MR guided focused ultrasound surgery (MRgFUS) vs radiofrequency thermoablation (RFA) in the imaging-guided treatment of osteoid osteoma: clinical and imaging results

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Congress:

ECR 2015

Poster Number:

B-0338

Type:

Scientific Paper

Keywords:

Bones, Extremities, Interventional non-vascular, MR, CT, Ablation procedures, Motility

Authors:

F. Arrigoni, S. Mariani, A. La Marra, L. M. Gregori, L. Zugaro, A. Barile, C. Masciocchi; L'Aquila/IT

DOI:

10.1594/ecr2015/B-0338

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/B-0338

Fig. 1

Fig. 2: Bone edema around the nidus of the Osteoid Osteoma (a) before the treatment;...

Fig. 3: Bone edema around the nidus of the Osteoid Osteoma (a) before the treatment;...

Fig. 4: Bone edema around the nidus of the Osteoid Osteoma (a) before the treatment;...

Purpose

To evaluate the effectiveness and the safety of minimally invasive treatment of Osteoid Osteoma (OO) with two imaging-guided techniques: Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) and RadioFrequency thermoAblation (RFA) with a 2 years follow up.

Methods and materials

From March 2011 we treated 34 Osteoid Osteoma (OO), 17 with MRgFUS and 17 with RFA. To be treat with MRgFUS the lesion had to have a good acoustic window: for appropriate acoustic window we intend a conical pathway between the transducer, which generates the ultrasounds, and the target lesion. This pathway must exclude metallic devices, scars or other structures that reflect or refract the ultrasound beam, which can prevent an effective ablation effect. In this regard, all lesions located deeper than 1.2 cm from...

Results

All patients, except one treated with MRgFUS, showed a disappearance of painful symptomatology. The mean hospitalization time was 2 days for patients treated with MRgFUS and 2.6 days for those submitted to RFA. Both the procedures were effective (improvement of mean VAS values: 98%). One week after the procedure, patientsreported improvement with reduction of symptoms, and 12 weeks after the procedure, the mean VAS values was 0 for both the procedures. Patient that was not responsive to the treatment with MRgFUS was retracted with RFA;...

Conclusion

Our study demonstrates the safety and effectiveness of these two techniques in the treatment of OO. The MRgFUS shows a lower rate of invasiveness than RFA, but requires specific inclusion criteria. If these specific criteria (the presence of an good acoustic window) is not met, there can be a failure.

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References

Masciocchi C., Conchiglia A., Gregori L.M. et al. Critical role of HIFU in musculoskeletal interventions. La Radiologia Medica, 1–6. doi:10.1007/s11547-014-0414-z Napoli A, Mastantuono M, Cavallo Maricola B. et al. Osteoid osteoma: MR-guided focused ultrasound for entirely noninvasive treatment. Radiology. 2013 May;267(2):514-21. Chai JW, Hong SH, Choi JY et al. Radiologic diagnosis of osteoid osteoma: from simple to challenging findings. Radiographics. 2010 May;30(3):737-49. Edeiken J, DePalma AF, Hodes PJ. Osteoid osteoma. (Roentgenographic emphasis). Clin Orthop Relat Res. 1966 Nov-Dec; 49:201-6. Imaging of Bone Tumors and Tumor-Like...