Percutaneous cryoablation for the treatment of osteoid osteoma in the adult population

• Published in: European radiology 2018-06, Vol.28 (6), p.2336-2344
• Main Authors: Santiago, Elodie, Pauly, Vanessa, Brun, Gilles, Guenoun, Daphné, Champsaur, Pierre, Le Corroller, Thomas
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; Anesthesia; Anesthesia, General; Anesthesia, Local; Biocompatibility; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - surgery; Complications; Computed tomography; Cryosurgery - methods; Diagnostic Radiology; Feasibility Studies; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Life Sciences; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Musculoskeletal; Neuroradiology; NMR; Nuclear magnetic resonance; Osteoid; Osteoid osteoma; Osteoma; Osteoma, Osteoid - diagnostic imaging; Osteoma, Osteoid - surgery; Pain; Pain Measurement - methods; Pain, Postoperative; Patients; Radiography, Interventional - methods; Radiology; Retrospective Studies; Tomography, X-Ray Computed - methods; Treatment Outcome; Ultrasound; Visual Analog Scale; Visual control
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-017-5164-6

Purpose To evaluate the technical feasibility and efficacy of percutaneous cryoablation for the treatment of osteoid osteoma (OO) in adults. Methods and materials 21 patients (12 male and nine female; mean age, 29.9 years) who underwent CT-guided percutaneous cryoablation for the treatment of OO were retrospectively evaluated. Procedures were carried out under local anaesthesia and conscious sedation in 13 patients, and under general anaesthesia in eight patients. Then, the ablation zone was evaluated with post-procedure magnetic resonance imaging at 6 weeks. Clinical outcome was assessed using a visual analogue scale (VAS) to evaluate severity of pain before procedure, as well as at primary (6 weeks) and secondary follow-up (6-40 months). Results All procedures were technically successful. Median VAS scores were: 8 (range, 5-10) before procedure and after procedure, respectively, 0 (range, 0-2; p < .0001 ) and 0 (range, 0-7; p < .0001 ) at primary and secondary follow-up. There were three minor complications (14.3%) and no major complication. A single patient reported symptom recurrence (4.8%) at secondary follow-up and successfully underwent a second cryoablation procedure. Conclusion CT-guided percutaneous cryoablation is safe and effective in the treatment of OO in adults, and can be accomplished without general anaesthesia in selected cases. Key Points • CT-guided percutaneous cryoablation of osteoid osteoma is safe and effective • Cryoablation allows precise visual control of the aggregated iceball during procedure • Percutaneous cryoablation can be accomplished without general anaesthesia in selected cases • Another advantage of cryoablation is reduction of immediate postprocedural pain • Post-procedure MRI is helpful in the evaluation of technical success