AH Mahnken MD MBA MME; P Bruners MD; H Delbrück MD; RW Günther MD; C Plumhans MD.
Contrast-enhanced MRI predicts local recurrence of osteoid osteoma after radiofrequency ablation
Article first published online: 5 SEP 2012
© 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists
Journal of Medical Imaging and Radiation Oncology
Volume 56, Issue 6, pages 617–621, December 2012
How to Cite
Mahnken, A. H., Bruners, P., Delbrück, H., Günther, R. W. and Plumhans, C. (2012), Contrast-enhanced MRI predicts local recurrence of osteoid osteoma after radiofrequency ablation. Journal of Medical Imaging and Radiation Oncology, 56: 617–621. doi: 10.1111/j.1754-9485.2012.02443.x
Conflict of interest: There is no conflict of interest to report.
- Issue published online: 5 DEC 2012
- Article first published online: 5 SEP 2012
- Manuscript Accepted: 3 MAY 2012
- Manuscript Received: 25 MAR 2012
- magnetic resonance imaging;
- musculoskeletal imaging;
- non-vascular interventional radiology
Osteoid osteoma is a painful benign tumour, which is commonly treated by radiofrequency ablation (RFA). The goal of this study is to assess the value of contrast-enhanced magnetic resonance imaging (MRI) for predicting clinical success after RFA of osteoid osteoma.
Twenty consecutive patients (14 male, 6 female; mean age 23.3 ± 13.4 years) suffering from osteoid osteoma underwent unenhanced and contrast-enhanced T1-weighted MRI the day after RFA. Post-interventional contrast enhancement of the nidus was analyzed by comparing signal-to-noise ratios (SNR) of the nidus before and after contrast administration. The SNR between pre- and post-contrast scans was computed.
There were no significant differences in SNR between pre- and post-contrast scans in the area of ablation (P = 0.1583), while the SNR exceeded one in four patients, indicating residual contrast enhancement. In three of these patients clinical symptoms recurred, requiring re-ablation, while one patient remained free from symptoms during follow-up. In patients with a pre- and post-contrast SNR of ≤1.18 no local recurrence was observed.
Contrast enhancement on T1-weighted MRI imaging seems to be predictive of clinically unsuccessful RFA in osteoid osteoma. Patients with a SNR increase of ≥20% after contrast administration might be considered for re-ablation to avoid symptomatic tumour recurrence.