Computed tomography guided radiofrequency ablation of multifocal osteoid osteoma.

Osteoid osteoma is a benign osteoblastic tumor characterized mostly by presence of one nidus, butvery infrequentlyniduses can be multiple. Radiofrequency ablation is a well-established treatment method for this disease. We report a case of a 19-year-old male patient with bifocal osteoid osteoma which was partially missed on the initial magnetic resonance imaging and treated successfully with two sessions of radiofrequency ablation. Following the second session of ablation, the pain resolved immediately and the patient remains pain-free for 6 months since the procedure. Our case report underlines the fact that although very rare, multifocal osteoid osteomas do exist and its niduses can be obscured during the magnetic resonance imaging due to the edema. It emphasizes the role of the initial computed tomography evaluation.

Multidetector computed tomography angiography in the management of transarterial embolization of primary and secondary liver malignancy.

BACKGROUND: Endovascular management is the mainstay of therapy for most patients with primary and secondary liver tumors. Radiologist should understand the anatomy of the hepatic vasculature and tumor feeding vessels to ensure successful conduction of the embolization procedure. The aim of this study was to evaluate the accuracy of multidetector computed tomographic angiography (MDCTA) for the evaluation of hepatic arterial anatomy and tumor feeding vessels prior to embolization procedure. METHODS: This study included 42 patients. They were 30 with hepatocellular carcinoma, 6 with colorectal cancer metastases, 3 with intrahepatic cholangiocellular carcinoma, 2 with giant focal nodular hyperplasia and 1 with gallbladder tumor. The findings of MDCTA were compared with the DSA findings, which served as the standard of reference. Sensitivity and specificity of the MDCTA were calculated. RESULTS: MDCTA showed 100% coincidence with the DSA and 100% accuracy in the evaluation of gross hepatic arterial anatomy and its variations. 61 out of the 64 feeders were correctly identified with the MDCTA. False positives and false negatives were 3 each. Accordingly sensitivity and specificity were 95.31%, 97.95% respectively. CONCLUSIONS: MDCT angiography permits accurate assessment of the hepatic vascular anatomy. Although some pathways of tumor irrigation may not be well visible on the computed tomography. These require detailed reevaluation of suspected tumor feeders during embolization procedure.