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

Orthopaedic Rizzoli Institute Bologna, Italy

 
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We have read with interest the article "Radiofrequency Ablation of Osteoid Osteoma with Cooled Probes and Impedance-Control Energy Delivery" [1] that clearly shows the experience gained by the authors in thermal ablation by radiofrequency with needle electrode using cooled probes with energy and impedance control in 11 patients affected by osteoid osteoma.

The article is very interesting because it mentions in detail the effect of the treatment on pain. The delivery of high energy entails the mandatory observation of some safety measures: staying at least 1.5 cm from the vascular–nervous structures and 1 cm from the skin. It is not clear how these parameters were observed in the peduncular location of T8 in that series [1].

From June 2001 to July 2006, we performed thermal ablation of osteoid osteomas in 327 patients (300 nonspinal locations, 27 vertebral locations) using the RFG 3C RFs Lesion Generator System, the SMK-TC 15 Kit by Radionics, and the biopsy set by Bonopty. The parameters that we currently use are delivery time (variable in relationship to the active tip of the needle electrode, site, and morphology and volume of the osteoid osteoma), not less than 18 minutes; temperature in the tip of the needle electrode, 90–95 C°; delivery energy, low, at the most 6 W (usually 1–3 W).

With these parameters, in the patients checked with MRI, we found a necrotic area of more than 25 mm in maximum diameter using a 15-mm active tip. The low energy of delivery, the reduced caliber of the needle electrode (20 gauge), and the active tip of varying length (5–15 mm) have also enabled us to perform successfully and without complications the thermal ablation of osteoid osteomas located in the spine and the surface of the bones of the hands and the feet.

In our experience, the pain caused by osteoid osteoma usually resolves after a few hours. In nonarticular and nonspinal locations, the patient resumes unrestricted normal daily activities the following day. We agree with the authors that thermal ablation with radiofrequency of osteoid osteomas is a safe and effective technique provided that the procedure is performed with precision and accuracy.

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1. Cantwell CP, O'Byrne J, Eustace S. Radiofrequency ablation of osteoid osteoma with cooled probes and impedance-control energy delivery. AJR 2006;186 [5 suppl]:S244 –S248[Abstract/Free Full Text]

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				C. P. Cantwell, S. Eustace, and J. O'Byrne Reply Am. J. Roentgenol., June 1, 2007; 188(6): W579 - W579. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Albisinni, U. Articles by Rimondi, E. Search for Related Content PubMed PubMed Citation Articles by Albisinni, U. Articles by Rimondi, E. Social Bookmarking                      What's this?