Role of radiofrequency (RF) ablation as minimally invasive management of chondroblastoma

• Published in: Journal of vascular and interventional radiology Vol. 24; no. 4; p. S178
• Main Authors: Dharia, T.P, Kulkarni, S.S, Shetty, N, Polnaya, A, Gandhi, R, Patil, S, Pendse, H.A, Thakur, M.H
• Format: Journal Article
• Language: English
• Published: 01.04.2013
• Subjects: Radiology
• ISSN: 1051-0443
• DOI: 10.1016/j.jvir.2013.01.450

Purpose To demonstrate the procedure technique, clinical and imaging outcomes of Radiofrequency (RF) ablation as minimally invasive management of chondroblastoma. Materials and Methods Approval was obtained from institutional review boards. Informed consent was taken. The records of patients with biopsy-proved chondroblastoma from Jan 2010 to February 2012 treated with RF ablation in our institute were reviewed. Bone access was gained with a COOK biopsy needle system. RF ablation was performed with a monopolar single and multi-tinged electrode by using computed tomography for guidance. Lesion characteristics were determined from imaging studies obtained at the time of the procedure. Quality of life was objectively evaluated using the EORTC QLQ C30 version 1.0. Range of movements’ pre and post procedure were documented in those cases involving the joints. Pain score was assessed using visual analog scale (VAS). Pre and post-procedure FDG-PET-CT was done routinely in all patients. The patients were followed up at 1, 3 and 6 months interval. Results Six male patients were treated (mean age, 18.4 years). The lesions were located in the proximal humerus (n = 1), proximal tibia (n = 2), proximal femur (n = 2), and distal femur (n = 1). The mean volume of the lesions was 2.25 mL. All patients reported resolution of symptoms at 2-6 weeks post ablation. No major complication was noted post procedure. All patients had complete response to ablation on FDG-F18 PET-CT . Long term follow-up are available in all of these patients and there is complete relief of symptoms with no need for medications and full return to all activities. None of the patients required to surgical intervention. All six patients' follow-up MRI studies demonstrated resolution of the oedema pattern around the lesion and temporal evolution of the internal signal characteristics with fatty replacement. Conclusion Radiofrequency ablation for chondroblastoma provides an alternative to surgical curettage, and we have demonstrated both a clinical improvement in symptoms and the follow-up MRI appearances.