Daniel Geiger MD, Presenter: Nothing to Disclose

Alessandro Napoli MD, Abstract Co-Author: Nothing to Disclose

Armando Conchiglia, Abstract Co-Author: Nothing to Disclose

Alberto Bazzocchi MD, Abstract Co-Author: Nothing to Disclose

Ugo Albisinni MD, Abstract Co-Author: Nothing to Disclose

Carlo Masciocchi, Abstract Co-Author: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

Purpose of this study was to evaluate MR-guided focused ultrasound (MRgFUS), in terms of success rate, for painful non-spinal osteoid osteoma treatment.

This IRB approved prospective multi-centric cohort study, performed at three university hospitals, included thirty patients (M:21;Mean age:24±11). Between May 2010 and April 2012 thirty painful non-spinal osteoid osteomas, diagnosed at imaging (including ce-dynamic MR [Gd-BOPTA, Bracco]) have been treated using MRgFUS (3.0-T/1.5-T GE Discovery MR 750/450 + InSightec ExAblate 2000). Treatment success in terms of pain reduction has been evaluated using visual analog scales (VAS). Sonications number and mean acoustic energy (J) have been recorded. One year clinical and imaging follow-up was performed to evaluate success rate, recurrence and complications. 

Thirty osteoid osteomas (26 lower limbs and 4 upper limbs) have been treated using MRgFUS. Complete clinical success rate was 90% (27/30), with a pain score ≤2 after treatment and at twelve months evaluation. Partial treatment was observed in 10% (3/30) and CTgRFA (2/30) or open surgery (1/30) was then performed. A single session treatment was sufficient in 93% (28/30) of cases to achieve clinical success. Two cases required MRgFUS retreatment. Types of anesthesia were spinal (21), peripheral (5) and general (4;in pts.≤16yo). Mean sonications number was 6±3; mean energy 1080±727 J. No complications were observed immediately after treatment or during follow-up. 

This multi-centric prospective cohort study demonstrated that MRgFUS has a high success rate (90%) and a relatively short learning curve for non-spinal osteoid osteoma treatment. Our results suggest that MRgFUS may be considered as an effective, totally non-invasive and safe alternative approach in osteoid osteoma interventional management. 

The safety and effectiveness of MRgFUS encourages its adoption in treating non-spinal osteoid osteoma. This procedure, differently from any other ablative technique, is totally non-invasive.

Geiger, D, Napoli, A, Conchiglia, A, Bazzocchi, A, Albisinni, U, Masciocchi, C, Catalano, C, MR-guided Focused Ultrasound (MRgFUS) Ablation for Non-spinal Osteoid Osteoma Treatment: A Prospective Multi-centric Cohort Study.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13023931.html