Percutaneous radiofrequency ablation of osteoid osteomas with use of real-time needle guidance for accurate needle placement: a pilot study.
OBJECTIVE
To evaluate the accuracy and technical success of positioning a radiofrequency ablation (RFA) electrode in osteoid osteomas by use of a new real-time needle guidance technology combining cone-beam computed tomography (CT) and fluoroscopy.


METHODS
Percutaneous RFA of osteoid osteomas was performed in five patients (median age 18 years), under general anesthesia, with the use of cone-beam CT and fluoroscopic guidance for electrode positioning. The outcome parameters were technical success, meaning correct needle placement in the nidus; accuracy defined as the deviation (in mm) from the center of the nidus; and clinical outcome at follow-up.


RESULTS
In all five cases, positioning was possible within 3 mm of the determined target location (median nidus size 6.8 mm; range 5-10.2 mm). All procedures were technically successful. All patients were free of pain at clinical follow-up. No complications were observed.


CONCLUSIONS
Real-time fluoroscopy needle guidance based on cone-beam CT is a useful tool to accurately position radiofrequency needles for minimally invasive treatment of osteoid osteomas.
Busser
Wendy M H
WM
Department of Radiology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. w.busser@rad.umcn.nl
Hoogeveen
Yvonne L
YL
Veth
Rene P H
RP
Schreuder
H W Bart
HW
Balguid
Angelique
A
Renema
W KlaasJan
WK
Schultzekool
Leo J
LJ
D000293:Adolescent; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D002675:Child, Preschool; D054893:Cone-Beam Computed Tomography; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000601:surgery*; D015641:Radiography, Interventional; D016896:Treatment Outcome