Acanfora Chiara, Grassi Enrico, Giacobbe Giuliana, Ferrante Marilina, Granata Vincenza, Barile Antonio, Cappabianca Salvatore
Diagnostic and Interventional Radiology, Department of Biotechnology and Applied Clinical Science, University of L'Aquila, 67100 L'Aquila, Italy.
Division of Radiology, Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy.
J Clin Med. 2022 Apr 2;11(7):1987. doi: 10.3390/jcm11071987.
The family of painful osteocytic tumors includes osteoblastomas and osteoid osteomas-these lesions are considered benign, but they could produce a significant painful symptomatology. Usually, people affected are between 20 s and 30 s. When symptomatic, an effective treatment is mandatory for the management of these lesions to allow for a ful quality of life. The possibilities of treatment range from chirurgical en-block resection (procedure of surgical oncology aiming to remove a tumoral mass in its entirety, completely surrounded by a continuous layer of healthy tissue) to interventional approaches that, nowadays, are considered the most affordable and sustainable in terms of effectiveness, recovery after procedure, and for bone structure sparing. The main techniques used for osteoid osteomas and osteoblastomas are radio frequency ablation (RFA) and magnetic resonance-guided focused ultrasound (MRgFUS): the most important difference between these approaches is the needleless approach of MRgFUS, which further reduces the minimal invasiveness of RFA (and the related consequences) and the absence of exposure to ionizing radiation. Despite their high efficacy, a recurrence of pathology may occur due to a failure in therapy. In light of this, describing the various possibilities of follow up protocols and the imaging aspects of recurrence or incomplete treatment is mandatory. In the scenario given in the literature, many authors have tried to asses an organized follow up protocol of these patients, but many of them did not undergo periodical magnetic resonance (MR) or computerized tomography (CT) because of the lack of symptomatology. However, even if it seems that clinical evolution is central, different papers describe the protocol useful to detect eventual relapse. The aim of our manuscript is to review the various possibilities of follow-up of these patients and to bring together the most salient aspects found during the management of these osteocytic bone lesions.
疼痛性骨细胞瘤家族包括骨母细胞瘤和骨样骨瘤——这些病变被认为是良性的，但它们可能会产生明显的疼痛症状。通常，受影响的人群年龄在20多岁到30多岁之间。出现症状时，必须采取有效的治疗措施来处理这些病变，以确保有完整的生活质量。治疗方法的选择范围从手术整块切除（外科肿瘤学的一种手术，旨在完整切除肿瘤块，肿瘤块完全被一层连续的健康组织包围）到介入方法，如今，就有效性、术后恢复以及保留骨结构而言，介入方法被认为是最经济且可持续的。用于骨样骨瘤和骨母细胞瘤的主要技术是射频消融（RFA）和磁共振引导聚焦超声（MRgFUS）：这些方法之间最重要的区别在于MRgFUS是无针方法，这进一步降低了RFA的微创性（以及相关后果），并且不存在电离辐射暴露。尽管它们疗效很高，但由于治疗失败，病理仍可能复发。有鉴于此，必须描述随访方案的各种可能性以及复发或治疗不完全的影像学表现。在文献给出的情形中，许多作者试图评估这些患者的有组织的随访方案，但其中许多患者由于没有症状而未接受定期磁共振（MR）或计算机断层扫描（CT）检查。然而，即使临床进展似乎很关键，但不同的论文描述了有助于检测最终复发的方案。我们这篇手稿的目的是回顾这些患者随访的各种可能性，并汇总在这些骨细胞性骨病变管理过程中发现的最突出方面。
