Percutaneous Image-Guided Cryoablation of Osteoblastoma
Roberto Luigi Cazzato1, Pierre Auloge1, Danoob Dalili2,3, Pierre De Marini1, Antonio Di Marco4, Julien Garnon1 and Afshin Gangi1 Show less
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Citation: American Journal of Roentgenology: 1-6. 10.2214/AJR.19.21390
AbstractFull TextReferencesPDFPDF PlusAdd to FavoritesPermissionsDownload Citation
ABSTRACT :
OBJECTIVE. The aim of this observational study was to assess safety and clinical outcomes of percutaneous image-guided cryoablation (CA) to treat osteoblastomas (OBs) at various osseous sites.
MATERIALS AND METHODS. A retrospective search was performed to identify patients presenting with painful OBs who underwent CA at the University Hospitals of Strasbourg between March 2007 and December 2018. Ten patients (seven men, three women; median age, 21 years old) were identified and included. Medical records were reviewed to assess complications and clinical outcomes.
RESULTS. Median OB diameter was 16.5 mm (range, 16–28 mm). OBs were located in the spine (n = 7), calcaneus (n = 1), fibula (n = 1), and third metacarpal bone (n = 1). In 90% of cases (n = 9), one or more critical structures were within 1 cm of the OB (median distance, 5 mm; range, 2–8 mm), thus requiring extensive protective measures. Technical success was achieved in all cases. Two (20%) immediate neural complications were noted. One major complication was consistent with a permanent sensory deficit of the arm. One minor complication was consistent with a transient right Horner syndrome, which completely resolved after 48 hours with high-dose steroids. Median clinical follow-up was 12 months. Primary clinical success was 100% and 78% at 1 and 12 months of follow-up, respectively, with two patients presenting with recurring pain.
CONCLUSION. Percutaneous image-guided CA represents an effective therapeutic option for patients affected by painful OBs; the safety profile of the procedure is acceptable as long as comprehensive protective measures are deployed in light of the frequent close proximity of critical structures.
Keywords: bone, cryotherapy, osteoblastoma
References
Previous section
1. Atesok KI, Alman BA, Schemitsch EH, Peyser A, Mankin H. Osteoid osteoma and osteoblastoma. J Am Acad Orthop Surg 2011; 19:678–689 [Crossref] [Medline] [Google Scholar]
2. Koch G, Cazzato RL, Gilkison A, Caudrelier J, Garnon J, Gangi A. Percutaneous treatments of benign bone tumors. Semin Intervent Radiol 2018; 35:324–332 [Crossref] [Medline] [Google Scholar]
3. Manaster BJ, Andrews CL, Petersilge CA, Roberts CC. Expertddx musculoskeletal, 1st ed. Salt Lake City, UT: Amirsys, 2008:II32–II33 [Google Scholar]
4. Berry M, Mankin H, Gebhardt M, Rosenberg A, Hornicek F. Osteoblastoma: a 30-year study of 99 cases. J Surg Oncol 2008; 98:179–183 [Crossref] [Medline] [Google Scholar]
5. Weber MA, Sprengel SD, Omlor GW, et al. Clinical long-term outcome, technical success, and cost analysis of radiofrequency ablation for the treatment of osteoblastomas and spinal osteoid osteomas in comparison to open surgical resection. Skeletal Radiol 2015; 44:981–993 [Crossref] [Medline] [Google Scholar]
6. Arrigoni F, Barile A, Zugaro L, et al. CT-guided radiofrequency ablation of spinal osteoblastoma: treatment and long-term follow-up. Int J Hyperthermia 2018; 34:321–327 [Crossref] [Medline] [Google Scholar]
7. Kumasaka S, Miyazaki M, Tsushima Y. CT-guided percutaneous cryoablation of an aggressive osteoblastoma: a case report. J Vasc Interv Radiol 2015; 26:1746–1748 [Crossref] [Medline] [Google Scholar]
8. Cazzato RL, Garnon J, Ramamurthy N, et al. Percutaneous image-guided cryoablation: current applications and results in the oncologic field. Med Oncol 2016; 33:140 [Crossref] [Medline] [Google Scholar]
9. Teixeira PAG, Chanson A, Beaumont M, et al. Dynamic MR imaging of osteoid osteomas: correlation of semiquantitative and quantitative perfusion parameters with patient symptoms and treatment outcome. Eur Radiol 2013; 23:2602–2611 [Crossref] [Medline] [Google Scholar]
10. Yoshimoto Y, Azuma K, Miya A, et al. A fundamental study of cryoablation on normal bone: diagnostic imaging and histopathology. Cryobiology 2014; 69:229–235 [Crossref] [Medline] [Google Scholar]
