Skip to main content
Top
Published in: Skeletal Radiology 11/2008

01-11-2008 | Scientific Article

Radiofrequency ablation of chondroblastoma: procedure technique, clinical and MR imaging follow up of four cases

Authors: M. Christie-Large, N. Evans, A. M. Davies, S. L. J. James

Published in: Skeletal Radiology | Issue 11/2008

Login to get access

Abstract

Purpose

The aim of this study is to describe the procedure technique, clinical and imaging outcomes of patients treated with radiofrequency ablation for chondroblastoma.

Materials and methods

Four patients (female/male, 3:1; mean age, 13 years; age range; 9–16 years) underwent the procedure. All had pre-operative magnetic resonance imaging (MRI) and symptomatic, biopsy-proven chondroblastomas (two proximal femur, two proximal tibia). The lesion size ranged from 1.5 to 2.5 cm in maximal dimension (mean size, 1.8 cm). Bone access was gained with a Bonopty biopsy needle system (mean number of radiofrequency needle placements, 5; mean ablation time, 31 min).

Results

Clinical and MRI follow-up was available in all cases (mean, 12.25 months; range, 5–18 months). All patients reported resolution of symptoms at 2–6 weeks post ablation. At their most recent clinical follow-up, three patients remained completely asymptomatic with full return to normal activities and one patient had minor local discomfort (different pain pattern) that was not limiting activity. All four patients’ follow-up MRI studies demonstrated resolution of the oedema pattern around the lesion and temporal evolution of the internal signal characteristics with fatty replacement.

