Intraoperative skeletal scintigraphy for localization of osteoid-osteoma in the spine. Case report.

Rinsky, Lawrence A.; Goris, Michael; Bleck, Ellen; Halpern, Alan A.; Hirshman, P

doi:10.2106/00004623-198062010-00026

Cited by 68 publications

(17 citation statements)

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“…Yildiz et al [22] recommended in-block resection of femoral neck and talar osteoid-osteomas due to difficulties in finding the nidus. Intraoperative guides would be mostly indicated in these locations in order to perform an economic resection and avoid complications [1,3,[6][7][8][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative localization of an osteoid-osteoma using a gamma probe

Etchebehere

Reganin

et al. 2004

International Orthopaedics (SICOT)

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The purpose of this study was to evaluate whether intraoperative nidus detection with a hand-held gamma probe was efficient enough for use as a routine procedure. Thirty-seven patients with osteoid-osteomas were submitted to surgical treatment. The first group consisted of 19 patients submitted to open nidus resection using a hand-held gamma probe as guide. The control group consisted of 18 patients operated on by conventional technique. The procedures were classified as successful if nidus resection could be confirmed by histology or postoperative imaging studies. Patients in the gamma group were followed for a mean of 13 months; patients in the control group for a mean of 39 months. In the gamma group, 17/19 procedures were successful; in the control group, only 12/18 procedures were successful. The gamma probe helped to locate the osteoid-osteoma nidus, and the same probe could be used in various hospitals.Résumé Le but de cette étude était d'évaluer si la découverte intra-opératoire du nidus par sonde gamma était assez effective pour l'envisager comme une procé-dure habituelle. Trente-sept malades avec un ostéome ostéoïde ont eu un traitement chirurgical. Le premier groupe a consisté en 19 malades traités par résection du nidus guidée par la sonde manuelle. Le groupe témoin a consisté en 18 malades opérés sur par la technique conventionnelle. Les procédures étaient classées comme efficaces si la résection du nidus pouvait être confirmée par l'histologie ou l'étude postopératoire des images. Les malades dans le groupe gamma ont été suivis avec une moyenne de 13 mois, malades dans le groupe témoin avec une moyenne de 39 mois. Dans le groupe Gamma 17/19 procédures étaient éfficaces, dans le groupe témoin seulement 12/18 l'étaient. La sonde gamma aide à localiser le nidus de l'ostéome ostéoïde et la même sonde pourraient être utilisée dans les plusieurs hôpitaux.

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Section: Discussionmentioning

confidence: 99%

Intraoperative localization of an osteoid-osteoma using a gamma probe

Etchebehere

Reganin

et al. 2004

International Orthopaedics (SICOT)

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“…The maintainance of high histological quality is necessary to make the correct tissue diagnosis. Sections should be cut at between 1 and 2 p for optimum resolution (14). The application of the emulsion should address evenness and thinness to attain the best results (16).…”

Section: Fig 2 (A)mentioning

confidence: 99%

“…Colton and Hardy (31, as well as Vigorita and Ghelman (21), have shown that injection of an isotope within a few hours of surgery can aid in surgically identifying the location of an osteoid osteoma. As the application of intraoperative bone scanning is receiving some attention (14), it is now important to correlate isotope activity with the histological findings. Preoperative isotope injection followed by microautoradiography of a bone biopsy or excised bony lesion may aid in the assessment of the biological behavior of a tumor or pathological condition of bone.…”

Section: Fig 4 (A)mentioning

confidence: 99%

Localization of technetium‐99m methylene diphosphonate in bone using microautoradiography

Einhorn

Vigorita

Aaron

1986

Journal Orthopaedic Research

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Technetium-99m methylene diphosphonate ([99mTc]MDP) is the most widely used bone-scanning agent today. In order to determine the precise bone locus of 99mTc corresponding to the delayed bone scan image, and to test the potential clinical use of this agent in enhancing the information obtained by bone scan, we employed [99mTc]MDP in this microautoradiographic study of normal bone and bone reparative tissue. Four white rabbits underwent operations in which two 1.5-mm drill holes were created in the subtrochanteric regions of both of their femora. An additional four white rabbits underwent sham operations of their femora, in which neither drilling nor periosteal injury occurred. Two rabbits were controls and did not undergo operation. After 7 days, the first two groups of rabbits were injected with [99mTc]MDP and bone scanned 2 h later. After the scans were completed, all three groups of animals were killed and their femora histologically processed for microautoradiography and routine histopathology. In the two groups that were injected with [99mTc]MDP, all bones showed the isotope to be clearly localized along mineralization fronts. The isotope was occasionally found in the substance of the osteoid, but was absent from the cytoplasm and nuclei of osteoblasts and osteocytes. Osteocytic lacunae showed the presence of isotope at their borders, but no identifiable pattern of isotope uptake was noted. Neither osteoclasts nor Howships lacunae showed isotope uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…We have performed open resection and in addition to that we have used PGS to localise the tumour and to control the extent of excision. Radioguided surgery for excision of osteoid osteomas has been used since 1980 [10,20] and large studies using PGS at the extremities exist [26]. As compared to a standard open resection, nidus resection with the intraoperative use of a gamma probe has proven to be significantly more successful [8].…”

Section: Discussionmentioning

confidence: 99%

“…Osteoid osteomas avidly accumulate boneseeking tracers such as technetium-labelled phosphonates and their gamma radiation can be detected by handheld probes. Intraoperative use of a radiation probe to guide detection and resection of osteoid osteomas has been primarily reported in 1980 [4,5] and probe-guided surgery (PGS) has been used to excise a spinal lesion the same year [20]. Since 1983 our own group has been using PGS [2] with good success in all skeletal regions [24].…”

Section: Introductionmentioning

confidence: 99%

The indication for gamma probe-guided surgery of spinal osteoid osteomas

et al. 2007

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The standard treatment for osteoid osteomas is CT-guided radiofrequency ablation (RFA). This minimally invasive procedure is effective in terms of pain reduction as well as the recurrence rate. Nevertheless, the use for spinal lesions is limited due to a possible thermal damage of neural structures. Although the literature is contradictory, RFA should only be used when a cortical shell between the lesion and the spinal canal is existent. We present seven cases (five males, two females, mean age 23 years) with spinal osteoid osteoma in which RFA was not applicable and open resection with the use of probe-guided surgery (PGS) was performed. The principle of PGS is that after preoperative bone scintigraphy, a handheld radiation probe is used intraoperatively for tumour localisation. Here, exposure and bone resection can be minimised and completeness of tumour excision may be estimated. At the initial measurement we found a hot-spot (maximum countrate) in all patients and after tumour resection, the signal decreased by a mean of 68% in the operative field. After a mean follow-up of 17 months one patient had residual pain but no patient had signs of tumour recurrence. The authors recommend to use PGS for those spinal osteoid osteomas where RFA is not applicable and intraoperative localisation-and here complete resection-of the tumour is difficult.

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Intraoperative skeletal scintigraphy for localization of osteoid-osteoma in the spine. Case report.

Cited by 68 publications

References 0 publications

Intraoperative localization of an osteoid-osteoma using a gamma probe

Intraoperative localization of an osteoid-osteoma using a gamma probe

Localization of technetium‐99m methylene diphosphonate in bone using microautoradiography

The indication for gamma probe-guided surgery of spinal osteoid osteomas

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