Open resection of osteoid osteoma guided by a gamma-probe

Abstract

Osteoid osteoma is the third most common type of bone tumour. Radiofrequency ablation and other percutaneous procedures are the treatment of choice. However, in some sites these methods are difficult or dangerous. Our objective of this study was to evaluate whether open resection and intraoperative nidus detection with a handheld gamma probe is an efficient method for treating this type of tumour. Fifty-three patients with osteoid osteomas were submitted to surgical treatment. The first group (gamma group) consisted of 34 patients submitted to open nidus resection guided by a hand-held gamma probe. The control group consisted of 19 patients operated on by conventional technique. In the postoperative period, histopathology, imaging studies, and clinical outcome were evaluated. The gamma group patients were followed up for an average 26.2 months; the control group patients were followed up for an average 38 months. There was no difference with regard to pain relief and histopathology findings between the two groups. However, in the postoperative imaging studies, there was significantly less nidus present in the gamma group (p=0.01).The gamma probe helped to locate the osteoid osteoma nidus more precisely, as demonstrated by the postoperative imaging studies.

Radiofrequency Ablation of Osteoid Osteoma in Atypical Locations: A Case Series

“…The lesion is surrounded by an intense reactive sclerotic rim [28]. The best method for localization is bone scintigraphy [28]. The classic scintigraphic double-density appearance is very specific for OO and is used as a guide for CT study [15,28].…”

“…OOs have been described in virtually all bones, but the typical locations of OOs are the long bones of lower extremities (especially femur and tibia), which comprise approximately 50% of the cases [12]. Among other bones, OOs involve upper limbs in 13% to 31% of cases and vertebrae in approximately 10% of cases [16,28]. OOs of other sites have lower incidences.…”

“…Therefore, surgery frequently is accompanied by several-day inpatient treatment and patients may need to restrict their activities for a while or have a period of protected weightbearing [8,16]. Long-term administration of NSAIDs, however, can lead to gastrointestinal side effects and patients do not tolerate it well [28,35]. Through the years, several image-guided, minimally invasive interventions have been developed to treat OOs.…”

“…The best method for localization is bone scintigraphy [28]. The classic scintigraphic double-density appearance is very specific for OO and is used as a guide for CT study [15,28]. CT is highly useful by clearly delineating the nidus from the surrounding sclerosis and periosteal reaction [1,4].…”

“…The lesion is surrounded by an intense reactive sclerotic rim [28]. The best method for localization is bone scintigraphy [28].…”