title: Percutaneous Biopsy and Radiofrequency Ablation of Osteoid Osteoma with Excess Reactive New Bone Formation and Cortical Thickening Using a Battery-Powered Drill for Access: A Technical Note.
abstract: OBJECTIVE
  To report our experience with the use of a battery-powered drill in biopsy and radiofrequency ablation of osteoid osteoma with excess reactive new bone formation. The battery-powered drill enables obtaining the sample while drilling.
  
  
  METHODS
  During the last 18 months, 14 patients suffering from painful osteoid osteoma with excess reactive new bone formation underwent CT-guided biopsy and radiofrequency ablation. In order to assess and sample the nidus of the osteoid osteoma, a battery-powered drill was used. Biopsy was performed in all cases. Then, coaxially, a radiofrequency electrode was inserted and ablation was performed with osteoid osteoma protocol. Procedure time (i.e., drilling including local anesthesia), amount of scans, technical and clinical success, and the results of biopsy are reported.
  
  
  RESULTS
  Access to the nidus through the excess reactive new bone formation was feasible in all cases. Median procedure time was 50.5 min. Histologic verification of osteoid osteoma was performed in all cases. Radiofrequency electrode was coaxially inserted within the nidus and ablation was successfully performed in all lesions. Median amount CT scans, performed to control correct positioning of the drill and precise electrode placement within the nidus was 11. There were no complications or material failure reported in our study.
  
  
  CONCLUSIONS
  The use of battery-powered drill facilitates access to the osteoid osteoma nidus in cases where excess reactive new bone formation is present. Biopsy needle can be used for channel creation during the access offering at the same time the possibility to extract bone samples.
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece. dfilippiadis@yahoo.gr.
authors.forename: D
authors.initials: D
authors.lastname: Filippiadis
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Gkizas
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Kostantos
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Mazioti
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece.
authors.forename: L
authors.initials: L
authors.lastname: Reppas
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Brountzos
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Kelekis
authors.affiliation: 2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kelekis
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D061646:Operative Time; D010012:Osteogenesis / Q000502:physiology; D010017:Osteoma, Osteoid / Q000473:pathology* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013525:Surgical Instruments; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*
keywords: Ablation; Biopsy; Computed tomography; Drill; Osteoid osteoma