Percutaneous Radiofrequency Ablation of Osteoid Osteomas with Use of Real-Time Needle Guidance for Accurate Needle Placement: A Pilot Study

• Published in: Cardiovascular and interventional radiology Vol. 34; no. 1; pp. 180 - 183
• Main Authors: Busser, Wendy M. H., Hoogeveen, Yvonne L., Veth, Rene P. H., Schreuder, H. W. Bart, Balguid, Angelique, Renema, W. KlaasJan, SchultzeKool, Leo J.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.02.2011; Springer Nature B.V
• Subjects: ABLATION; ACCURACY; Adolescent; ANESTHESIA; BIOMEDICAL RADIOGRAPHY; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - surgery; Cardiology; Catheter Ablation - instrumentation; Child, Preschool; COMPUTERIZED TOMOGRAPHY; Cone-Beam Computed Tomography; DIAGNOSTIC TECHNIQUES; ELECTROMAGNETIC RADIATION; Female; FLUOROSCOPY; Humans; Imaging; Male; MATERIALS; MEDICINE; Medicine & Public Health; Middle Aged; Needles; NUCLEAR MEDICINE; Osteoma, Osteoid - diagnostic imaging; Osteoma, Osteoid - surgery; PAIN; PATIENTS; RADIATIONS; Radiography, Interventional; RADIOLOGY; RADIOLOGY AND NUCLEAR MEDICINE; RADIOWAVE RADIATION; SYMPTOMS; Technical Note; TOMOGRAPHY; Treatment Outcome; Ultrasound; Radiofrequency ablation; Real-time needle guidance; Osteoid osteoma
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-010-9950-7

Purpose To evaluate the accuracy and technical success of positioning a radiofrequency ablation (RFA) electrode in osteoid osteomas by use of a new real-time needle guidance technology combining cone-beam computed tomography (CT) and fluoroscopy. Materials and Methods Percutaneous RFA of osteoid osteomas was performed in five patients (median age 18 years), under general anesthesia, with the use of cone-beam CT and fluoroscopic guidance for electrode positioning. The outcome parameters were technical success, meaning correct needle placement in the nidus; accuracy defined as the deviation (in mm) from the center of the nidus; and clinical outcome at follow-up. Results In all five cases, positioning was possible within 3 mm of the determined target location (median nidus size 6.8 mm; range 5–10.2 mm). All procedures were technically successful. All patients were free of pain at clinical follow-up. No complications were observed. Conclusion Real-time fluoroscopy needle guidance based on cone-beam CT is a useful tool to accurately position radiofrequency needles for minimally invasive treatment of osteoid osteomas.