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European Radiology

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01-11-2020 | osteoid osteoma | Musculoskeletal

CT-guided radiofrequency ablation for osteoid osteomas: a systematic review

Authors: Mickael Tordjman, Laetitia Perronne, Guillaume Madelin, Rahul D. Mali, Christopher Burke

Published in: European Radiology | Issue 11/2020

Abstract

Objectives

CT-guided radiofrequency ablation (CT-RFA) is considered to be the gold standard for treatment of osteoid osteoma (OO) yet treatment failures (TFs) continue to be reported. This systematic review was conducted to evaluate factors associated with TF, such as ablation time, lesion location, and patient age as well as evaluating how TF has trended over time.

Methods

Original studies reporting on patients undergoing CT-RFA of OO published between 2002 and 2019 were identified. TF was defined as patients with (1) recurrent or persistent pain +/− (2) imaging evidence of persistent OO. TFs were subdivided into those occurring after the index procedure (primary TF) or those occurring after repeat RFA (secondary TF). Subgroup analysis was performed for TF based on the study date (2002–2010 or 2010–2019), time duration of ablation at 90 °C (6 min or > 6 min), patient age, and tumor location (spinal vs. appendicular).

Results

Sixty-nine studies were included for a total of 3023 patients. The global primary TF rate was 8.3% whereas the secondary TF rate was 3.1%. The TF rate reported in studies published after 2011(7%) was about half that during the earlier time period 2002–2010 (14%). There was no statistical difference in TF corrected for age, OO location, or duration of ablation (respectively p = 0.39, 0.13, and 0.23). The global complication rate was 3%, the most frequent being skin burns (n = 24; 0.7%).

Conclusions

A decrease in TF observed between 2011–2019 compared to 2002–2010 may reflect improvements in operator technique or advancements in equipment. Duration of ablation, patient age, or location of OO failed to significantly correlate with TF.

Key Points

• CT-guided radiofrequency ablation of osteoid osteomas is a safe technique with a low rate of treatment failure (8.3% failure rate after the primary radiofrequency reducing to 3.1% following a secondary treatment).

• The treatment failure rate has decreased over time, possibly due to an improved understanding of the disease process, better technique, and advances in equipment.

• Duration of ablation, patient age, or lesion location did not significantly correlate with treatment failure.

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Title: CT-guided radiofrequency ablation for osteoid osteomas: a systematic review
Authors: Mickael Tordjman
Laetitia Perronne
Guillaume Madelin
Rahul D. Mali
Christopher Burke
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keyword: osteoid osteoma
Published in: European Radiology / Issue 11/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06970-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

CT-guided radiofrequency ablation for osteoid osteomas: a systematic review

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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