Osteoid osteoma treated with percutaneous radiofrequency ablation: MR imaging follow-up.
OBJECTIVE
We evaluated follow-up magnetic resonance (MR) images for osteoid osteoma treated with percutaneous radiofrequency ablation (RFA).


METHODS
Sixteen patients with osteoid osteoma treated with RFA underwent follow-up MR imaging. The protocol included T1, T2 and contrast-enhanced (CE) T1-weighted images with fat saturation at each visit immediately for 17 months after the treatment. MR images were jointly reviewed by two radiologists, regarding the appearance of treated areas, presence of complications, and the best sequence for visualization of signal intensity (SI) changes. The therapeutic response was evaluated to be a clinical success with the relief of pain.


RESULTS
The treated areas had a target-like appearance on MR images: a central ablated zone (Z1) surrounded by a band (Z2), and a peripheral area (Z3). Z1 was a non-enhancing, hypointense core on T1, T2WI. Z2 was a well-enhancing, hyperintense rim on T2WI. Z3 was less hyperintense and less enhanced than Z2. All nidi were within Z1. This appearance became evident from 1 week to 1 and 2 months. Following up after 2 months, Z2 showed progressive inward enhancement from the periphery, resulting in almost complete enhancement of Z1 and Z2 with a diminishing size. Z3 gradually showed a decrease in signal change and enhancement. No complications were found. CE-T1WI was the best for visualizing SI changes. The clinical success was achieved in all patients except for one patient with a recurrence at 17 months following treatment that had a second ablation.


CONCLUSIONS
MR imaging demonstrated a characteristic appearance and subsequent changes of treated areas for osteoid osteoma following RFA.
Lee
Min Hee
MH
Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-dong, Jongro-gu, Seoul 110-746, South Korea. min.h.lee@samsung.com
Ahn
Joong Mo
JM
Chung
Hye Won
HW
Lim
Hyo K
HK
Suh
Jae Gon
JG
Kwag
Hyon Joo
HJ
Hong
Hyun Pyo
HP
Kim
Byung Moon
BM
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010017:Osteoma, Osteoid / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome
D003287:Contrast Media