Computed tomography guided radiofrequency ablation of osteoid osteoma in children: a single center’s experience

Filippiadis, Dimitrios; Stefanou, Danai E.; Mazioti, Argyro; Foti, Louiza; Tsochatzis, Athanasios; Kelekis, Nikolaos; Kelekis, Alexis

doi:10.1007/s00256-021-03904-7

Cited by 7 publications

(5 citation statements)

References 38 publications

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“…There is existing literature regarding consensus use of PIO procedures to treat osteoid osteomas 20 , 21 , 22 and accumulating experience regarding the treatment of pediatric patients with primary liver tumors or retinoblastoma. 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 Our single‐institution experience provides insight regarding additional patient cohorts to potentially pursue for future study.…”

Section: Discussionmentioning

confidence: 99%

“…17 While limited by the lack of clinically relevant endpoints, these publications support the safety and tolerability of PIO procedures. [17][18][19] There is existing literature regarding consensus use of PIO procedures to treat osteoid osteomas [20][21][22] and accumulating experience regarding the treatment of pediatric patients with primary liver tumors or retinoblastoma. [23][24][25][26][27][28][29][30] Our single-institution experience provides insight regarding additional patient cohorts to potentially pursue for future study.…”

Section: Malignant Lesionsmentioning

confidence: 99%

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A single‐institution pediatric and young adult interventional oncology collaborative: Novel therapeutic options for relapsed/refractory solid tumors

Shaikh,

Weil,

Weldon

et al. 2023

Cancer Medicine

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Background Pediatric interventional oncology (PIO) is a growing field intended to provide additional or alternative treatment options for pediatric patients with benign or malignant tumors. Large series of patients treated uniformly and subjected to rigorous endpoints for efficacy are not available. Methods We designed a collaborative initiative to capture data from pediatric patients with benign and malignant tumors who underwent a therapeutic interventional radiology procedure. Modified Response Evaluation Criteria in Solid Tumors (mRECIST) was utilized as a measure of radiologic response and data were collected regarding improvement in pain and functional endpoints. Cumulative incidence of progressive disease was calculated using both the treated site and the patient as the analytic unit. Findings Forty patients, 16 with malignant tumors and 24 with benign tumors, underwent a total of 88 procedures. Cryo‐ and radiofrequency ablation were the most frequently utilized techniques for both cohorts of patients. A complete or partial response, or prolonged disease stability, were achieved in approximately 40% of patients with malignant tumors and 60% of patients with benign tumors. No patients had progressive disease as their best response. Resolution of pain and improved mobility with return‐to‐baseline activity were demonstrated across patients from both cohorts. Only minor complications were experienced. Interpretation Interventional radiology‐guided interventions can serve as an alternative or complementary approach to the treatment of benign and malignant tumors in pediatric patients. Prospective, multi‐institutional trials are required to adequately study utility, treatment endpoints, and durability of response.

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Section: Discussionmentioning

confidence: 99%

Section: Malignant Lesionsmentioning

confidence: 99%

A single‐institution pediatric and young adult interventional oncology collaborative: Novel therapeutic options for relapsed/refractory solid tumors

Shaikh,

Weil,

Weldon

et al. 2023

Cancer Medicine

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“…This is the largest series of atypical, early-onset OO in children younger than 4 years old, and the only series focused on minimally invasive treatment in this age group. Indeed, recent research focused on CT-guided RFA for OO in children included patients in the usually expected age range (5–18 years old) [ 25 ]. The results of our analyses are in line with the previous series focused on adults and/or children in regard to the safety and effectiveness of this treatment [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…In our series, due to the few patients included, we did not observe disease recurrence. This eventuality varies mainly depending on lesion locations and is reported to account for 2% of cases for non-spinal OO and for 6–12% for spinal ones [ 25 , 26 , 27 , 28 , 29 ]. Nonetheless, it is well-known that some OO locations may not be safely treated with RFA, particularly due to the proximity to neural structures (e.g., particular spinal locations).…”

