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MRI Features After Radiofrequency Ablation of Osteoid Osteoma with Cooled Probes and Impedance-Control Energy Delivery

Colin P. Cantwell1, Jennifer Kerr1, John O'Byrne1,2 and Stephen Eustace1,2

1 Department of Radiology, Mater Misericordiae University Hospital, Eccles St., Dublin 7, Ireland.
2 Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland.


Figure 1
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  		Fig. 1 —Diagram shows measurement of zone of marrow ablation from coronal image.

 

Figure 2
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  		Fig. 2A —CT and MR images of tibia in 11-year-old girl with extensive endosteal new bone formation around osteoid osteoma. Axial CT image obtained before procedure shows extensive endocortical thickening of tibial cortex.

 

Figure 3
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  		Fig. 2B —CT and MR images of tibia in 11-year-old girl with extensive endosteal new bone formation around osteoid osteoma. Axial turbo spin-echo T1 image obtained 1 day after therapy at same level as A shows low marrow signal.

 

Figure 4
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  		Fig. 3A —MRI of distal femur performed after radiofrequency ablation in 30-year-old woman with osteoid osteoma. Coronal STIR image at 1 day shows heterogeneous high signal in marrow (arrow) adjacent to probe placement tract.

 

Figure 5
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  		Fig. 3B —MRI of distal femur performed after radiofrequency ablation in 30-year-old woman with osteoid osteoma. Axial STIR image at 1 day shows high signal along drill hole (arrow). Heterogeneous high signal is seen in marrow adjacent to probe placement tract deep in relation to high-signal nidus. High signal is seen in soft tissues and periosteum superficial to drill hole. No band of peripheral marrow signal change is seen.

 

Figure 6
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  		Fig. 3C —MRI of distal femur performed after radiofrequency ablation in 30-year-old woman with osteoid osteoma. Coronal turbo spin-echo T1 image at 1 day shows low marrow signal (arrow) along probe placement tract deep in relation to cortical drill hole.

 

Figure 7
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  		Fig. 3D —MRI of distal femur performed after radiofrequency ablation in 30-year-old woman with osteoid osteoma. Coronal STIR image obtained 7 days after radiofrequency ablation shows heterogeneous isointense signal in marrow adjacent to probe placement tract. Band of high peripheral marrow signal change (arrow) is seen.

 

Figure 8
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  		Fig. 3E —MRI of distal femur performed after radiofrequency ablation in 30-year-old woman with osteoid osteoma. Coronal turbo spin-echo T1 image obtained 7 days after radiofrequency ablation shows heterogeneous isointense signal in marrow adjacent to probe placement tract. Band of low peripheral marrow signal change (arrow) is seen. No significant change was seen in STIR and T1 imaging features 28 days after radiofrequency ablation.

 

Figure 9
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  		Fig. 4A —MR images 28 days after radiofrequency therapy of osteoid osteoma of tibia in 16-year-old girl with extensive local new bone formation. Coronal turbo spin-echo T1 image shows demarcation of zone of marrow therapy with band of homogeneous low signal (arrow). Intermediate signal is seen in drill hole in cortex adjacent to osteoid osteoma (right).

 

Figure 10
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  		Fig. 4B —MR images 28 days after radiofrequency therapy of osteoid osteoma of tibia in 16-year-old girl with extensive local new bone formation. Coronal STIR image shows demarcation of zone of marrow therapy with homogeneous high-signal band (arrow). Band of high signal (right) is still seen in drill tract at cortex.

 

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