Araştırma Makalesi
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Efficacy, safety, and short-term follow-up results of CT-guided radiofrequency and microwave ablation in the treatment of Osteoid Osteoma

Yıl 2025, Cilt: 10 Sayı: 1, 28 - 33, 20.03.2025
https://doi.org/10.22391/fppc.1629511

Öz

Introduction: The use of Computed Tomography-guided (CT-guided) percutaneous thermal ablation (PTA) techniques in the treatment of osteoid osteoma (OO) has been increasingly adopted worldwide. This study aims to evaluate the efficacy and safety of thermal ablation techniques in OO treatment, with a particular focus on short-term clinical success rates.
Methods: A retrospective analysis was conducted on 19 patients who underwent radiofrequency ablation (RFA) or microwave ablation (MWA) CT-guided in the Interventional Radiology Department of Pamukkale University Faculty of Medicine Hospital between October 2018 and December 2024. Data were obtained from hospital records. All procedures were performed under sedation by a single interventional radiologist, and follow-up evaluations were recorded on post-procedure day 1 and month 1. Visual Analog Scale (VAS) scores and lesion characteristics were reviewed from medical records. Technical success was defined as complete ablation of the nidus, while clinical success was defined as a post-procedure VAS score of ≤3.
Results: The mean age of the 19 patients who underwent thermal ablation was 13.6 years. Of the cohort, 36.8% (n=7) were female, and 63.2% (n=12) were male. The mean nidus diameter was 4.57 mm. The mean pre-procedure VAS score was 8.32, which significantly decreased to 1.11 on the first day post-procedure and 0.37 at the first-month follow-up. The technical success rate was 100%, while the clinical success rate was 95%. Minor complications were observed in 10.53% of cases, and major complications were reported in 5.26% of cases. Subgroup analyses revealed significant differences in pain perception between pediatric and adolescent patients before the procedure, but all groups showed statistically significant reductions in VAS scores post-procedure.
Conclusion: CT-guided PTA techniques are effective, safe, and minimally invasive treatment options for osteoid osteoma. In addition to high technical and clinical success rates, they offer a rapid recovery period. The findings support the use of PTA techniques as a first-line treatment option for OO. However, due to the retrospective study design, larger, multi-center, prospective randomized studies are required to confirm and expand these findings.

Etik Beyan

Permission was obtained from Pamukkale University Non-Interventional Clinical Research Ethics Committee for the study (permission date: January 21, 2025, permission number: E-60116787-020-643270).

Kaynakça

  • 1. Bianchi G, Zugaro L, Palumbo P, Candelari R, Paci E, Floridi C, Giovagnoni A. Interventional Radiology’s Osteoid Osteoma Management: Percutaneous Thermal Ablation. J. Clin. Med. 2022, 11, 723. https://doi.org/10.3390/jcm11030723
  • 2. De Filippo M, Russo U, Papapietro VR, Ceccarelli F, Pogliacomi F, Vaienti E, Piccolo C, Capasso R, Sica A, Cioce F, Carbone M, Bruno F, Masciocchi C, Miele V. Radiofrequency ablation of osteoid osteoma. Acta Biomed. 2018 Jan 19;89(1-S):175-185. https://doi.org/10.23750/abm.v89i1-s.7021
  • 3. Rosenthal DI, Alexander A, Rosenberg AE, Springfield D. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology. 1992 Apr;183(1):29-33. https://doi.org/10.1148/radiology.183.1.1549690
  • 4. Boscainos PJ, Cousins GR, Kulshreshtha R, Oliver TB, Papagelopoulos PJ. Osteoid osteoma. Orthopedics. 2013;36(10):792-800. https://doi.org/10.3928/01477447-20130920-10
  • 5. Tillotson CL, Rosenberg AE, Rosenthal DI. Controlled thermal injury of bone. Report of a percutaneous technique using radiofrequency electrode and generator. Invest Radiol. 1989 Nov;24(11):888-92. https://doi.org/10.1097/00004424-198911000-00009
  • 6. Parmeggiani A, Martella C, Ceccarelli L, Miceli M, Spinnato P, Facchini G. Osteoid osteoma: which is the best mininvasive treatment option? Eur J Orthop Surg Traumatol. 2021 Dec;31(8):1611-1624. https://doi.org/10.1007/s00590-021-02946-w
  • 7. Shanmugasundaram S, Nadkarni S, Kumar A, Shukla PA. Percutaneous Ablative Therapies for the Management of Osteoid Osteomas: A Systematic Review and Meta-Analysis. Cardiovasc Intervent Radiol. 2021 May;44(5):739-49. https://doi.org/10.1007/s00270-021-02804-6
  • 8. Shu M, Ke J. The surgical management of osteoid osteoma: A systematic review. Front Oncol. 2022 Jul;22(12):935640. https://doi.org/10.3389/fonc.2022.935640
  • 9. Mutlu IN, Cingoz M, Guzelbey T, Cingoz E, Kilickesmez O. Percutaneous CT-Guided Microwave Ablation for the Treatment of Osteoid Osteomas: A Single Center Experience. Acad Radiol. 2024 Sep;31(9):3725-31. https://doi.org/10.1016/j.acra.2024.02.025
  • 10. Reis J, Chang Y, Sharma AK. Radiofrequency ablation vs microwave ablation for osteoid osteomas: long-term results. Skeletal Radiol. 2020 Dec;49(12):1995-2000. https://doi.org/10.1007/s00256-020-03518-5

