Osteoid Osteoma Treatment in Children Using MR-HIFU

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Osteoid osteoma is a benign, but painful, bone tumor commonly occurring in children and young adults. Osteoid osteoma treatment options include surgical excision or, more commonly, CT-guided radiofrequency ablation.  Osteoid osteoma treatment with radiofrequency ablation is less invasive than surgery, but still requires drilling from the skin through muscle and soft tissue into bone in order to ablate the osteoid osteoma nidus . It also exposes the patient and operator to ionizing radiation from CT guidance.

Magnetic Resonance guided High Intensity Focused Ultrasound (MR-HIFU) provides precise and controlled delivery of heat to ablate the osteoid osteoma nidus using an external ultrasound probe, without the need for a scalpel or needle. MR-HIFU has been successfully used to treat painful bone metastases in adult clinical trials and one recent report suggests that it can also be used for osteoid osteoma treatment.

MR-HIFU ablation of osteoid osteoma may provide a better alternative to surgical resection or radiofrequency ablation as it is completely non-invasive and does not require ionizing radiation. These two qualities of MR-HIFU are especially beneficial for growing children and young adults. Furthermore, MR-HIFU osteoid osteoma treatment is quick, with expected total procedure time of less than one hour. Such short treatments offer additional safety benefits from reduced anesthesia / sedation requirement compared to surgery and radiofrequency ablation.

At Children’s National, we currently have the first osteoid osteomat treatment trial open for enrollment evaluating the safety and feasibility of MR-HIFU for the ablation of osteoid osteoma (ClinicalTrials.gov Identifier NCT02349971). Patients less than 25 years of age with osteoid osteoma may be eligible to enroll.

Background and motivation

  • Osteoid Osteoma is a benign, but painful, bone tumor commonly occurring in children and young adults.
  • Common treatment options are surgical excision or, more recently, CT-guided radiofrequency ablation. Radiofrequency ablationis less invasive, but it still requires drilling from the skin through muscle and soft tissue into bone. It also exposes the patient and operator to ionizing radiation.
  • Magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) ablation of osteoid osteoma may provide a better alternative to surgical resection or radiofrequency ablationas it is completely non-invasive and does not require ionizing radiation. These two qualities of MR-HIFU are especially beneficial in growing children and young adults.
  • Furthermore, MR-HIFU osteoid osteoma ablation is quick, with expected total procedure time of less than two hours. Such short treatments offer additional safety benefits from reduced anesthesia / sedation requirement compared to surgery and radiofrequency ablation.
  • We propose the first pediatric clinical trial in the USA of MR-HIFU for the ablation osteoid osteoma

Study Goals

  • To evaluate safety and feasibility of MR-HIFU ablation for osteoid osteoma in children

Eligibility

  • Children and young adults ≤ 25 years of age with osteoid osteoma

Features and Benefits

  • Non-invasive MR-HIFU ablation
  • No ionizing radiation
  • Precise MRI-based therapy planning and execution
  • Real-time temperature imaging in soft tissue
  • Cure of osteoid osteoma and associated pain.

For more information, please contact

  • Clinical Trial Coordinator
    • Stephanie Forlenza, MA, CRRP
    • saforlenza@childrensnational.org | 202-476-6841
  • Principal Investigator
    • Karun V. Sharma, MD, PhD
    • KVSharma@Childrensnational.org | 202-476-1283

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