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Objective To report a single center's experience evaluating the efficacy and safety of computed tomography-guided radiofrequency ablation for the treatment of osteoid osteoma in children. Materials and methods Institutional database research identified 33 symptomatic patients (<= 18 years of age; male/female ratio: 21/12, mean age 13.09 +/- 3.66) with osteoid osteoma who were treated by CT-guided RFA. Technical and clinical success as well as complication rates were recorded. The duration of the procedure, the number of computed tomography scans and the results of the biopsy were assessed. Pain, prior, the following morning and 1 week, 1/6/12 months after the procedure were compared by means of a numeric visual scale (NVS) questionnaire. Results Mean lesion size was 8.28 +/- 4.24 mm. Mean follow-up was 23.33 +/- 17.61 months (range 12-62). Mean pain score prior to radiofrequency ablation was 9.06 +/- 0.80 NVS units. On week 1 and 1/6/12 months, all patients were pain-free reporting 0 NVS units (p < 0.05). The mean procedure time was 54 min (range 51-59) and a mean of 7 CT scans were performed during the ablation session. RF electrode was successfully placed in the center of the nidus in all cases. In our study, none of our patient experienced recurrence of the pain, nor complications. Conclusion The present study demonstrates that percutaneous CT-guided radiofrequency ablation constitutes a safe and effective technique for osteoid osteoma treatment in children.

Background and Objectives: The aim of the present study was to report the safety and efficacy of percutaneous navigation under local anesthesia for computed tomography-guided microwave ablation of malignant liver lesions located in the hepatic dome. Patients with primary and secondary malignant liver lesions located in the hepatic dome who underwent percutaneous computed tomography-guided microwave ablation using a computer-assisted navigation system under local anesthesia were prospectively evaluated. The primary objective was technical success. Materials and Methods: The sample consisted of 10 participants (16 lesions) with a mean age of 60.60 years (SD = 9.25 years) and a mean size of 20.37 inverted iota 7.29 cm, and the mean follow-up time was 3.4 months (SD = 1.41) months. Results: Primary technical success was 93.75%. Tumor remnant was noticed at one month follow-up in a single metastatic lesion, which was re-treated with an ablation session, and no tumor remnant was depicted in the subsequent imaging follow-up (secondary technical success 100%). Grade I self-limited complications (according to the CIRSE classification system) included small pleural effusion (n = 1) and minor bleeding post antenna removal (n = 1) requiring nothing but observation. Conclusions: the findings of the present study indicate that percutaneous navigation under local anesthesia is a safe and efficacious approach for computed tomography-guided microwave ablation of malignant liver lesions located in the hepatic dome. Large randomized controlled studies are warranted to observe treatment effectiveness and compare the results with those of other options.

To compare different parameters of the sphericity index of the ablation zone following microwave ablation (MWA) on cirrhotic- and healthy-liver parenchyma in a series of patients treated with the same MWA system. Institutional database research identified 46 patients (77 lesions) who underwent MWA. “Cirrhotic liver group” (CLG) included 35 hepatocellular carcinoma lesions; “healthy liver group” (HLG) included 42 metastatic lesions. The long axis (LAD), short axis 1 (SAD-1) and 2 (SAD-2), the mean SAD-1 and SAD-2 (mSAD) diameter (in mm) and the mean sphericity (mSPH) index of the ablation zones were evaluated for each treated lesion in both groups from baseline to follow-up. A mixed model analysis of variance reported significant main effect of group on SAD-1 (p = 0.023), SAD-2 (p = 0.010) and mSAD (p = 0.010), with HLG showing lower values compared to CLG. No differences were detected on the LAD (p(FDR) = 0.089; d = 0.45), and mSPH (p(FDR) = 0.148, d = 0.40) between the two groups. However, a significant main effect of time was found on LAD (p < 0.001), SAD-1 (p < 0.001), SAD-2 (p < 0.001) and mSAD (p < 0.001), with decreased values in all indices at follow-up compared to baseline. A significant group by time interaction was observed on mSPH (p = 0.044); HLG had significantly lower mSPH at follow-up where CLG did not show any significant change. Our findings indicate that although in cirrhotic liver short axis diameter of the MWA zone seems to be significantly longer, this has no effect on the sphericity index which showed no significant difference between cirrhotic vs. healthy liver lesions. On the contrary, on one month follow-up ablation zones tend to become significant more ellipsoid in healthy whilst remains stable in cirrhotic liver.

The purpose of this current pictorial review is to define the solitary round pulmonary lesion (SRPL), to familiarize with its prevalence in the pediatric population, and, moreover, to educate radiologists on its vast differential diagnosis and imaging manifestations. Furthermore, by highlighting valuable clues, it intends to assist radiologists efficiently partake in its diagnosis, work-up, and follow-up in order to narrow down the differential diagnosis by working alongside the clinician and combining clinical information, lab results, and radiological findings.