Francesco Arrigoni, Presenter: Nothing to Disclose

Armando Conchiglia, Abstract Co-Author: Nothing to Disclose

Lorenzo Maria Gregori, Abstract Co-Author: Nothing to Disclose

Luigi Zugaro, Abstract Co-Author: Nothing to Disclose

Antonio Barile, Abstract Co-Author: Nothing to Disclose

Carlo Masciocchi, Abstract Co-Author: Nothing to Disclose

To compare the clinical and morphological results, two years after the procedure, of the treatment of 27 osteoid osteomas with Magnetic Resonance guided Focus Ultrasound Surgery (MRgFUS) versus the treatment with Radiofrequency termoablation (RF).

From March 2011 we treated 27 osteoid osteomas, 12 using MRgFUS (ExAblate InSightech, Israel) and 15 using RF (LeVeen Needle Electrode Boston Scientific - USA). The osteoid osteomas treated with MRgFUS were located in the femour (n.8), tibia (n.3) and in the talus (n. 1). The lesions treated with RFs were located in the femour (n. 9), talus (n.2), vertebral body (L3 and L5) and tibial plateau (n.2). All the lesions were diagnosed by plain films, CT and MRI and controlled after the procedure by MRI and CT. The clinical evaluation was performed by VAS scale.

All the patients treated with RF termoablation showed a regression in painful symptomatology with a mean VAS decreasing from 8 to 1.2 two years after the treatment. The treatment with MRgFUS was successful in 10 out of 12 patients (mean VAS dropped from 8.1 to 1.3 two years after the treatment). The two cases unresponsive were re-treated successfully with RF. The MRI evaluation showed a disappearance of bone edema already to the first controls at 6 months after the treatment in all the patients treated successfully. In the CT controls no substantial changes were found, except for the disappearance of the central calcification of the nidus in the 40% of cases treated with MRgFUS.

Although further studies with a longer term and a larger number of cases are needed, our experience demonstrates the effectiveness of the treatment of osteoid osteomas with MRgFUS. In particular this treatment is successful in the 83% of cases. The main limit is today represented by the accessibility of the lesion by the ultrasound. However the treatment is repeatable and does not preclude treatments with other techniques (with the RFs, the percentage of success is of 100%).

This study explain an innovative and non-bloody technique to treat osteoid osteoma of bone.

Arrigoni, F, Conchiglia, A, Gregori, L, Zugaro, L, Barile, A, Masciocchi, C, Radiofrequency Thermoablation versus Magnetic Resonance Guided Focalized Ultrasound Surgery (MRgFUS) in the Treatment of Osteoid Osteoma: Experience on 27 Consecutive Cases.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13015463.html