CT-guided radiofrequency ablation for osteoid osteomas: a systematic review

Area of Science:

• Interventional Radiology
• Orthopedic Oncology
• Pain Management

Background:

• CT-guided radiofrequency ablation (CT-RFA) is the standard treatment for osteoid osteoma (OO).
• Despite its efficacy, treatment failures (TFs) are still reported.
• Understanding factors influencing TF is crucial for optimizing patient outcomes.

Purpose of the Study:

• To systematically review factors associated with CT-RFA treatment failures in osteoid osteoma.
• To evaluate trends in treatment failure rates over time.
• To assess the impact of ablation time, lesion location, and patient age on treatment success.

Main Methods:

• A systematic review of studies published between 2002 and 2019 involving CT-RFA for OO.
• Treatment failure defined as persistent pain or imaging evidence of residual OO.
• Subgroup analyses were conducted based on study date, ablation duration, patient age, and tumor location.

Main Results:

• Sixty-nine studies with 3023 patients were analyzed.
• The global primary TF rate was 8.3%, decreasing to 3.1% after secondary treatment.
• TF rates significantly decreased from 14% (2002-2010) to 7% (2011-2019).
• No significant correlation was found between TF and ablation duration, patient age, or OO location.
• The overall complication rate was 3%, with skin burns being the most common.

Conclusions:

• CT-RFA is a safe and effective treatment for osteoid osteoma with low failure rates.
• The observed decrease in TF over time suggests improvements in technique and technology.
• Ablation duration, patient age, and lesion location are not significant predictors of treatment failure.