor Ablation System (DFINE; San Jose, CA) were reviewed. The location of each osteoid osteoma, nidus volume, and procedural details were recorded. Treatment efficacy and long-term complications were assessed at clinical follow-up. RESULTS: During the study period, 18 osteoid osteomas were radiofrequency ablated with the multidirectional bipolar system. Lesion locations included the femur (50%; 9/18), tibia (22%; 4/18), cervical spine (11%; 2/18), calcaneus (5.5%; 1/18), iliac bone (5.5%; 1/18), and fibula (5.5%; 1/18). The median nidus volume of these cases was 0.33 mL (range 0.12-2.0 mL). All tumors were accessed via a single osseous channel. Median cumulative ablation time was 5 min and 0 s (range 1 min and 32 s-8 min and 50 s). All patients with clinical follow-up reported complete symptom resolution. No complications occurred. CONCLUSION: Safe and effective CT-guided radiofrequency ablation of osteoid osteomas can be performed in a variety of locations using a multidirectional bipolar system.
Authors: Antonio Izzo; Luigi Zugaro; Eva Fascetti; Federico Bruno; Carmine Zoccali; Francesco Arrigoni Journal: J Clin Med Date: 2021-12-07 Impact factor: 4.241