Microwave ablation of osteoid osteomas using dynamic MR imaging for early treatment assessment: preliminary experience

J Vasc Interv Radiol. 2014 Jan;25(1):106-11. doi: 10.1016/j.jvir.2013.09.009. Epub 2013 Nov 26.

Abstract

Purpose: To evaluate the efficacy of microwave ablation for osteoid osteomas by using dynamic contrast-enhanced magnetic resonance (MR) imaging in early treatment assessment.

Materials and methods: Ten patients (two female, eight male; mean age, 28 y; range, 16-47 y) presenting with osteoid osteomas were treated between June 2010 and December 2012 with the use of computed tomography (CT)-guided microwave ablation. Osteoid osteomas were found at the femoral neck (n = 4), tibia (n = 3), calcaneus (n = 1), navicular bone (n = 1), and dorsal rib (n = 1). Dynamic contrast-enhanced MR imaging at 3.0 T was performed 1 day before microwave ablation and again after ablation. The procedure was considered successful if the signal intensity (SI) of the lesion on MR imaging decreased by at least 50% and the patient was pain-free within 1 week of intervention.

Results: All patients were pain-free within 1 week after microwave ablation and remained so during the 6 months of follow-up. No major or minor complications developed. On average, SI of the lesions decreased by 75% (range, 55.5%-89.1%) after treatment. The difference in lesion SI before versus after ablation was significant by t test (P < .0001; confidence interval, 120.26-174.96) and Wilcoxon test (P = .0020).

Conclusions: Microwave ablation treatment of osteoid osteoma was highly successful, without any complications observed. Dynamic contrast-enhanced MR imaging is a useful tool for diagnosing osteoid osteoma and evaluating treatment.

Keywords: 3D; NSAID; PG; RF; SI; TWIST; nonsteroidal antiinflammatory drug; prostaglandin; radiofrequency; signal intensity; three-dimensional; time-resolved imaging with stochastic trajectories.

MeSH terms

  • Ablation Techniques* / adverse effects
  • Adolescent
  • Adult
  • Bone Neoplasms / diagnostic imaging
  • Bone Neoplasms / pathology
  • Bone Neoplasms / surgery*
  • Contrast Media
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Microwaves / adverse effects
  • Microwaves / therapeutic use*
  • Middle Aged
  • Osteoma, Osteoid / diagnostic imaging
  • Osteoma, Osteoid / pathology
  • Osteoma, Osteoid / surgery*
  • Pain, Postoperative / etiology
  • Predictive Value of Tests
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Substances

  • Contrast Media