title: The use of microwaves ablation in the treatment of epiphyseal osteoid osteomas.
abstract: OBJECTIVE
  This study was designed to demonstrate the feasibility and the reliability of microwave ablation (MWA) of epiphyseal osteoid osteomas (OO).
  
  
  METHODS
  From February to November 2012, 7 patients (4 males and 3 females; age range 16-30 years) with epiphyseal OOs were treated with MWA. The treatment was performed with 16 G antennas with a power of 20 W for 2 min. The OOs were approached by using coaxial needles inserted with hammer or with automatic drill. All patients underwent spinal anaesthesia, with posttreatment 6-8 h observation before discharging. We treated epiphyseal OOs placed away from nervous and vascular nontarget structures, located in: femoral head (n = 2), femoral lesser trochanter (n = 2), femoral neck (n = 2), and proximal tibial epiphysis (n = 1). CT was used to visualize the nidus and to insert the needle for thermal ablation and for postprocedure control. Technical success was considered the positioning of the antenna in the nidus, while the efficacy of treatment was clinically evaluated as the complete remission of pain after the procedure by using the visual analogue score (VAS). Follow-up was performed by using VAS score 1 day, 1 week, and 1, 3, and 6 months after the procedure, whereas MRI examination was performed immediately after the procedure, at 1 month, and in any case of recurrence. Complications were also recorded.
  
  
  RESULTS
  All patients experienced resolution of the symptomatology (VAS = 0) in ~1 week until the last follow-up, with residual VAS < 2 points occurring only from 1 to 7 days after the procedure. No intraprocedural complication was noted, whereas one patient had back pain for 2 months after the procedure, likely due to spinal analgesic injection.
  
  
  CONCLUSIONS
  In our experience, MWA can be safely performed with excellent results without complications in selected cases of epiphyseal OOs; however, the clinical significance of this report is limited because there were only few patients included in this study. Thus, these data must be confirmed by further and larger studies.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Garibaldi Centro Hospital, Piazza Santa Maria del Gesù, 95124, Catania, Italy, antodoc@yahoo.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Basile
authors.forename: Giovanni
authors.initials: G
authors.lastname: Failla
authors.forename: Angelo
authors.initials: A
authors.lastname: Reforgiato
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scavone
authors.forename: Elena
authors.initials: E
authors.lastname: Mundo
authors.forename: Martina
authors.initials: M
authors.lastname: Messina
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caltabiano
authors.forename: Francesco
authors.initials: F
authors.lastname: Arena
authors.forename: Viola
authors.initials: V
authors.lastname: Ricceri
authors.forename: Antonio
authors.initials: A
authors.lastname: Scavone
authors.forename: Salvatore
authors.initials: S
authors.lastname: Masala
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004838:Epiphyses / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D010017:Osteoma, Osteoid / Q000601:surgery*; D010147:Pain Measurement; D015641:Radiography, Interventional; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome