SeeStar^®

Osteoid osteoma is a slow-growing tumour with limited growth potential. In the past, treatment comprised open surgery with en-bloc resection or curettage of the tumour. In recent years, various minimally invasive percutaneous treatments have gained popularity. We report on six patients who underwent computed tomography-guided percutaneous radiofrequency ablations of osteoid osteomas between January 2000 and December 2003 in a regional hospital in Hong Kong. Technical success was achieved in all procedures, with a mean follow-up of 40 months (range, 18-65 months). Five of the six patients achieved complete pain relief after the procedure and remained pain-free on subsequent follow-up. One patient with persistent symptoms after the first ablation was successfully treated with a second ablation. The mean in-hospital stay was 2.4 days. Progress in radiological healing was observed in all patients. There was one complication of skin burn over the needle entry site. Our experience shows that percutaneous computed tomography-guided radiofrequency ablation is a minimally invasive and cost-effective treatment for osteoid osteoma.

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OBJECTIVE: To preliminarily evaluate a new CT-biopsy guidance device, the SeeStar® (Radi, Uppsala, Sweden), for use in musculoskeletal applications. DESIGN: The device was evaluated using an imaging phantom and in various simulated clinical biopsy situations. The phantom study was undertaken to optimize the linear metallic artifacts produced by the guidance device. The phantom and guidance device were imaged with CT after altering different imaging parameters, including field of view, filter, focal spot size, kV, mAs, slice thickness and pitch. Clinical biopsy situations were simulated for a superficial biopsy, a deep biopsy and a horizontal biopsy approach.
RESULTS: Altering CT parameters had little effect on the subjective appearance of the linear metal artifact, which is used to plan the biopsy approach. Placement of an 18-G needle inside of the biopsy device was subjectively helpful in exaggerating the artifact. Use of this artifact could be helpful in planning biopsy approach for deep lesions or lesions near critical structures. The metal guide on the device adequately supports a standard biopsy needle, making it potentially advantageous for biopsy of superficial lesions and lesions approached from a horizontal orientation.
CONCLUSION: Use of this CT-biopsy guidance device is potentially useful for musculoskeletal applications. The linear metal artifact produced by the device can help plan the biopsy approach. The device can also be useful in biopsy situations where the biopsy needle requires external support during imaging.