title: CT-guided radiofrequency ablation of osteoid osteoma using a novel battery-powered drill.
abstract: OBJECTIVE
  To evaluate the use of a novel battery-powered drill, enabling specimen requirement while drilling, in radiofrequency ablation of osteoid osteoma as an alternative to conventional orthopedic drills.
  
  
  METHODS
  Between 2009 and 2013, altogether 33 patients underwent CT-guided radiofrequency ablation of an osteoid osteoma at our institution. To access the nidus of the clinically and radiologically suspected osteoid osteoma, a channel was drilled using the OnControl Bone Marrow Biopsy System (OBM, Arrow OnControl, Teleflex, Shavano Park, TX, USA) and a biopsy was taken. Procedure time (i.e., drilling including local anesthesia), amount of scans (i.e., single-shot fluoroscopy), radiation exposure, and the results of biopsy were investigated and compared retrospectively to a classical approach using either a manual bone biopsy system or a conventional orthopedic drill (n = 10) after ethical review board approval.
  
  
  RESULTS
  Drilling the tract into the nidus was performed without problems in 22 of the 23 OBM cases. Median procedure time was 7 min compared to 13 min using the classical approach (p < 0.001). Median amount CT scans, performed to control correct positioning of the drill was comparable with 26 compared to 24.5 (p = NS) scans. Histologically, the diagnosis of osteoid osteomas could be determined in all 17 cases where a biopsy was taken. Radiofrequency ablation could be performed without problems in any case.
  
  
  CONCLUSIONS
  The use of the battery-powered drill was feasible and facilitated the access to the osteoid osteoma's nidus offering the possibility to extract a specimen in the same step.
authors.affiliation: Department of Radiology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany, dirk.schnapauff@charite.de.
authors.forename: Dirk
authors.initials: D
authors.lastname: Schnapauff
authors.forename: Florian
authors.initials: F
authors.lastname: Streitparth
authors.forename: Korinna
authors.initials: K
authors.lastname: Jöhrens
authors.forename: Gero
authors.initials: G
authors.lastname: Wieners
authors.forename: Federico
authors.initials: F
authors.lastname: Collettini
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D011211:Electric Power Supplies; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000601:surgery*; D010027:Osteotomy / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*; D016896:Treatment Outcome; D055815:Young Adult