Abstract
Objective
To evaluate and compare novel robotic guidance and manual approaches based on procedural accuracy, procedural time, procedural performance, image quality as well as patient dose during image-guided microwave thermoablation.
Method
The study was prospectively performed between June 2013 and December 2013 using 70 patients. Forty randomly selected patients (group 1) were treated with manual guidance and 30 patients (group 2) were treated using a novel robotic guidance. Parameters evaluated were procedural accuracy, total procedural time, procedural performance, quantitative/qualitative image quality and patient dose. Two-sided Student’s t test and Wilcoxon rank-sum test were used to test the significance of the data and p values less than 0.05 were considered statistically significant.
Result
Accuracy parameters were significantly higher in group 2 (all p < 0.05). Total procedural time showed a mean time difference of 3 min (group 2 > group 1; p = 0.0008). Volume CT dose index and dose–length product were significantly lower for group 2 compared to group 1 (all p < 0.05) for CT fluoroscopy imaging. Total procedural performance score was higher for group 2 compared to group 1 (p = 0.0001). Image quality parameters were insignificant between examined groups.
Conclusion
The novel robotic guided approach improved the accuracy of targeting the target tumour, reduced patient dose and increased procedural performance (which influences the procedural safety) during ablation.
Key Points
• Few reports are available in the literature regarding robotic-assisted liver microwave ablation.
• The robotic guided approach improved accuracy of localizing the target tumour.
• Radiation dose on patients was reduced with the robotic guidance.
• Numbers of insertions and readjustments were reduced, lowering chances of complications.
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Acknowledgments
We would like to thank Mrs. Neddermann and Mr. Ackermann of Johann Wolfgang Goethe University Frankfurt, Germany as well as Dr. Anjali of Perfint Healthcare for their relentless support and efforts during the time of this study. The authors would also like to acknowledge and thank Perfint Healthcare India for allowing the use of their MAXIO robotic system during the duration of the study. The scientific guarantor of this publication is Jijo Paul, Ph.D. The authors of this manuscript declare relationships with the following companies: Prakash Balakrishnan, M.Sc. is an employer of Perfint Healthcare Pvt. Ltd. The authors would like to thank Perfint Healthcare for loaning us their system for our study. The authors state that this work did not receive any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. The study has not been reported before anywhere. Methodology: prospective, performed at one institution.
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Mbalisike, E.C., Vogl, T.J., Zangos, S. et al. Image-guided microwave thermoablation of hepatic tumours using novel robotic guidance: an early experience. Eur Radiol 25, 454–462 (2015). https://doi.org/10.1007/s00330-014-3398-0
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DOI: https://doi.org/10.1007/s00330-014-3398-0