Yu Feng, Niu Xiao-Hui, Zhang Qing, Zhao Hai-Tao, Xu Li-Hui, Deng Zhi-Ping
Department of Orthopedic Oncology, Beijing Jishuitan Hospital, Peking University, Beijing, China.
Br J Radiol. 2015;88(1056):20140535. doi: 10.1259/bjr.20140535. Epub 2015 Sep 29.
To evaluate the efficacy of intraoperative three-dimensional (3D) Iso-C C-arm-navigated percutaneous radiofrequency ablation (RFA) of osteoid osteomas.
35 patients (20 males and 15 females) with osteoid osteomas underwent treatment with intraoperative 3D Iso-C C-arm navigation-guided RFA. The tumour was first biopsied for pathological examination, the core needle was removed and the RFA needle was inserted into the nidus. Post-operative X-rays and CT scans were performed to evaluate the degree of ablation and to assess for recurrence at 3-month follow-up. Patients also completed a visual analogue scale (VAS) both pre-operatively and 3 days post-operatively to subjectively assess pain.
Pathological diagnosis confirmed osteoid osteoma in 19 cases. The other 16 cases were not pathologically diagnosed owing to inadequate biopsy specimens. In all cases, localized pain was immediately relieved following RFA. Patients reported significantly decreased pain, with mean pre-operative VAS scores of 3.4 reducing to 0.80 at 3 days post-operatively and further to 0.06 at 3-month follow-up (p < 0.05). The mean follow-up time was 15.5 months (range: 3-38 months).
3D Iso-C C-arm navigation-guided RFA is a safe and effective option for the treatment of osteoid osteomas and may be considered in place of intraoperative CT-guided and open resection.
C-arm image-guided percutaneous RFA mitigates the need for pre-operative CT as well as intraoperative scintigraphy, provides real-time imaging of the anatomy, facilitates accurate resection of the tumour and enables immediate confirmation of excision.
评估术中三维（3D）Iso-C型C臂导航引导下经皮射频消融（RFA）治疗骨样骨瘤的疗效。
35例骨样骨瘤患者（20例男性，15例女性）接受了术中3D Iso-C型C臂导航引导下的RFA治疗。首先对肿瘤进行活检以进行病理检查，取出芯针并将RFA针插入瘤巢。术后进行X线和CT扫描以评估消融程度，并在3个月随访时评估有无复发。患者还在术前和术后3天完成视觉模拟量表（VAS）以主观评估疼痛。
病理诊断确诊19例骨样骨瘤。另外16例因活检标本不足未得到病理诊断。在所有病例中，RFA后局部疼痛立即缓解。患者报告疼痛明显减轻，术前VAS平均评分为3.4，术后3天降至0.80，3个月随访时进一步降至0.06（p<0.05）。平均随访时间为15.5个月（范围：3 - 38个月）。
3D Iso-C型C臂导航引导下的RFA是治疗骨样骨瘤的一种安全有效的选择，可考虑替代术中CT引导和开放切除。
C臂图像引导下经皮RFA减少了术前CT以及术中闪烁扫描的需求，提供了解剖结构的实时成像，有助于准确切除肿瘤并能立即确认切除情况。
