Purpose: To assess if RF ablation of osteoid osteoma under cone beam CT (CBMT) can reduce radiation dose, fluoroscopy time, and procedure time compared to conventional CT. Also, to assess the safety and efficacy of the procedure with help of visual analog score (VAS), postoperative MRI and CT imaging

Materials and Methods: 19 patients who underwent RFA under CBMT at our clinic between 2019-2023 were analyzed and total radiation doses(dose area product)(DAP)and effective dose (ED), fluoroscopy and procedure time were recorded. In addition, these patients were followed up with postoperative MRI and CT and they were assessed clinically with visual analog score (VAS) for finding out clinical efficacy.

Results: Our mean procedure time was 43 minutes, mean DAP was 26.73 Gycm2 , mean ED was 0.27 mSv and mean fluoroscopy time was 6.8 minutes. Technical success was %100, no major complications were recorded and one minor complication was recorded during the follow-up period (intramuscular hematoma). One tumor was retreated at 4 months because of pain persistence.

Conclusion: Radiofrequency ablation of osteoid osteoma under CBCT is a safe and effective technique. CBCT guiding can lower patient and operator radiation dose compared to conventional CT.