Evaluation of accuracy and precision of CT-guidance in Radiofrequency Ablation for osteoid osteoma in 86 patients.

BACKGROUND AND PURPOSE: Osteoid osteoma is a benign skeletal tumour that accounts for 2-3% of all bone tumours. The male-to-female ratio is around 4:1 and it predominates in children and young adults. The most common symptom is pain, frequently at night-time. Historically the main form of treatment has been surgical excision. With the development of Radiofrequency Ablation (RFA) there is a percutaneus alternative. Success rates of RFA are lower but the main advantage is the minimal invasive character of the therapy and the low complication rate. As a result of the minimal invasiveness the hospitalization- and rehabilitation periods are relatively short. However, in current literature no values for accuracy and precision are known for the CT-guided positioning.

METHODS: Accuracy and precision of the needle position are determined for 86 procedures. Furthermore the population is divided into groups based on tumour diameter, location and procedure outcome.

RESULTS: The clinical success rate was 81.4%. In 79% of procedures complete ablation was achieved. Accuracy was 2.84 mm on average, precision was 2.94 mm. Accuracy was significantly lower in more profound lesions. Accuracy in tibia and fibula was significantly higher compared to the femur. No significant difference was found between different tumour diameters.

INTERPRETATION: The accuracy and precision found are considered good. Needle position is of major importance for procedure outcomes. The question however rises how the results of this therapy will turn out in treatment of larger tumours.