11. Gu Y, Srimathveeravalli G, Cai L, et al. Pirfeni-done inhibits cryoablation induced local macrophage infiltration along with its associated TGFb1 expression and serum cytokine level in a mouse model. Cryobiology 2018; 82:106–111 [Crossref] [Medline] [Google Scholar]
12. Tsoumakidou G, Koch G, Caudrelier J, et al. Image-guided spinal ablation: a review. Cardiovasc Intervent Radiol 2016; 39:1229–1238 [Crossref] [Medline] [Google Scholar]
13. Tsoumakidou G, Thénint MA, Garnon J, Buy X, Steib JP, Gangi A. Percutaneous image-guided laser photocoagulation of spinal osteoid osteoma: a single-institution series. Radiology 2016; 278:936–943 [Crossref] [Medline] [Google Scholar]
14. Tsoumakidou G, Buy X, Garnon J, Enescu J, Gangi A. Percutaneous thermal ablation: how to protect the surrounding organs. Tech Vasc Interv Radiol 2011; 14:170–176 [Crossref] [Medline] [Google Scholar]
15. Kurup AN, Morris JM, Schmit GD, et al. Neuro-anatomic considerations in percutaneous tumor ablation. RadioGraphics 2013; 33:1195–1215 [Crossref] [Medline] [Google Scholar]
16. Kurup AN, Morris JM, Boon AJ, et al. Motor evoked potential monitoring during cryoablation of musculoskeletal tumors. J Vasc Interv Radiol 2014; 25:1657–1664 [Crossref] [Medline] [Google Scholar]
17. Cazzato RL, Garnon J, Shaygi B, et al. How to perform a routine cryoablation under MRI guidance. Top Magn Reson Imaging 2018; 27:33–38 [Crossref] [Medline] [Google Scholar]
18. Whitmore MJ, Hawkins CM, Prologo JD, et al. Cryoablation of osteoid osteoma in the pediatric and adolescent population. J Vasc Interv Radiol 2016; 27:232–237; quiz, 238 [Crossref] [Medline] [Google Scholar]
19. Boriani S, Amendola L, Bandiera S, et al. Staging and treatment of osteoblastoma in the mobile spine: a review of 51 cases. Eur Spine J 2012; 21:2003–2010 [Crossref] [Medline] [Google Scholar]
20. Li Z, Zhao Y, Hou S, Mao N, Yu S, Hou T. Clinical features and surgical management of spinal osteoblastoma: a retrospective study in 18 cases. PLoS One 2013; 8:e74635 [Crossref] [Medline] [Google Scholar]
Address correspondence to R. L. Cazzato (roberto-luigi.cazzato@chru-strasbourg.fr).
Read More: https://www.ajronline.org/doi/abs/10.2214/AJR.19.21390
Roberto Luigi Cazzato1, Pierre Auloge1, Danoob Dalili2,3, Pierre De Marini1, Antonio Di Marco4, Julien Garnon1 and Afshin Gangi1 Show less
Share Share
+ Affiliations:
Citation: American Journal of Roentgenology: 1-6. 10.2214/AJR.19.21390
AbstractFull TextReferencesPDFPDF PlusAdd to FavoritesPermissionsDownload Citation
ABSTRACT :
OBJECTIVE. The aim of this observational study was to assess safety and clinical outcomes of percutaneous image-guided cryoablation (CA) to treat osteoblastomas (OBs) at various osseous sites.
MATERIALS AND METHODS. A retrospective search was performed to identify patients presenting with painful OBs who underwent CA at the University Hospitals of Strasbourg between March 2007 and December 2018. Ten patients (seven men, three women; median age, 21 years old) were identified and included. Medical records were reviewed to assess complications and clinical outcomes.
RESULTS. Median OB diameter was 16.5 mm (range, 16–28 mm). OBs were located in the spine (n = 7), calcaneus (n = 1), fibula (n = 1), and third metacarpal bone (n = 1). In 90% of cases (n = 9), one or more critical structures were within 1 cm of the OB (median distance, 5 mm; range, 2–8 mm), thus requiring extensive protective measures. Technical success was achieved in all cases. Two (20%) immediate neural complications were noted. One major complication was consistent with a permanent sensory deficit of the arm. One minor complication was consistent with a transient right Horner syndrome, which completely resolved after 48 hours with high-dose steroids. Median clinical follow-up was 12 months. Primary clinical success was 100% and 78% at 1 and 12 months of follow-up, respectively, with two patients presenting with recurring pain.
CONCLUSION. Percutaneous image-guided CA represents an effective therapeutic option for patients affected by painful OBs; the safety profile of the procedure is acceptable as long as comprehensive protective measures are deployed in light of the frequent close proximity of critical structures.