Section: Discussionmentioning

confidence: 99%

CT-Guided Radiofrequency Thermal Ablation for the Treatment of Atypical, Early-Onset Osteoid Osteoma in Children Younger than 4 Years Old: Single-Institution Experience and Literature Review

et al. 2022

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The aim of our study is to report our experience on CT-guided radiofrequency ablation (RFA) for osteoid osteoma (OO) in children under 4 years of age and to review the literature regarding this atypical, early onset of the disease. We retrospectively reviewed the clinical and radiological records of the patients treated with CT-guided RFA for OO at our institution (2006–2021), including those under 4 years of age. Data regarding technical success, clinical success, and biopsy diagnostic yield were collected. Moreover, we performed a literature review including previous articles on early-onset OO. We found only 12 patients that were under 4 years of age (12/842–1.4%) at the time of RFA treatment: 4 F and 8 M, mean age at the time of the treatment 35.3 months (range 22–46 months). The mean follow-up was 22.8 months (range 6–96 months). Technical success was achieved in all cases (12/12). In all patients (12/12), a complete remission of the pain symptoms was achieved at clinical follow-up controls. No recurrence of pain or complications were documented. The histopathological diagnosis was confirmed in 4 patients (4/12–33.3%). Moreover, we found another 9 articles in the literature with a main focus on early-onset OO (<4 years old), with a total of 12 patients included; 6 of those patients (6/12–50%) were treated with CT-guided RFA, with success reported 5 cases (5/6–83.3%). Our series of cases treated at a single institution, together with the existing data from the literature, confirms that CT-guided RFA is effective and safe for the treatment of osteoid osteoma, even in atypical, early onset in children under 4 years of age.

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“…The traditional surgical approaches for spinal osteoid osteoma include curettage and en bloc excision 9 , 10 . Recently, minimally invasive interventions including CT‐guided excision and radio‐frequency ablation have also been encouraged 3 , 11 , 12 . However, there have limited studies on systemically analyzing the factors contributing to misdiagnosis and missed diagnosis of spinal osteoid osteoma or presenting strategies to eliminate misdiagnosis and missed diagnosis of the disease.…”

Section: Introductionmentioning

confidence: 99%

Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center Experience

Liu

et al. 2022

Orthopaedic Surgery

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Objectives To analyze the causes of misdiagnosis and missed diagnosis in spinal osteoid osteoma, and to put forward solutions to improve diagnosis accuracy and treatment efficacy in patients. Methods We performed a retrospective cohort study on patients with spinal osteoid osteoma in Beijing Jishuitan Hospital from January 1983 to September 2019. All patients underwent surgery. The outcome measures were the extent of local pain, nocturnal pain, radicular symptoms of extremities after surgery, and reduction or disappearance of lesions on CT after surgery. Results Thirty‐seven patients with spinal osteoid osteoma were recruited in the study. A total of 27% were female, and the mean (SD) age at diagnosis was 21.3 (8.7) years. A total of 87.0% of patients presented with nocturnal pain, and 94.7% of patients were responsive to NSAIDS treatment. The mean (SD) time from the initial onset of symptoms to the final diagnosis was 14.7 (12.5) months. Only four of 37 (10.8%) patients were correctly diagnosed with spinal osteoid osteoma on the first visit to the local hospital. CT is associated with a higher diagnosis rate than X‐ray or MRI on the first visit. Surgical navigation was used in 88.9% of patients who underwent curettage resection, and in 10% of patients who underwent en bloc resection. A total of 37 of 37 patients (100%) reported relief of local pain and radicular symptoms of extremities after surgery, and no recurrence of tumors was found during follow‐ups. Conclusions Spinal CTs are recommended to be performed if osteoid osteoma is suspected based on clinical manifestation, including nocturnal pain and responsiveness to NSAIDS treatment, to avoid misdiagnosis and missed diagnosis of spinal osteoid osteoma.

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Computed tomography guided radiofrequency ablation of osteoid osteoma in children: a single center’s experience

Cited by 7 publications

References 38 publications

A single‐institution pediatric and young adult interventional oncology collaborative: Novel therapeutic options for relapsed/refractory solid tumors

A single‐institution pediatric and young adult interventional oncology collaborative: Novel therapeutic options for relapsed/refractory solid tumors

CT-Guided Radiofrequency Thermal Ablation for the Treatment of Atypical, Early-Onset Osteoid Osteoma in Children Younger than 4 Years Old: Single-Institution Experience and Literature Review

Avoiding Misdiagnosis and Missed Diagnosis for Appropriately Treating Spinal Osteoid Osteomas: A Single‐Center Experience

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