Qualitative evaluation of magnetic resonance imaging features in aneurysmal bone cysts after percutaneous cryoablation.
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BACKGROUND: Aneurysmal bone cysts (ABCs) are benign vascular lesions commonly affecting the pediatric population. OBJECTIVE: To assess magnetic resonance imaging (MRI) features of ABCs after percutaneous cryoablation. MATERIALS AND METHODS: A retrospective review of the hospital's electronic medical record database was conducted to identify patients who underwent percutaneous image-guided cryoablation for aneurysmal bone cysts between March 2014 and April 2024. Patients were excluded if they lacked pre- or post-treatment MRI, underwent surgical curettage and bone grafting between cryoablation treatments, or received adjunctive therapies such as sclerotherapy or bone grafting. Demographic data and pre- and post-cryoablation MRI characteristics of the lesions were collected and analyzed. RESULTS: We retrospectively analyzed 20 patients (mean age = 14.6 years). The average ABC volume decreased from 83 cm3 pre-treatment to 32.7 cm3 post-treatment. In the final post-treatment MRI, there was a 50% decrease in the cystic component in 90% (n = 18) of patients, improved cortical integrity in 75% (n = 9), resolution of peri-lesional edema and mass effect in all (n = 20), and development of organized fibrosis in 50% (n = 10) of the patients. The average time was 8.3 months for a 50% reduction in cystic component, 7.3 months for improvement in cortical integrity, 6.4 months for improvement in mass effect, 15 months for complete resolution of peri-lesional enhancement, and 16.1 months for the development of organized fibrosis. CONCLUSION: These findings suggest MRI is a valuable tool for monitoring ABC response to cryotherapy, guiding future treatment protocols.