Selection criteria for osteoid osteomas/osteoblastoma’s treatment by ablation with radiofrequency needles or high intensity focused ultrasound: our experience

Osteoid Osteomas (OO) and Osteoblastomas (OB) are relatively rare benign bone lesions necessitating effective treatment to alleviate associated pain and functional limitations. Radiofrequency Thermal Ablation (RFA) and Focused Ultrasound (MRgFUS) have emerged as minimally invasive techniques for their management. This study aims to retrospectively evaluate and compare the selection criteria for these two treatments.

A retrospective analysis was conducted on 102 cases of OO/OB treated between January 2013 and July 2020. Eight potential factors influencing treatment selection were assessed, including lesion characteristics and proximity to critical structures. Statistical regression using the Wilcoxon test was performed to compare treatment outcomes.

Significant differences were observed between the RFA and MRgFUS groups concerning the proximity of vascular-nervous structures to the lesion (p = 0.001), lesion depth (p < 0.001), nidus size (p < 0.001), and the presence of an acoustic window (p < 0.001). Additionally, lesion depth (p < 0.001), sclerosis (p = 0.03), and nidus size (p = 0.02) were significant factors.

Our findings underscore the importance of considering multiple factors when selecting a treatment modality for OO and OB. While both RFA and MRgFUS offer comparable efficacy, careful assessment of patient-specific features, particularly the presence of an acoustic window and sclerosis, should guide treatment decisions.