Magnetic-resonance-guided focused ultrasound treatment of non-spinal osteoid osteoma in children: multicentre experience.


Journal

Pediatric radiology
ISSN: 1432-1998
Titre abrégé: Pediatr Radiol
Pays: Germany
ID NLM: 0365332

Informations de publication

Date de publication:
08 2019
Historique:
received: 12 10 2018
accepted: 13 05 2019
revised: 05 03 2019
pubmed: 28 5 2019
medline: 1 7 2020
entrez: 27 5 2019
Statut: ppublish

Résumé

Osteoid osteoma is a benign and painful musculoskeletal tumour that usually affects children. Current standard treatment is CT-guided radiofrequency ablation, a minimally invasive percutaneous procedure, with clinical success rates ranging between 85% and 98%. Though minimally invasive, however, this type of procedure is not free from complications. To investigate the efficacy and safety of magnetic resonance (MR)-guided focused ultrasound (MRgFUS), a needleless procedure of thermal ablation employed in the treatment of non-spinal osteoid osteoma in paediatric patients. We report the results of 33 procedures of ablation of osteoid osteoma performed with MRgFUS in three university hospitals. To ablate a lesion on the bone surface, MRgFUS employs the ultrasound energy transduced along the soft tissue. The follow-up studies lasted 24 months and were performed combining clinical and imaging data. Mean age of the children was 13.8 years. The clinical outcome showed a primary success of 97%. One case alone was submitted to repeat treatment because the first one failed (secondary success). No major or minor complications were recorded. During the investigation time, no relapse of symptomatology or delayed complications were observed. Although our study is preliminary and limited by a low number of patients, our data show that MRgFUS is effective. This suggests that it might be useful as the first-line treatment in paediatric patients with osteoid osteoma.

Sections du résumé

BACKGROUND
Osteoid osteoma is a benign and painful musculoskeletal tumour that usually affects children. Current standard treatment is CT-guided radiofrequency ablation, a minimally invasive percutaneous procedure, with clinical success rates ranging between 85% and 98%. Though minimally invasive, however, this type of procedure is not free from complications.
OBJECTIVE
To investigate the efficacy and safety of magnetic resonance (MR)-guided focused ultrasound (MRgFUS), a needleless procedure of thermal ablation employed in the treatment of non-spinal osteoid osteoma in paediatric patients.
MATERIALS AND METHODS
We report the results of 33 procedures of ablation of osteoid osteoma performed with MRgFUS in three university hospitals. To ablate a lesion on the bone surface, MRgFUS employs the ultrasound energy transduced along the soft tissue. The follow-up studies lasted 24 months and were performed combining clinical and imaging data.
RESULTS
Mean age of the children was 13.8 years. The clinical outcome showed a primary success of 97%. One case alone was submitted to repeat treatment because the first one failed (secondary success). No major or minor complications were recorded. During the investigation time, no relapse of symptomatology or delayed complications were observed.
CONCLUSION
Although our study is preliminary and limited by a low number of patients, our data show that MRgFUS is effective. This suggests that it might be useful as the first-line treatment in paediatric patients with osteoid osteoma.

Identifiants

pubmed: 31129699
doi: 10.1007/s00247-019-04426-0
pii: 10.1007/s00247-019-04426-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1209-1216

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Auteurs

Francesco Arrigoni (F)

Department of Emergency Radiology, San Salvatore Hospital, via Vetoio, 67100, L'Aquila, Italy. arrigoni.francesco@gmail.com.

Alessandro Napoli (A)

Department of Radiologic, Oncologic and Pathologic Sciences, La Sapienza University of Rome, Rome, Italy.

Alberto Bazzocchi (A)

Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy.

Luigi Zugaro (L)

Department of Emergency Radiology, San Salvatore Hospital, via Vetoio, 67100, L'Aquila, Italy.

Roberto Scipione (R)

Department of Radiologic, Oncologic and Pathologic Sciences, La Sapienza University of Rome, Rome, Italy.

Federico Bruno (F)

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila Via Giovanni Di Vincenzo, L'Aquila, Italy.

Pierpaolo Palumbo (P)

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila Via Giovanni Di Vincenzo, L'Aquila, Italy.

Michele Anzidei (M)

Department of Radiologic, Oncologic and Pathologic Sciences, La Sapienza University of Rome, Rome, Italy.

Daniele Mercatelli (D)

Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy.

Giovanni Luca Gravina (GL)

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila Via Giovanni Di Vincenzo, L'Aquila, Italy.

Carmine Zoccali (C)

Oncological Orthopedics Department, Regina Elena National Cancer Institute, Rome, Italy.

Pejman Ghanouni (P)

Department of Radiology, Stanford University Medical Center, Stanford, CA, USA.

Antonio Barile (A)

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila Via Giovanni Di Vincenzo, L'Aquila, Italy.

Carlo Catalano (C)

Department of Radiologic, Oncologic and Pathologic Sciences, La Sapienza University of Rome, Rome, Italy.

Carlo Masciocchi (C)

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila Via Giovanni Di Vincenzo, L'Aquila, Italy.

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