Technical Feasibility and Outcome of Cryoablation of Aneurysmal Bone Cysts in Pediatric Patients.

PURPOSE: To evaluate the clinical and imaging outcome of aneurysmal bone cysts (ABCs) in children using percutaneous cryoablation as the sole treatment.

MATERIALS AND

METHODS

This retrospective study included 7 children with a mean age of 8.7 years (range, 3.0-11.9 years) who underwent at least 1 cryoablation for ABC. Cryoablation needles were placed and guided by computed tomography (CT). Imaging follow-up and clinical examination were performed by radiography 1 and 6 months after the procedure and magnetic resonance (MR) imaging was performed 3 and 12 months after the procedure. Additional cryoablation was performed in case of MR imaging-detected recurrence. Data were analyzed by anatomical location, measurement of lesion volume, numbers of intralesional cysts, grade of mineralization (5-point Likert scale), pain (0 [none] to 4 [severe]), and grade of fluid-fluid levels (FFLs; 4-point Likert scale).

RESULTS

Fourteen cryoablations were performed. Patients showed volume reduction, with 1 showing a complete response and 6 showing partial response. Following treatment, there was a substantial reduction in lesion volume compared with baseline, leading to a mean volume decrease of 81.9% (range, 66.8%-100%). The grade of mineralization (3.2 [SD ± 1.2] after therapy vs 1.1 [SD ± 0.3] at baseline), grade of FFL (1.6 [SD ± 0.5] after therapy vs 3.4 [SD ± 1.1] at baseline), and pain (0.29 [SD ± 0.4] after therapy vs 1.86 [SD ± 0.7] at baseline) significantly improved after therapy (all P < .05). One severe adverse event occurred.

CONCLUSIONS

Cryoablation is an effective treatment option for ABC in children. Further research is needed to compare it with other techniques.