BT kılavuzluğunda radyofrekans ve mikrodalga ablasyonun Osteoid Osteoma tedavisindeki etkinliği, güvenliği ve kısa dönem takip sonuçları

Yıl 2025, Cilt: 10 Sayı: 1, 28 - 33, 20.03.2025
https://doi.org/10.22391/fppc.1629511

Öz

Giriş: Osteoid Osteom (OO) tedavisinde Bilgisayarlı Tomografi (BT) kılavuzluğunda uygulanan perkütan termal ablasyon (PTA) teknikleri tüm dünyada giderek yaygınlaşmaktadır. Bu çalışmanın amacı OO tedavisinde termal ablasyon tekniklerinin etkinliğini, güvenilirliğini ve özellikle klinik başarı oranlarının kısa dönem takip sonuçları değerlendirmektir.
Yöntem: Ekim 2018 ile Aralık 2024 tarihleri arasında Pamukkale Üniversitesi Tıp Fakültesi Hastanesi Girişimsel Radyoloji bölümünde BT kılavuzluğunda PTA teknikleri olan Radyofrekans Ablasyon (RFA) ve Mikrodalga Ablasyon (MDA) uygulanan 19 hasta retrospektif olarak değerlendirildi. Veriler hastane kayıtlarındaki hasta dosyalarından elde edildi. Tüm işlemler, sedasyon altında, tek bir girişimsel radyolog tarafından gerçekleştirilmiş olduğu ve işlem sonrası 1. gün ve 1. ayda takipleri kayıtlardan elde edildi. Hastaların Görsel Analog Ölçek (GAÖ) skorları ve lezyon özellikleri kayıtlardan incelendi. Teknik başarı nidusun tamamen ablasyonuyla, klinik başarı ise işlem sonrası GAÖ skorunun ≤3 olmasıyla tanımlandı.
Bulgular: Termal ablasyon uygulanan 19 hastanın yaş ortalaması 13,6 olup, hasta grubunun %36,8’ini (n=7) kadın, %63,2’sini (n=12) erkek hastalar oluşturmuştur. İşlem öncesinde ortalama nidus çapı 4,57 mm olarak saptanmıştır. GAÖ skorları işlem öncesinde ortalama 8,32 olarak kaydedilirken, işlem sonrası 1. günde 1,11’e ve 1. ayda 0,37’ye anlamlı düzeyde azalma göstermiştir. Teknik başarı oranı %100, klinik başarı oranı ise %95 olarak saptanmıştır. Minör komplikasyon oranı %10,53, majör komplikasyon oranı ise %5,26 olarak gözlenmiştir. Alt grup analizlerinde çocuk ve ergen hastalar arasında işlem öncesi ağrı algısında belirgin farklılıklar tespit edilmiş olmakla birlikte, tüm gruplarda işlem öncesine göre GAÖ skorlarında istatistiksel olarak anlamlı azalmalar kaydedilmiştir.
Sonuç: BT kılavuzluğunda uygulanan PTA teknikleri osteoid osteom tedavisinde etkili, güvenli ve minimal invaziv yöntemlerdir. Yüksek teknik ve klinik başarı oranlarına ek olarak, hızlı iyileşme süresi sağlamaktadır. Bulgular OO tedavisinde PTA tekniklerinin birinci basamak tedavi seçeneği olarak kullanımını desteklemektedir. Ancak, çalışmanın retrospektif tasarımı nedeniyle elde edilen sonuçların doğrulanması ve genişletilmesi için daha büyük hasta grupları ile yapılacak çok merkezli prospektif randomize çalışmalar gerekmektedir.

