Kulkarni Suyash S, Shetty Nitin S, Polnaya Ashwin M, Janu Amit, Kumar Suresh, Puri Ajay, Gulia Ashish, Rangarajan Venkatesh
Interventional Radiology Unit, Department of Radio-Diagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India.
Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
Indian J Radiol Imaging. 2017 Jul-Sep;27(3):318-323. doi: 10.4103/ijri.IJRI_30_17.
The aim of this study is to evaluate the clinical efficacy of computed tomography (CT)-guided radiofrequency (RF) ablation as a minimally invasive therapy for osteoid osteoma.
This is a retrospective analysis of prospectively maintained data of 43 symptomatic osteoid osteoma patients who were treated by radiofrequency ablation (RFA). Forty out of 43 patients were naive cases and underwent primary treatment for osteoid osteoma with RFA, whereas 3 patients included in the study underwent RFA for local recurrence after having undergone surgical treatment. Diagnosis was based on clinical and characteristic imaging findings, and biopsy was done for cases with atypical presentation. Pre and post procedure Visual Analog Score (VAS) was documented in all cases. Monopolar RFA system was used in all patients, and the electrode was placed within the lesion nidus under CT guidance coaxially through 11G introducer needle. Ablation was performed at 90° C for 5 min.
Technical success rate of intranidal placement of electrode was 100%. The primary clinical success in our study was 97.7% (42 of 43), and the secondary clinical success was 100%. Pre and postprocedure VAS score in our study group was 7.8 and 0.4, respectively. Mean follow-up period in our study was 48 months (Range: 4-129 months). One patient had recurrence of pain 4 years after treatment and was treated successfully by a second session. Minor complications were seen in 3 patients with two cases of RF pad burns and one case of skin burn at the treatment site, and these were managed conservatively. No patients developed temporary/permanent neurological deficits, and no procedure-related mortality was seen in our study.
CT-guided percutaneous RFA is a simple, safe, minimally invasive, and highly effective treatment option for osteoid osteoma with good long-term pain control and potentially low disease recurrence.
本研究旨在评估计算机断层扫描（CT）引导下射频（RF）消融作为骨样骨瘤微创治疗的临床疗效。
这是一项对43例接受射频消融（RFA）治疗的有症状骨样骨瘤患者的前瞻性维护数据进行的回顾性分析。43例患者中有40例为初发病例，接受了RFA治疗骨样骨瘤的初次治疗，而纳入研究的3例患者在接受手术治疗后因局部复发接受了RFA治疗。诊断基于临床和特征性影像学表现，对于表现不典型的病例进行了活检。所有病例均记录了术前和术后视觉模拟评分（VAS）。所有患者均使用单极RFA系统，电极在CT引导下通过11G穿刺针同轴放置在病变巢内。在90°C下进行5分钟的消融。
电极巢内放置的技术成功率为100%。我们研究中的主要临床成功率为97.7%（43例中的42例），次要临床成功率为100%。我们研究组术前和术后VAS评分分别为7.8和0.4。我们研究的平均随访期为48个月（范围：4 - 129个月）。1例患者在治疗4年后疼痛复发，通过第二次治疗成功治愈。3例患者出现轻微并发症，2例为射频垫烧伤，1例为治疗部位皮肤烧伤，均经保守处理。我们的研究中没有患者出现临时/永久性神经功能缺损，也没有观察到与手术相关的死亡。
CT引导下经皮RFA是一种简单、安全、微创且高效的骨样骨瘤治疗选择，具有良好的长期疼痛控制效果，疾病复发率可能较低。
