Post-ablation Follow-up of Benign and Painful Bone Lesions: Imaging Features and Proposal for a Scheduled Protocol

Purpose or Learning Objective: To review the follow-up of benign bone lesions treated in musculoskeletal interventional radiology centers to assess the feasibility of a standardized follow-up protocol.

Osteoid osteoma (OO) is the most frequently benign lesion treated, and follow-up is usually clinical. However, the knowledge of the evolution of the lesion after treatment could be useful to evaluate relapsed patients.

Interventional radiology is becoming an important tool in treating the less frequent lesions characterized by a higher local aggressiveness (e.g., osteoblastoma [OB], tenosynovial giant cell relapse, aggressive fibromatosis, aneurysmal bone cyst, and more). In these cases, follow-up is not standardized but is crucial to assess treatment effectiveness.

Methods or Background: We reviewed the treatment and follow-up of > 170 bone lesions, with OO and OB the most frequent among the other benign lesions.

We divided our patients into two groups: the OO group and a second group that included all other lesions. The latter lesions are usually characterized by a higher local aggressiveness; in our cluster, they were mainly OB. In this group, the imaging follow-up is mandatory to assess the effectiveness of the ablation (i.e., untreated portions of the lesion) and to detect relapses as soon as possible.

Results or Findings: Imaging follow-up is usually based on magnetic resonance imaging performed at 3 or 6 months after the initial treatment, depending on clinical findings. We plan to discuss analytically how and when to use follow-up methods, including nuclear medicine, to assess relapse and/or treatment effectiveness.

Conclusion: In both groups, the follow-up is mainly guided by the reoccurrence of symptoms. For OB and other aggressive benign lesions, a tailor-made follow-up is necessary.

Publication History

Article published online:
02 June 2022