Electromagnetic Navigation System-Guided Microwave Ablation of Hepatic Tumors: A Matched Cohort Study

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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Funding

This study was not supported by any funding.

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Correspondence to K. I. Ringe.

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Conflict of interest

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.

Informed Consent

This study has obtained IRB approval from Hannover Medical School and the need for informed consent was waived.

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Consent for publication was obtained for every individual person’s data included in the study.

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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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Keywords

  • Microwave ablation
  • Electromagnetic
  • Navigation
  • Computed tomography
  • Accuracy