Abstract
Purpose
To assess the accuracy and applicability of an electromagnetic navigation system (EMNS) for CT-guided microwave ablation (MWA) of hepatic tumors in comparison with conventional CT-guidance.
Materials and Methods
34 patients (m = 20/f = 14, mean age 34 y) with 34 liver tumors (primary = 22, metastases = 14, mean size 20 mm) referred for CT-guided MWA were included in this IRB-approved study. Interventions were performed prospectively using an EMNS in 17 patients (navigation group), and results were compared to a matched historic cohort of 17 patients using conventional CT-guidance (control group, t-test, p < 0.05 deemed significant). Primary outcome measurement: accuracy of antenna placement (deviation). Secondary outcome measurements: setup time, number of control scans, duration and radiation exposure for antenna placement.
Results
Ablations were performed using a single or a double-angulated approach. Application of the EMNS was feasible in 14 cases (82%). Mean total deviation of the antenna feed point in the navigation and control group was 2.4 mm (range 0.2–4.8 mm) and 3.9 mm (range 0.4–7.8 mm), p < 0.05. Mean setup time for the EMNS was 6.75 ± 3.9 min (range 3–12 min). Mean number of control scans in the navigation and control group was 3 ± 0.9 (range 1–4) and 6 ± 1.3 (range 4–8), p < 0.0001; mean time for antenna placement was 9 ± 7.3 min (range 1.4–25.9 min) and 11.45 ± 6.1 min (range 3.9–27.4 min), p = 0.3164. Radiation exposure was significantly less in the navigation group.
Conclusion
Our experience in a limited number of patients suggests that EMNS enables intuitive CT-guided MWA of liver tumors with higher accuracy when compared to ablations performed without navigation and with fewer control scans needed.
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This study was not supported by any funding.
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Hatem Rabeh is employed by IMACTIS. All other authors declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendment or comparable ethical standards.
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This study has obtained IRB approval from Hannover Medical School and the need for informed consent was waived.
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Ringe, K.I., Pöhler, G.H., Rabeh, H. et al. Electromagnetic Navigation System-Guided Microwave Ablation of Hepatic Tumors: A Matched Cohort Study. Cardiovasc Intervent Radiol 44, 500–506 (2021). https://doi.org/10.1007/s00270-020-02761-6
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DOI: https://doi.org/10.1007/s00270-020-02761-6