Etik Beyan

Permission was obtained from Pamukkale University Non-Interventional Clinical Research Ethics Committee for the study (permission date: January 21, 2025, permission number: E-60116787-020-643270).

Kaynakça

  • 1. Bianchi G, Zugaro L, Palumbo P, Candelari R, Paci E, Floridi C, Giovagnoni A. Interventional Radiology’s Osteoid Osteoma Management: Percutaneous Thermal Ablation. J. Clin. Med. 2022, 11, 723. https://doi.org/10.3390/jcm11030723
  • 2. De Filippo M, Russo U, Papapietro VR, Ceccarelli F, Pogliacomi F, Vaienti E, Piccolo C, Capasso R, Sica A, Cioce F, Carbone M, Bruno F, Masciocchi C, Miele V. Radiofrequency ablation of osteoid osteoma. Acta Biomed. 2018 Jan 19;89(1-S):175-185. https://doi.org/10.23750/abm.v89i1-s.7021
  • 3. Rosenthal DI, Alexander A, Rosenberg AE, Springfield D. Ablation of osteoid osteomas with a percutaneously placed electrode: a new procedure. Radiology. 1992 Apr;183(1):29-33. https://doi.org/10.1148/radiology.183.1.1549690
  • 4. Boscainos PJ, Cousins GR, Kulshreshtha R, Oliver TB, Papagelopoulos PJ. Osteoid osteoma. Orthopedics. 2013;36(10):792-800. https://doi.org/10.3928/01477447-20130920-10
  • 5. Tillotson CL, Rosenberg AE, Rosenthal DI. Controlled thermal injury of bone. Report of a percutaneous technique using radiofrequency electrode and generator. Invest Radiol. 1989 Nov;24(11):888-92. https://doi.org/10.1097/00004424-198911000-00009
  • 6. Parmeggiani A, Martella C, Ceccarelli L, Miceli M, Spinnato P, Facchini G. Osteoid osteoma: which is the best mininvasive treatment option? Eur J Orthop Surg Traumatol. 2021 Dec;31(8):1611-1624. https://doi.org/10.1007/s00590-021-02946-w
  • 7. Shanmugasundaram S, Nadkarni S, Kumar A, Shukla PA. Percutaneous Ablative Therapies for the Management of Osteoid Osteomas: A Systematic Review and Meta-Analysis. Cardiovasc Intervent Radiol. 2021 May;44(5):739-49. https://doi.org/10.1007/s00270-021-02804-6
  • 8. Shu M, Ke J. The surgical management of osteoid osteoma: A systematic review. Front Oncol. 2022 Jul;22(12):935640. https://doi.org/10.3389/fonc.2022.935640
  • 9. Mutlu IN, Cingoz M, Guzelbey T, Cingoz E, Kilickesmez O. Percutaneous CT-Guided Microwave Ablation for the Treatment of Osteoid Osteomas: A Single Center Experience. Acad Radiol. 2024 Sep;31(9):3725-31. https://doi.org/10.1016/j.acra.2024.02.025
  • 10. Reis J, Chang Y, Sharma AK. Radiofrequency ablation vs microwave ablation for osteoid osteomas: long-term results. Skeletal Radiol. 2020 Dec;49(12):1995-2000. https://doi.org/10.1007/s00256-020-03518-5
Toplam 10 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi, Radyoloji ve Organ Görüntüleme
Bölüm Araştırma Makalesi (Original Article)
Yazarlar

