Michailidis A, Panos A, Samoladas E, Dimou G, Mingou G, Kosmoliaptsis P, Arvaniti M, Giankoulof C, Petsatodis E. Cryoablation of osteoid osteomas: Is it a valid treatment option? World J Radiol 2024; 16(9): 389-397 [DOI: 10.4329/wjr.v16.i9.389]
Corresponding Author of This Article
Evangelos Petsatodis, PhD, Consultant Physician-Scientist, Doctor, Department of Interventional Radiology, Georgios Papanikolaou General Hospital of Thessaloniki, Leoforos Papanikolaou, Exohi, Thessaloniki 57010, Greece. irpapanikolaou@gmail.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Antonios Michailidis, Georgios Dimou, Georgia Mingou, Panagiotis Kosmoliaptsis, Christos Giankoulof, Evangelos Petsatodis, Department of Interventional Radiology, Georgios Papanikolaou General Hospital of Thessaloniki, Thessaloniki 57010, Greece
Athanasios Panos, Efthimios Samoladas, Department of 1st Orthopaedic Clinic, Georgios Papanikolaou General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
Maria Arvaniti, Dental School, EKPA, Athens 15773, Greece
Author contributions: Petsatodis E and Samoladas E designed the research; Michailidis A, Kosmoliaptsis P, Dimou G, and Mingou G performed the research; Petsatodis E and Arvaniti M contributed new reagents or analytic tools; Petsatodis E and Giankoulof C analyzed data; Michailidis A and Panos A wrote the paper.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of General Hospital of Thessaloniki “G. Papanikolaou” (Protocol Code 77481-12 and 05-04-2024).
Informed consent statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: Consent for publication was obtained for every individual person’s data included in the study.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Evangelos Petsatodis, PhD, Consultant Physician-Scientist, Doctor, Department of Interventional Radiology, Georgios Papanikolaou General Hospital of Thessaloniki, Leoforos Papanikolaou, Exohi, Thessaloniki 57010, Greece. irpapanikolaou@gmail.com
Received: April 17, 2024 Revised: August 20, 2024 Accepted: September 2, 2024 Published online: September 28, 2024 Processing time: 162 Days and 9.3 Hours
Abstract
BACKGROUND
Osteoid osteoma is a benign bone tumor with characteristic clinical symptomatology. The selected method for its treatment is percutaneous radiofrequency ablation. However, percutaneous cryoablation is an alternative method with certain advantages.
AIM
To evaluate percutaneous computed tomography (CT)-guided cryoablation for the treatment of osteoid osteoma in young patients and adults.
METHODS
A total of 25 patients were treated with percutaneous CT- guided cryoablation for osteoid osteomas between October 2020 and March 2023 at a single institution. All patients were above 14-years-old (mean age, 24-years-old), and all procedures were performed under local anesthesia. Of the 25 patients, 8 were female and 17 were male. Tumor sites included the femur (n = 9), medial malleolus (n = 4), sacral ala (n = 4), facets (n = 4), humerus (n = 3), and tibia (n = 1). One cryoprobe was used in each procedure and, when possible, the lesion was covered by the ice-ball using an extraosseous position without penetrating the nidus. All necessary thermal protective techniques were used depending on the anatomical structure at risk.
RESULTS
All patients treated had complete response (100% clinical success rate) starting on the day of the procedure. Technical success was achieved in all cases. Visual analog scale (VAS) scores at 1 year were 0, compared to a mean VAS score of 8.5 ± 1 (SD) before the procedure. No recurrences were reported at the 1-year follow-up and no complications were observed. In 11/25 cases, an extraosseous position of the cryoprobe was used with less procedural time achieving technical and clinical success and no complications with less patient discomfort. All patients were discharged from the hospital on the same day as the procedure.
CONCLUSION
Cryoablation of osteoid osteomas is an efficacious and safe procedure with durable clinical results. Its greatest advantage is that the procedure can be performed under local anesthesia using an extraosseous position of the cryoprobe when possible.
Core Tip: This study aims to evaluate percutaneous cryoablation for the treatment of osteoid osteomas. Our results prove that cryoablation is safe and effective as a treatment option for these tumors and has certain advantages over other ablative methods. Cryoablation has the advantage of extraosseous positioning of the cryoprobe, avoiding bone drilling, less procedural and post-procedural pain, making it possible for the procedure to be performed strictly under local anesthesia and the ability to treat larger lesions with a single probe placement.
