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Postinterventional MRI findings following MRI-guided laser ablation of osteoid osteoma
S Fuchs1, B Gebauer1, L Stelter1
1Department of Radiology, Charité, Humboldt University, Berlin, Germany.
Objective:
To evaluate postinterventional magnetic resonance imaging (MRI) characteristics following MRI-guided laser ablation of osteoid osteoma (OO).
Materials And Methods:
35 patients treated with MRI-guided laser ablation underwent follow-up MRI immediately after the procedure, after 3, 6, 12, 24, 36, and up to 48 months. The imaging protocol included multiplanar fat-saturated T2w TSE, unenhanced and contrast-enhanced T1w SE, and subtraction images. MR images were reviewed regarding the appearance and size of treated areas, and presence of periablation bone and soft tissue changes. Imaging was correlated with clinical status.
Results:
Mean follow-up time was 13.6 months. 28/35 patients (80%) showed a postinterventional "target-sign" appearance consisting of a fibrovascular rim zone and a necrotic core area. After an initial increase in total lesion diameter after 3 months, a subsequent progressive inward remodeling process of the zonal compartments was observed for up to 24 months. Periablation bone and soft tissue changes showed a constant decrease over time. MR findings correlated well with the clinical status. Clinical success was achieved in 32/35 (91%).
Conclusions:
Evaluation of long-term follow-up MRI after laser ablation of OO identified typical postinterventional changes and thus may contribute to the interpretation of therapeutic success and residual or recurrent OO in suspected cases.
Insights
Post-procedural MRI in osteoid osteoma (OO) patients treated with laser ablation shows typical changes. These findings aid in assessing treatment success and detecting residual or recurrent OO.
Area of Science:
- Musculoskeletal Radiology
- Interventional Radiology
- Oncology
Background:
- Osteoid osteoma (OO) is a benign bone tumor often treated with minimally invasive techniques.
- MRI-guided laser ablation offers a precise therapeutic option for OO.
- Understanding post-treatment MRI findings is crucial for evaluating treatment efficacy.
Purpose of the Study:
- To characterize the magnetic resonance imaging (MRI) features of osteoid osteoma (OO) after MRI-guided laser ablation.
- To correlate imaging findings with clinical outcomes.
- To establish typical imaging patterns for assessing treatment success and recurrence.
Main Methods:
- Prospective follow-up MRI scans were performed on 35 patients post-laser ablation at multiple time points up to 48 months.
- Standardized MRI sequences included T2w TSE, T1w SE (unenhanced and contrast-enhanced), and subtraction imaging.
- Image analysis focused on treated area appearance, size, and periablation changes, correlated with clinical status.
Main Results:
- Eighty percent of patients exhibited a characteristic "target-sign" post-ablation.
- Lesion diameter initially increased then remodeled inward over 24 months.
- Periablation changes decreased over time, correlating with good clinical success (91%).
Conclusions:
- Long-term MRI follow-up reveals typical post-laser ablation changes in osteoid osteoma.
- These characteristic imaging findings are valuable for interpreting therapeutic success.
- MRI aids in identifying residual or recurrent osteoid osteoma after treatment.
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