Skip to main content
Erschienen in: European Radiology 4/2006

01.04.2006 | Musculoskeletal

Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results

verfasst von: Bernhard Tins, Victor Cassar-Pullicino, Iain McCall, Paul Cool, David Williams, David Mangham

Erschienen in: European Radiology | Ausgabe 4/2006

Einloggen, um Zugang zu erhalten

Abstract

The standard treatment for chondroblastoma is surgery, which can be difficult and disabling due to its apo- or epiphyseal location. Radiofrequency (RF) ablation potentially offers a minimally invasive alternative. The often large size of chondroblastomas can make treatment with plain electrode systems difficult or impossible. This article describes the preliminary experience of RF treatment of chondroblastomas with a multi-tined expandable RF electrode system. Four cases of CT guided RF treatment are described. The tumour was successfully treated in all cases. In two cases, complications occurred; infraction of a subarticular chondroblastoma in one case and cartilage and bone damage in the unaffected compartment of a knee joint in the other. Radiofrequency treatment near a joint surface threatens the integrity of cartilage and therefore long-term joint function. In weight-bearing areas, the lack of bone replacement in successfully treated lesions contributes to the risk of mechanical failure. Multi-tined expandable electrode systems allow the treatment of large chondroblastomas. In weight-bearing joints and lesions near to the articular cartilage, there is a risk of cartilage damage and mechanical weakening of the bone. In lesions without these caveats, RF ablation appears promising. The potential risks and benefits need to be evaluated for each case individually.
Literatur
1.
Zurück zum Zitat Ramappa AJ, Lee FY, Tang P, Carlson JR, Gebhardt MC, Mankin HJ (2000) Chondroblastoma of bone. J Bone Joint Surg Am 82–A:1140–1145 Ramappa AJ, Lee FY, Tang P, Carlson JR, Gebhardt MC, Mankin HJ (2000) Chondroblastoma of bone. J Bone Joint Surg Am 82–A:1140–1145
2.
Zurück zum Zitat Springfield DS, Capanna R, Gherlinzoni F, Picci P, Campanacci M (1985) Chondroblastoma. A review of seventy cases. J Bone Joint Surg Am 67:748–755 Springfield DS, Capanna R, Gherlinzoni F, Picci P, Campanacci M (1985) Chondroblastoma. A review of seventy cases. J Bone Joint Surg Am 67:748–755
3.
Zurück zum Zitat Schuppers HA, van der Eijken JW (1998) Chondroblastoma during the growing age. J Pediatr Orthop B 7:293–297 Schuppers HA, van der Eijken JW (1998) Chondroblastoma during the growing age. J Pediatr Orthop B 7:293–297
4.
Zurück zum Zitat Bloem JL, Mulder JD (1985) Chondroblastoma: a clinical and radiological study of 104 cases. Skeletal Radiol 14:1–9 Bloem JL, Mulder JD (1985) Chondroblastoma: a clinical and radiological study of 104 cases. Skeletal Radiol 14:1–9
5.
Zurück zum Zitat Erickson J, Rosenthal D, Zaleske D, Gebhardt M, Cates J (2001) Primary treatment of chondroblastoma with percutaneous radio-frequency heat ablation: report of three cases. Radiology 221:463–468 Erickson J, Rosenthal D, Zaleske D, Gebhardt M, Cates J (2001) Primary treatment of chondroblastoma with percutaneous radio-frequency heat ablation: report of three cases. Radiology 221:463–468
6.
Zurück zum Zitat Davis KW, Choi JJ, Blankenbaker DG (2004) Radiofrequency ablation in the musculoskeletal system. Semin Roentgenol 39:129–144 Davis KW, Choi JJ, Blankenbaker DG (2004) Radiofrequency ablation in the musculoskeletal system. Semin Roentgenol 39:129–144
7.
Zurück zum Zitat Callstrom MR, Charboneau JW, Goetz MP, Rubin J, Wong GY, Sloan JA, Novotny PJ, Lewis BD, Welch TJ, Farrell MA, Maus TP, Lee RA, Reading CC, Petersen IA, Pickett DD (2002) Painful metastases involving bone: feasibility of percutaneous CT- and US-guided radio-frequency ablation. Radiology 224:87–97 Callstrom MR, Charboneau JW, Goetz MP, Rubin J, Wong GY, Sloan JA, Novotny PJ, Lewis BD, Welch TJ, Farrell MA, Maus TP, Lee RA, Reading CC, Petersen IA, Pickett DD (2002) Painful metastases involving bone: feasibility of percutaneous CT- and US-guided radio-frequency ablation. Radiology 224:87–97
8.
Zurück zum Zitat Cioni R, Armillotta N, Bargellini I, Zampa V, Cappelli C, Vagli P, Boni G, Marchetti S, Consoli V, Bartolozzi C (2004) CT-guided radiofrequency ablation of osteoid osteoma: long-term results. Eur Radiol 14:1203–1208 Cioni R, Armillotta N, Bargellini I, Zampa V, Cappelli C, Vagli P, Boni G, Marchetti S, Consoli V, Bartolozzi C (2004) CT-guided radiofrequency ablation of osteoid osteoma: long-term results. Eur Radiol 14:1203–1208
9.
Zurück zum Zitat Gazelle GS, Goldberg SN, Solbiati L, Livraghi T (2000) Tumor ablation with radio-frequency energy. Radiology 217:633–646 Gazelle GS, Goldberg SN, Solbiati L, Livraghi T (2000) Tumor ablation with radio-frequency energy. Radiology 217:633–646
10.
