nach oben

International Journal of Computer Assisted Radiology and Surgery

Erschienen in:

01.02.2016 | Original Article

Robot-assisted microwave thermoablation of liver tumors: a single-center experience

verfasst von: L. P. Beyer, B. Pregler, C. Niessen, M. Dollinger, B. M. Graf, M. Müller, H. J. Schlitt, C. Stroszczynski, P. Wiggermann

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate and compare the needle placement accuracy, patient dose, procedural time, complication rate and ablation success of microwave thermoablation using a novel robotic guidance approach and a manual approach.

Methods

We performed a retrospective single-center evaluation of 64 microwave thermoablations of liver tumors in 46 patients (10 female, 36 male, mean age 66 years) between June 2014 and February 2015. Thirty ablations were carried out with manual guidance, while 34 ablations were performed using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and MRI) was performed on all patients.

Results

The total procedure time and dose-length product were significantly reduced under robotic guidance (18.3 vs. 21.7 min, \(p<0.001\); 2216 vs. 2881 mGy\(\times \)cm, \(p = 0.04\)). The position of the percutaneous needle was more accurate using robotic guidance (needle deviation 1.6 vs. 3.3 mm, \(p< 0.001\)). There was no significant difference between both groups regarding the complication rate and the ablation success.

Conclusion

Robotic assistance for liver tumor ablation reduces patient dose and allows for fast positioning of the microwave applicator with high accuracy. The complication rate and ablation success of percutaneous microwave thermoablation of malignant liver tumors using either CT fluoroscopy or robotic guidance for needle positioning showed no significant differences in the 6-week follow-up.

Lubner MG, Brace CL, Hinshaw JL, Lee FT Jr (2010) Microwave tumor ablation: mechanism of action, clinical results, and devices. J Vasc Interv Radiol JVIR 21(8 Suppl):S192–S203. doi:10.1016/j.jvir.2010.04.007 CrossRefPubMed

Shibata T, Niinobu T, Ogata N, Takami M (2000) Microwave coagulation therapy for multiple hepatic metastases from colorectal carcinoma. Cancer 89(2):276–284CrossRefPubMed

Tanaka K, Shimada H, Nagano Y, Endo I, Sekido H, Togo S (2006) Outcome after hepatic resection versus combined resection and microwave ablation for multiple bilobar colorectal metastases to the liver. Surgery 139(2):263–273. doi:10.1016/j.surg.2005.07.036 CrossRefPubMed

Kurumi Y, Tani T, Naka S, Shiomi H, Shimizu T, Abe H, Endo Y, Morikawa S (2007) MR-guided microwave ablation for malignancies. Int J Clin Oncol 12(2):85–93. doi:10.1007/s10147-006-0653-7 CrossRefPubMed

Kuang M, Lu MD, Xie XY, Xu HX, Mo LQ, Liu GJ, Xu ZF, Zheng YL, Liang JY (2007) Liver cancer: increased microwave delivery to ablation zone with cooled-shaft antenna-experimental and clinical studies. Radiology 242(3):914–924. doi:10.1148/radiol.2423052028 CrossRefPubMed

Shimada S, Hirota M, Beppu T, Matsuda T, Hayashi N, Tashima S, Takai E, Yamaguchi K, Inoue K, Ogawa M (1998) Complications and management of microwave coagulation therapy for primary and metastatic liver tumors. Surg Today 28(11):1130–1137CrossRefPubMed

Kloeckner R, dos Santos DP, Schneider J, Kara L, Dueber C, Pitton MB (2013) Radiation exposure in CT-guided interventions. Eur J Radiol 82(12):2253–2257. doi:10.1016/j.ejrad.2013.08.035 CrossRefPubMed

Rathmann N, Haeusler U, Diezler P, Weiss C, Kostrzewa M, Sadick M, Schoenberg SO, Diehl SJ (2014) Evaluation of radiation exposure of medical staff during CT-guided interventions. J Am Coll Radiol JACR. doi:10.1016/j.jacr.2014.04.012

Kato R, Katada K, Anno H, Suzuki S, Ida Y, Koga S (1996) Radiation dosimetry at CT fluoroscopy: physician’s hand dose and development of needle holders. Radiology 201(2):576–578. doi:10.1148/radiology.201.2.8888264

10.

Solomon SB, Patriciu A, Bohlman ME, Kavoussi LR, Stoianovici D (2002) Robotically driven interventions: a method of using CT fluoroscopy without radiation exposure to the physician. Radiology 225(1):277–282. doi:10.1148/radiol.2251011133 PubMedCentralCrossRefPubMed

11.

Mbalisike EC, Vogl TJ, Zangos S, Eichler K, Balakrishnan P, Paul J (2014) Image-guided microwave thermoablation of hepatic tumours using novel robotic guidance: an early experience. Eur Radiol. doi:10.1007/s00330-014-3398-0

12.

Abdullah BJ, Yeong CH, Goh KL, Yoong BK, Ho GF, Yim CC, Kulkarni A (2015) Robotic-assisted thermal ablation of liver tumours. Eur Radiol 25(1):246–257. doi:10.1007/s00330-014-3391-7 CrossRefPubMed

13.

Omary RA, Bettmann MA, Cardella JF, Bakal CW, Schwartzberg MS, Sacks D, Rholl KS, Meranze SG, Lewis CA (2003) Quality improvement guidelines for the reporting and archiving of interventional radiology procedures. J Vasc Interv Radiol JVIR 14(9 Pt 2):S293–S295CrossRefPubMed

14.

Prosch H, Stadler A, Schilling M, Burklin S, Eisenhuber E, Schober E, Mostbeck G (2012) CT fluoroscopy-guided vs. multislice CT biopsy mode-guided lung biopsies: accuracy, complications and radiation dose. Eur J Radiol 81(5):1029–1033. doi:10.1016/j.ejrad.2011.01.064 CrossRefPubMed

15.

Elias D, Di Pietroantonio D, Gachot B, Menegon P, Hakime A, De Baere T (2006) Liver abscess after radiofrequency ablation of tumors in patients with a biliary tract procedure. Gastroenterol Clin Biol 30(6–7):823–827CrossRefPubMed

Titel: Robot-assisted microwave thermoablation of liver tumors: a single-center experience
verfasst von: L. P. Beyer
B. Pregler
C. Niessen
M. Dollinger
B. M. Graf
M. Müller
H. J. Schlitt
C. Stroszczynski
P. Wiggermann
Publikationsdatum: 01.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 2/2016
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-015-1286-y

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

Robot-assisted microwave thermoablation of liver tumors: a single-center experience