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Skeletal Radiology
Published in: Skeletal Radiology 6/2019

Open Access 01-06-2019 | Scientific Article

Radiofrequency ablation in the treatment of atypical cartilaginous tumours in the long bones: lessons learned from our experience

Authors: Edwin F. Dierselhuis, Jelle Overbosch, Thomas C. Kwee, Albert J. H. Suurmeijer, Joris J. W. Ploegmakers, Martin Stevens, Paul C. Jutte

Published in: Skeletal Radiology | Issue 6/2019

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Abstract

Background

Surgery is the cornerstone of treatment of symptomatic cartilaginous neoplasms. We previously studied the application of radiofrequency ablation of atypical cartilaginous tumours in the long bones. The purpose of the present study was to investigate the additional effect of placing multiple needles and a longer procedure duration on the proportion of completely ablated tumours. Post-ablation MRI findings and the occurrence of complications were also assessed.

Methods

We prospectively included 24 patients with atypical cartilaginous tumours in the long bones. Patients underwent CT-guided radiofrequency ablation followed by curettage with adjuvant phenolisation 3 months later, retrieving material assessed for viable tumour. Before curettage, gadolinium-enhanced MRI was performed to check for residual tumour. The occurrence of complications was noted.

Results

Complete tumour ablation was achieved in 17 out of 24 patients (71%). Complete ablation was achieved in 5 of the 6 cases (83%) when multiple needles were used in tumours ≥30 mm. There was incomplete ablation in 8% of patients. Post-ablation gadolinium-enhanced MRI findings agreed with the histological results in 17 out of 23 cases and there was a negative predictive value of 83%. One patient suffered a fracture after radiofrequency ablation.

Conclusion

Radiofrequency ablation could be an alternative to curettage when treating atypical cartilaginous tumours in the long bones. It was shown that multiple needle placement in addition to longer duration of the ablation procedure is an effective measure in achieving complete ablation in tumours ≥30 mm. Gadolinium-enhanced MRI has a negative predictive value of 83% and could guide post-ablation follow-up.
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Metadata
Title
Radiofrequency ablation in the treatment of atypical cartilaginous tumours in the long bones: lessons learned from our experience
Authors
Edwin F. Dierselhuis
Jelle Overbosch
Thomas C. Kwee
Albert J. H. Suurmeijer
Joris J. W. Ploegmakers
Martin Stevens
Paul C. Jutte
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 6/2019
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-018-3078-2

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