Zurück zum Zitat Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 174:323–331 Goldberg SN, Gazelle GS, Mueller PR (2000) Thermal ablation therapy for focal malignancy: a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol 174:323–331
11.
Zurück zum Zitat Mulier S, Miao Y, Mulier P, Dupas B, Pereira P, de Baere T, Lencioni R, Leveillee R, Marchal G, Michel L, Ni Y (2005) Electrodes and multiple electrode systems for radiofrequency ablation: a proposal for updated terminology. Eur Radiol 15:798–808 Mulier S, Miao Y, Mulier P, Dupas B, Pereira P, de Baere T, Lencioni R, Leveillee R, Marchal G, Michel L, Ni Y (2005) Electrodes and multiple electrode systems for radiofrequency ablation: a proposal for updated terminology. Eur Radiol 15:798–808
12.
Zurück zum Zitat Haemmerich D, Wright AW, Mahvi DM, Lee FT Jr, Webster JG (2003) Hepatic bipolar radiofrequency ablation creates coagulation zones close to blood vessels: a finite element study. Med Biol Eng Comput 41:317–323 Haemmerich D, Wright AW, Mahvi DM, Lee FT Jr, Webster JG (2003) Hepatic bipolar radiofrequency ablation creates coagulation zones close to blood vessels: a finite element study. Med Biol Eng Comput 41:317–323
13.
Zurück zum Zitat Cantwell CP, Obyrne J, Eustace S (2004) Current trends in treatment of osteoid osteoma with an emphasis on radiofrequency ablation. Eur Radiol 14:607–617 Cantwell CP, Obyrne J, Eustace S (2004) Current trends in treatment of osteoid osteoma with an emphasis on radiofrequency ablation. Eur Radiol 14:607–617
14.
Zurück zum Zitat Lindner NJ, Ozaki T, Roedl R, Gosheger G, Winkelmann W, Wortler K (2001) Percutaneous radiofrequency ablation in osteoid osteoma. J Bone Joint Surg Br 83:391–396 Lindner NJ, Ozaki T, Roedl R, Gosheger G, Winkelmann W, Wortler K (2001) Percutaneous radiofrequency ablation in osteoid osteoma. J Bone Joint Surg Br 83:391–396
15.
Zurück zum Zitat Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ (2003) Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 229:171–175 Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ (2003) Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology 229:171–175
16.
Zurück zum Zitat Venbrux AC, Montague BJ, Murphy KP, Bobonis LA, Washington SB, Soltes AP, Frassica FJ (2003) Image-guided percutaneous radiofrequency ablation for osteoid osteomas. J Vasc Interv Radiol 14:375–380 Venbrux AC, Montague BJ, Murphy KP, Bobonis LA, Washington SB, Soltes AP, Frassica FJ (2003) Image-guided percutaneous radiofrequency ablation for osteoid osteomas. J Vasc Interv Radiol 14:375–380
17.
Zurück zum Zitat Woertler K, Vestring T, Boettner F, Winkelmann W, Heindel W, Lindner N (2001) Osteoid osteoma: CT-guided percutaneous radiofrequency ablation and follow-up in 47 patients. J Vasc Interv Radiol 12:717–722 Woertler K, Vestring T, Boettner F, Winkelmann W, Heindel W, Lindner N (2001) Osteoid osteoma: CT-guided percutaneous radiofrequency ablation and follow-up in 47 patients. J Vasc Interv Radiol 12:717–722
18.
Zurück zum Zitat Diaz SH, Nelson SI, Wong BJ (2003) Rate process analysis of thermal damage in cartilage. Phys Med Biol 48:19–29 Diaz SH, Nelson SI, Wong BJ (2003) Rate process analysis of thermal damage in cartilage. Phys Med Biol 48:19–29
19.
Zurück zum Zitat Ye J, Haro H, Takahashi M, Kuroda H, Shinomiya K (2003) Induction of apoptosis of articular chondrocytes and suppression of articular cartilage proteoglycan synthesis by heat shock. J Orthop Sci 8:387–395 Ye J, Haro H, Takahashi M, Kuroda H, Shinomiya K (2003) Induction of apoptosis of articular chondrocytes and suppression of articular cartilage proteoglycan synthesis by heat shock. J Orthop Sci 8:387–395
20.
Zurück zum Zitat Zuger BJ, Ott B, Mainil-Varlet P, Schaffner T, Clemence JF, Weber HP, Frenz M (2001) Laser solder welding of articular cartilage: tensile strength and chondrocyte viability. Lasers Surg Med 28:427–434 Zuger BJ, Ott B, Mainil-Varlet P, Schaffner T, Clemence JF, Weber HP, Frenz M (2001) Laser solder welding of articular cartilage: tensile strength and chondrocyte viability. Lasers Surg Med 28:427–434
21.
Zurück zum Zitat Liebergall M, Simkin A, Mendelson S, Rosenthal A, Amir G, Segal D (1998) Effect of moderate bone hyperthermia on cell viability and mechanical function. Clin Orthop 349:242–248 Liebergall M, Simkin A, Mendelson S, Rosenthal A, Amir G, Segal D (1998) Effect of moderate bone hyperthermia on cell viability and mechanical function. Clin Orthop 349:242–248
Metadaten
Titel
Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results
verfasst von
Bernhard Tins
Victor Cassar-Pullicino
Iain McCall
Paul Cool
David Williams
David Mangham
Publikationsdatum
01.04.2006
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 4/2006
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-005-0022-3

Weitere Artikel der Ausgabe 4/2006

European Radiology 4/2006 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.