Gamma probe guided surgery for osteoid osteoma: is there any additive value of quantitative bone scintigraphy?

OBJECTIVE: The aim of this study is to evaluate the efficiency of gamma probe guided osteoid osteoma surgery and the applicability of quantitative analyses obtained from preoperative bone scan images.

MATERIAL AND METHODS: This study involved 12 osteoid osteoma patients who were treated with gamma probe guided surgery after preoperative bone scan. The calculated contrast ratios between nidus and adjacent healthy bone from preoperative bone scan and the calculated percentages of count reduction after resection of nidus during intraoperative gamma probe application were compared. Patients were followed up for any recurrence or complications.

RESULTS: The mean contrast ratio between nidus and adjacent healthy bone calculated from preoperative bone scan was 43.6% (range 33-53%). Following the nidus excision, an average of 55.8% (range 28-73%) count reduction was estimated with gamma probe in the tumor area. There was no correlation between preoperative scintigraphic contrast ratio and intraoperative gamma probe count reduction ratio (r = 0.46, p = 0.13). Complete cure was achieved in 11 (92%) patients with single operation, during the postoperative follow up period. None of the patients had any major or minor complications during or after the surgery.

CONCLUSIONS: Due to high clinical success and low complication rate in osteoid osteoma surgery, gamma probe application is an effective and safe method that should be used more extensively in daily practice.