Conclusion

Radiofrequency ablation for chondroblastoma provides an alternative to surgical curettage, and we have demonstrated both a clinical improvement in symptoms and the follow-up MRI appearances.
Literature
1.
go back to reference Campanacci M. Bone and soft tissue tumours: clinical features, imaging, pathology and treatment, 2nd ed. New York: Springer; 1999. p. 247–264.CrossRef Campanacci M. Bone and soft tissue tumours: clinical features, imaging, pathology and treatment, 2nd ed. New York: Springer; 1999. p. 247–264.CrossRef
2.
go back to reference Resnick D. Diagnosis of bone and joint disorders, 4th ed. WB Saunders Company: Philadelphia; 2002. p. 3850–3866. Resnick D. Diagnosis of bone and joint disorders, 4th ed. WB Saunders Company: Philadelphia; 2002. p. 3850–3866.
3.
go back to reference Stoller DW, Tirman PFJ, Bredella MA. Diagnostic imaging in orthopaedics. Salt Lake City: Amirsys; 2004. p. 26–28. Stoller DW, Tirman PFJ, Bredella MA. Diagnostic imaging in orthopaedics. Salt Lake City: Amirsys; 2004. p. 26–28.
4.
go back to reference Rosenthal D, Alexander A, Rosenberg AE, Springfield D. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology 1992; 183: 29–33.CrossRef Rosenthal D, Alexander A, Rosenberg AE, Springfield D. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology 1992; 183: 29–33.CrossRef
5.
go back to reference Rosenthal D. Radiofrequency treatment. Orthop Clin N Am 2006; 37: 475–484.CrossRef Rosenthal D. Radiofrequency treatment. Orthop Clin N Am 2006; 37: 475–484.CrossRef
6.
go back to reference Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gebhardt MC, Mankin HJ. Percutaneous radiofrequency ablation of osteoid osteoma compared with operative treatment. J Bone Jt Surg Am 1998; 80: 815–821.CrossRef Rosenthal DI, Hornicek FJ, Wolfe MW, Jennings LC, Gebhardt MC, Mankin HJ. Percutaneous radiofrequency ablation of osteoid osteoma compared with operative treatment. J Bone Jt Surg Am 1998; 80: 815–821.CrossRef
7.
go back to reference Erickson JK, Rosenthal DI, Zaleske DJ, Gebhardt MC, Cates JM. Primary treatment of chondroblastoma with percutaneous radiofrequency heat ablation: report of three cases. Radiology 2001; 221: 463–468.CrossRef Erickson JK, Rosenthal DI, Zaleske DJ, Gebhardt MC, Cates JM. Primary treatment of chondroblastoma with percutaneous radiofrequency heat ablation: report of three cases. Radiology 2001; 221: 463–468.CrossRef
8.
go back to reference Tins B, Cassar-Pullicino V, McCall I, Cool P, Williams D, Mangham D. Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results. Eur Radiol 2006; 16: 804–810.CrossRef Tins B, Cassar-Pullicino V, McCall I, Cool P, Williams D, Mangham D. Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results. Eur Radiol 2006; 16: 804–810.CrossRef
9.
go back to reference Van Der Geest IC, Van Noort MP, Schreuder HW, Pruszczynski M, De Rooy JW, Veth RP. The cryosurgical treatment of chondroblastoma of bone: long term oncologic and functional results. J Surg Oncol 2007; 96(3): 230–234.CrossRef Van Der Geest IC, Van Noort MP, Schreuder HW, Pruszczynski M, De Rooy JW, Veth RP. The cryosurgical treatment of chondroblastoma of bone: long term oncologic and functional results. J Surg Oncol 2007; 96(3): 230–234.CrossRef
10.
go back to reference Suneja R, Grimer RJ, Belthur M, et al. Chondroblastoma of bone: long-term results and functional outcome after intralesional curettage. J Bone Jt Surg Br 2005; 87(7): 974–978.CrossRef Suneja R, Grimer RJ, Belthur M, et al. Chondroblastoma of bone: long-term results and functional outcome after intralesional curettage. J Bone Jt Surg Br 2005; 87(7): 974–978.CrossRef
11.
go back to reference Ramappa AJ, Lee FYI, Tang P, Carlson JR, Gebhardt MC, Mankin HJ. Chondroblastoma of bone. J Bone Jt Surg Am 2000; 82A: 1140–1145.CrossRef Ramappa AJ, Lee FYI, Tang P, Carlson JR, Gebhardt MC, Mankin HJ. Chondroblastoma of bone. J Bone Jt Surg Am 2000; 82A: 1140–1145.CrossRef
12.
go back to reference Springfield DS, Capanna R, Gherlinzoni F, Picci P, Campanacci M. Chondroblastoma: a review of seventy cases. J Bone Jt Surg Am 1985; 67: 748–755.CrossRef Springfield DS, Capanna R, Gherlinzoni F, Picci P, Campanacci M. Chondroblastoma: a review of seventy cases. J Bone Jt Surg Am 1985; 67: 748–755.CrossRef
13.
go back to reference Davis KW, Choi JJ, Blankenbaker DG. Radiofrequency ablation in the musculoskeletal system. Semin Roentgenol 2004; 39: 129–144.CrossRef Davis KW, Choi JJ, Blankenbaker DG. Radiofrequency ablation in the musculoskeletal system. Semin Roentgenol 2004; 39: 129–144.CrossRef
14.
go back to reference Petsas T, Megas P, Papathanassiou Z. Radiofrequency ablation of two femoral head chondroblastomas. Eur J Radiol 2007; 63: 63–67.CrossRef Petsas T, Megas P, Papathanassiou Z. Radiofrequency ablation of two femoral head chondroblastomas. Eur J Radiol 2007; 63: 63–67.CrossRef
15.
go back to reference Rybak LD, Rosenthal DI, Wittig J. Radiofrequency ablation of chondroblastomas: an alternative to surgical resection in selected cases. A presentation at RSNA 2007 (abstract). Rybak LD, Rosenthal DI, Wittig J. Radiofrequency ablation of chondroblastomas: an alternative to surgical resection in selected cases. A presentation at RSNA 2007 (abstract).
16.
go back to reference Martel J, Bueno A, Dominguez MP, Llorens P, Quiros J, Delgado C. Percutaneous radiofrequency ablation: relationship between different probe types and procedure time on length and extent of osteonecrosis in dog long bones. Skeletal Radiol 2008; 37: 147–152.CrossRef Martel J, Bueno A, Dominguez MP, Llorens P, Quiros J, Delgado C. Percutaneous radiofrequency ablation: relationship between different probe types and procedure time on length and extent of osteonecrosis in dog long bones. Skeletal Radiol 2008; 37: 147–152.CrossRef
17.
go back to reference Vanderscheuren GM, Taminiau AHM, Obermann WR, van den Berg-Huysmans AA, Bloem JL, van Erkel AR. The healing pattern of osteoid osteomas on computed tomography and magnetic resonance imaging after thermocoagulation. Skeletal Radiol 2007; 36: 813–821.CrossRef Vanderscheuren GM, Taminiau AHM, Obermann WR, van den Berg-Huysmans AA, Bloem JL, van Erkel AR. The healing pattern of osteoid osteomas on computed tomography and magnetic resonance imaging after thermocoagulation. Skeletal Radiol 2007; 36: 813–821.CrossRef
18.
go back to reference Lee MH, Ahn JM, Chung HW, et al. Osteoid osteoma treated with percutaneous radiofrequency ablation: MR imaging follow up. Eur J Radiol 2007; 64(2): 309–314.CrossRef Lee MH, Ahn JM, Chung HW, et al. Osteoid osteoma treated with percutaneous radiofrequency ablation: MR imaging follow up. Eur J Radiol 2007; 64(2): 309–314.CrossRef
Metadata
Title
Radiofrequency ablation of chondroblastoma: procedure technique, clinical and MR imaging follow up of four cases
Authors
M. Christie-Large
N. Evans
A. M. Davies
S. L. J. James
Publication date
01-11-2008
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 11/2008
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-008-0526-4

Other articles of this Issue 11/2008

Skeletal Radiology 11/2008 Go to the issue

Perspective

Toxic synovitis

Browser's Notes

Browser’s notes