ISSN: 1899-0967
Polish Journal of Radiology
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1/2021
vol. 86
 
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Interventional radiology
abstract:
Original paper

Computed tomography-guided percutaneous radiofrequency and laser ablation for the treatment of osteoid osteoma – long-term follow-up from 5 to 10 years

Tomasz Lorenc
1
,
Hanna Kocoń
2
,
Marek Gołębiowski
1

1.
1st Department of Clinical Radiology, Medical University of Warsaw, Poland
2.
Department of Orthopedics and Traumatology of the Musculoskeletal System, Medical University of Warsaw, Poland
Pol J Radiol 2021; 86: e19-e30
Online publish date: 2021/01/12
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Introduction
The impact of computed tomography (CT)-guided, percutaneous radiofrequency ablation and interstitial laser ablation (ILA) on the management of patients with osteoid osteoma was studied. This was carried out by assessing immediate and long-term clinical outcomes, the complication rate, and repeat therapy effectiveness in recurrent patients who have already experienced percutaneous ablation.

Material and methods
Consecutive patients with osteoid osteoma were assessed before the interventional treatment in a single centre from 2010 to 2015. Patient demographics, complications, and recurrence were recorded. The pain was evaluated with Visual Analogue Scale (VAS). Percutaneous procedures were performed by means of radiofrequency thermoablation or ILA. Epidural or regional anaesthesia in the CT suite was applied in all procedures. Success, whether primary or secondary, was measured as complete pain relief without evidence of recurrence after the first or second procedure, respectively. Osteoid osteoma characteristics, procedure overview, and technical success were looked for in pre-procedural and procedural scans.

Results
Eighty-three per cent of osteoid osteomas were located in lower extremities, 56% of tumours were intracortical, and 83% of osteoid osteomas were extra-articular. The mean pre-procedure VAS score was 8.5 ± 0.8, while the overall primary success rate of radiofrequency thermoablation and ILA was 87.5%. No major complications were noted. The mean follow-up period for patients in was 7.5 years (5.0-10.2 years).

Conclusions
Percutaneous, CT-guided thermoablation proved to be effective and should become the method of choice in osteoid osteoma treatment because of its minimal invasiveness. Our results show that there is no risk of very late recurrence after achieving primary and secondary treatment success.

keywords:

osteoid osteoma, radiofrequency ablation, laser ablation, multidetector computed tomography

 
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