Department of Emergency Radiology, San Salvatore Hospital, L'Aquila, Italy.
Second Department of Radiology, University General ATTIKON Hospital Athens, Athens, Greece.
J Vasc Interv Radiol. 2021 Jul;32(7):1044-1051. doi: 10.1016/j.jvir.2021.03.528. Epub 2021 Mar 26.
To assess the safety and efficacy of computed tomography-guided radiofrequency (RF) ablation and magnetic resonance-guided focused ultrasound (MRgFUS) in the treatment of osteoid osteoma with a long-term follow-up study.
Database research was performed at 2 different centers with experience in musculoskeletal interventions. Both centers, one performing RF ablation and the other MRgFUS, identified 116 patients who underwent either RF ablation or MRgFUS procedures for the treatment of symptomatic osteoid osteoma and retrospectively evaluated data regarding pain scores using a visual analog scale (VAS). Complications were recorded according to the Cardiovascular and Interventional Radiological Society of Europe classification system. Propensity score matching for multiple variables was performed. Pain scores before and after therapy were compared.
Of 116 patients treated, 61 and 55 underwent RF ablation and MRgFUS, respectively. Before treatment, the mean reported pain in the 2 groups were 9.1 ± 0.88 (RF ablation) and 8.7 ± 0.73 (MRgFUS) VAS units. After treatment, a statistically significant (P < .00001) overall reduction in pain symptomatology was recorded. No statistically significant difference was observed between the mean values of pain after treatment in both groups (P = .256). Over a mean of >2 years of follow-up, 4 cases of relapse (RF ablation, 1; MRgFUS, 3) and 1 complication (RF ablation) were observed. The analysis from propensity score matching that identified a matched cohort of 48 patients showed similar results.
The 2 techniques for the treatment of osteoid osteoma resulted in profound and similar pain relief. The presence of thick cortical bone over the nidus can reduce the effectiveness of MRgFUS.
通过长期随访研究，评估 CT 引导下射频（RF）消融和磁共振引导下聚焦超声（MRgFUS）治疗骨样骨瘤的安全性和有效性。
在 2 家具有肌肉骨骼介入经验的不同中心进行数据库研究。这 2 家中心，一家进行 RF 消融，另一家进行 MRgFUS，共确定了 116 名接受 RF 消融或 MRgFUS 治疗症状性骨样骨瘤的患者，并回顾性评估了使用视觉模拟评分（VAS）评估疼痛评分的数据。根据心血管和介入放射学会欧洲分类系统记录并发症。对多个变量进行倾向评分匹配。比较治疗前后的疼痛评分。
在 116 名接受治疗的患者中，61 名和 55 名分别接受了 RF 消融和 MRgFUS 治疗。在治疗前，2 组报告的平均疼痛分别为 9.1 ± 0.88（RF 消融）和 8.7 ± 0.73（MRgFUS）VAS 单位。治疗后，疼痛症状总体显著（P <.00001）减轻。治疗后 2 组的平均疼痛值无统计学差异（P =.256）。在平均 >2 年的随访中，观察到 4 例复发（RF 消融，1 例；MRgFUS，3 例）和 1 例并发症（RF 消融）。通过倾向评分匹配确定的 48 例匹配队列分析显示出相似的结果。
这 2 种治疗骨样骨瘤的技术均能显著减轻疼痛。骨样骨瘤病灶上方厚皮质骨的存在会降低 MRgFUS 的疗效。