Keywords: bone, cryotherapy, osteoblastoma
References
Previous section
1. Atesok KI, Alman BA, Schemitsch EH, Peyser A, Mankin H. Osteoid osteoma and osteoblastoma. J Am Acad Orthop Surg 2011; 19:678–689 [Crossref] [Medline] [Google Scholar]
2. Koch G, Cazzato RL, Gilkison A, Caudrelier J, Garnon J, Gangi A. Percutaneous treatments of benign bone tumors. Semin Intervent Radiol 2018; 35:324–332 [Crossref] [Medline] [Google Scholar]
3. Manaster BJ, Andrews CL, Petersilge CA, Roberts CC. Expertddx musculoskeletal, 1st ed. Salt Lake City, UT: Amirsys, 2008:II32–II33 [Google Scholar]
4. Berry M, Mankin H, Gebhardt M, Rosenberg A, Hornicek F. Osteoblastoma: a 30-year study of 99 cases. J Surg Oncol 2008; 98:179–183 [Crossref] [Medline] [Google Scholar]
5. Weber MA, Sprengel SD, Omlor GW, et al. Clinical long-term outcome, technical success, and cost analysis of radiofrequency ablation for the treatment of osteoblastomas and spinal osteoid osteomas in comparison to open surgical resection. Skeletal Radiol 2015; 44:981–993 [Crossref] [Medline] [Google Scholar]
6. Arrigoni F, Barile A, Zugaro L, et al. CT-guided radiofrequency ablation of spinal osteoblastoma: treatment and long-term follow-up. Int J Hyperthermia 2018; 34:321–327 [Crossref] [Medline] [Google Scholar]
7. Kumasaka S, Miyazaki M, Tsushima Y. CT-guided percutaneous cryoablation of an aggressive osteoblastoma: a case report. J Vasc Interv Radiol 2015; 26:1746–1748 [Crossref] [Medline] [Google Scholar]
8. Cazzato RL, Garnon J, Ramamurthy N, et al. Percutaneous image-guided cryoablation: current applications and results in the oncologic field. Med Oncol 2016; 33:140 [Crossref] [Medline] [Google Scholar]
9. Teixeira PAG, Chanson A, Beaumont M, et al. Dynamic MR imaging of osteoid osteomas: correlation of semiquantitative and quantitative perfusion parameters with patient symptoms and treatment outcome. Eur Radiol 2013; 23:2602–2611 [Crossref] [Medline] [Google Scholar]
10. Yoshimoto Y, Azuma K, Miya A, et al. A fundamental study of cryoablation on normal bone: diagnostic imaging and histopathology. Cryobiology 2014; 69:229–235 [Crossref] [Medline] [Google Scholar]
11. Gu Y, Srimathveeravalli G, Cai L, et al. Pirfeni-done inhibits cryoablation induced local macrophage infiltration along with its associated TGFb1 expression and serum cytokine level in a mouse model. Cryobiology 2018; 82:106–111 [Crossref] [Medline] [Google Scholar]
12. Tsoumakidou G, Koch G, Caudrelier J, et al. Image-guided spinal ablation: a review. Cardiovasc Intervent Radiol 2016; 39:1229–1238 [Crossref] [Medline] [Google Scholar]
13. Tsoumakidou G, Thénint MA, Garnon J, Buy X, Steib JP, Gangi A. Percutaneous image-guided laser photocoagulation of spinal osteoid osteoma: a single-institution series. Radiology 2016; 278:936–943 [Crossref] [Medline] [Google Scholar]
14. Tsoumakidou G, Buy X, Garnon J, Enescu J, Gangi A. Percutaneous thermal ablation: how to protect the surrounding organs. Tech Vasc Interv Radiol 2011; 14:170–176 [Crossref] [Medline] [Google Scholar]
15. Kurup AN, Morris JM, Schmit GD, et al. Neuro-anatomic considerations in percutaneous tumor ablation. RadioGraphics 2013; 33:1195–1215 [Crossref] [Medline] [Google Scholar]
16. Kurup AN, Morris JM, Boon AJ, et al. Motor evoked potential monitoring during cryoablation of musculoskeletal tumors. J Vasc Interv Radiol 2014; 25:1657–1664 [Crossref] [Medline] [Google Scholar]
17. Cazzato RL, Garnon J, Shaygi B, et al. How to perform a routine cryoablation under MRI guidance. Top Magn Reson Imaging 2018; 27:33–38 [Crossref] [Medline] [Google Scholar]
18. Whitmore MJ, Hawkins CM, Prologo JD, et al. Cryoablation of osteoid osteoma in the pediatric and adolescent population. J Vasc Interv Radiol 2016; 27:232–237; quiz, 238 [Crossref] [Medline] [Google Scholar]
19. Boriani S, Amendola L, Bandiera S, et al. Staging and treatment of osteoblastoma in the mobile spine: a review of 51 cases. Eur Spine J 2012; 21:2003–2010 [Crossref] [Medline] [Google Scholar]
20. Li Z, Zhao Y, Hou S, Mao N, Yu S, Hou T. Clinical features and surgical management of spinal osteoblastoma: a retrospective study in 18 cases. PLoS One 2013; 8:e74635 [Crossref] [Medline] [Google Scholar]
Address correspondence to R. L. Cazzato (roberto-luigi.cazzato@chru-strasbourg.fr).
Read More: https://www.ajronline.org/doi/abs/10.2214/AJR.19.21390
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