Halil Serdar Aslan 0000-0002-5255-8618

Kadirhan Alver 0000-0002-4692-2401

Ahmet Nadir Aydemir 0000-0002-3095-4935

Yayımlanma Tarihi 20 Mart 2025
Gönderilme Tarihi 30 Ocak 2025
Kabul Tarihi 28 Şubat 2025
Yayımlandığı Sayı Yıl 2025Cilt: 10 Sayı: 1

Kaynak Göster

APA Aslan, H. S., Alver, K., & Aydemir, A. N. (2025). Efficacy, safety, and short-term follow-up results of CT-guided radiofrequency and microwave ablation in the treatment of Osteoid Osteoma. Family Practice and Palliative Care, 10(1), 28-33. https://doi.org/10.22391/fppc.1629511
AMA Aslan HS, Alver K, Aydemir AN. Efficacy, safety, and short-term follow-up results of CT-guided radiofrequency and microwave ablation in the treatment of Osteoid Osteoma. Fam Pract Palliat Care. Mart 2025;10(1):28-33. doi:10.22391/fppc.1629511
Chicago Aslan, Halil Serdar, Kadirhan Alver, ve Ahmet Nadir Aydemir. “Efficacy, Safety, and Short-Term Follow-up Results of CT-Guided Radiofrequency and Microwave Ablation in the Treatment of Osteoid Osteoma”. Family Practice and Palliative Care 10, sy. 1 (Mart 2025): 28-33. https://doi.org/10.22391/fppc.1629511.
EndNote Aslan HS, Alver K, Aydemir AN (01 Mart 2025) Efficacy, safety, and short-term follow-up results of CT-guided radiofrequency and microwave ablation in the treatment of Osteoid Osteoma. Family Practice and Palliative Care 10 1 28–33.
IEEE H. S. Aslan, K. Alver, ve A. N. Aydemir, “Efficacy, safety, and short-term follow-up results of CT-guided radiofrequency and microwave ablation in the treatment of Osteoid Osteoma”, Fam Pract Palliat Care, c. 10, sy. 1, ss. 28–33, 2025, doi: 10.22391/fppc.1629511.
ISNAD Aslan, Halil Serdar vd. “Efficacy, Safety, and Short-Term Follow-up Results of CT-Guided Radiofrequency and Microwave Ablation in the Treatment of Osteoid Osteoma”. Family Practice and Palliative Care 10/1 (Mart 2025), 28-33. https://doi.org/10.22391/fppc.1629511.
JAMA Aslan HS, Alver K, Aydemir AN. Efficacy, safety, and short-term follow-up results of CT-guided radiofrequency and microwave ablation in the treatment of Osteoid Osteoma. Fam Pract Palliat Care. 2025;10:28–33.
MLA Aslan, Halil Serdar vd. “Efficacy, Safety, and Short-Term Follow-up Results of CT-Guided Radiofrequency and Microwave Ablation in the Treatment of Osteoid Osteoma”. Family Practice and Palliative Care, c. 10, sy. 1, 2025, ss. 28-33, doi:10.22391/fppc.1629511.
Vancouver Aslan HS, Alver K, Aydemir AN. Efficacy, safety, and short-term follow-up results of CT-guided radiofrequency and microwave ablation in the treatment of Osteoid Osteoma. Fam Pract Palliat Care. 2025;10(1):28-33.

Family Practice and Palliative Care      ISSN 2458-8865       E-ISSN 2459-1505