Radiologia Interventistica, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Napoli (IT), Naples, Italy.
PLoS One. 2021 Mar 18;16(3):e0248589. doi: 10.1371/journal.pone.0248589. eCollection 2021.
To assess efficacy and safety of imaging-guided radiofrequency ablation (RFA) of Osteoid Osteoma (OO) in both typical and atypical sites.
Between January 2014 and March 2019, 102 consecutive percutaneous RFA were performed and retrospectively reviewed. The procedures were performed using a RFA bipolar ablation system (Covidien, exposed tip of 0.7-1cm), under Computed Tomography (CT) guidance or using a navigation system (Masmec) under CT and Cone Beam CT (CBCT) guidance. Patients were followed up over 24 months. Clinical success and recurrences were considered on the base of established criteria. In patients with clinical failure and/or imaging evidence of relapse, retreatment was considered.
Administered power per-procedure was ≤8 W (mean temperature, 90°C). The pre-procedure average value of visual analog scale (VAS) was 8.33+/-0.91. Primary and secondary success rate 96.08% (98/102) and100% (102/102), respectively. No major complication was described. Technical success was proved in every patient by CT scan acquisition after needle positioning. Relapse and tumour location were significantly correlated (p-value = 0.0165). The mean dose-length product was 751.55 mGycm2. Advanced bone healing was noted in 68 lesions after 1y-follow up and in 86 lesions after 2y-follow up.
Imaging-guided percutaneous RFA is a highly effective technique for OO, both in typical and atypical sites. CT or CBCT guidance, navigation systems and operator experience grant the technical success, which is the most crucial parameter affecting outcome.
评估影像学引导下经皮射频消融（RFA）治疗典型和非典型部位骨样骨瘤（OO）的疗效和安全性。
2014 年 1 月至 2019 年 3 月，连续对 102 例接受经皮 RFA 的患者进行回顾性分析。手术在 CT 引导下使用射频双极消融系统（Covidien，暴露尖端 0.7-1cm）或在 CT 和锥形束 CT（CBCT）引导下使用导航系统（Masmec）进行。所有患者均随访 24 个月。根据既定标准评估临床疗效和复发情况。对于临床治疗失败和/或影像学复发的患者，考虑进行再次治疗。
每例患者的治疗功率均≤8W（平均温度 90°C）。术前平均视觉模拟评分（VAS）为 8.33±0.91。首次和二次成功率分别为 96.08%（98/102）和 100%（102/102）。无严重并发症发生。通过 CT 扫描获取的针道位置图像证实了所有患者均达到了技术成功。肿瘤位置与复发显著相关（p 值=0.0165）。平均剂量长度乘积为 751.55mGycm2。在 1 年随访时，68 个病变处和 2 年随访时 86 个病变处出现了骨愈合。
影像学引导下经皮 RFA 是治疗典型和非典型部位 OO 的一种有效方法。CT 或 CBCT 引导、导航系统和操作者的经验是保证技术成功的关键，而技术成功是影响治疗效果的最重要因素。
