Evaluation of a robotic system for irreversible electroporation (IRE) of malignant liver tumors: initial results
- 347 Downloads
Comparison of conventional CT-guided manual irreversible electroporation (IRE) of malignant liver tumors and a robot-assisted approach regarding procedural accuracy, intervention time, dose, complications, and treatment success.
A retrospective single-center analysis of 40 cases of irreversible electroporation of malignant liver tumors in 35 patients (6 females, 29 males, average age 60.3 years). Nineteen of these ablation procedures were performed manually and 21 with robotic assistance. A follow-up (ultrasound, CT, and MRI) was performed after 6 weeks in all patients.
The time from the planning CT scan to the start of the ablation as well as the dose-length product were significantly lower under robotic assistance (63.5 vs. 87.4 min, \(p < 0.001\); 2132 vs. 4714 mGy cm, \(p < 0.001\)). The procedural accuracy, measured as the deviation of the IRE probes with respect to a defined reference probe, was significantly higher using robotic guidance (2.2 vs. 3.1 mm, \(p < 0.001\)). There were no complications. There was one incomplete ablation in the manual group.
Robotic assistance for IRE of liver tumors allows for faster procedure times with higher accuracy while reducing radiation dose as compared to the manual placement of IRE probes.
KeywordsInterventional radiology Robotic assistance Irreversible electroporation Liver tumor CT-guided
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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 amendments or comparable ethical standards. This study was evaluated retrospectively. For this type of study, formal consent is not required.
- 6.Lu DSK, Yu NC, Raman SS, Limanond P, Lassman C, Murray K, Tong MJ, Amado RG, Busuttil RW (2005) Radiofrequency ablation of hepatocellular carcinoma: treatment success as defined by histologic examination of the explanted liver. Radiology 234:954–60. doi: 10.1148/radiol.2343040153 CrossRefPubMedGoogle Scholar
- 7.Kingham TP, Karkar AM, D’Angelica MI, Allen PJ, DeMatteo RP, Getrajdman GI, Sofocleous CT, Solomon SB, Jarnagin WR, Fong Y (2012) Ablation of perivascular hepatic malignant tumors with irreversible electroporation. J Am Coll Surg 215:379–387. doi: 10.1016/j.jamcollsurg.2012.04.029 CrossRefPubMedGoogle Scholar
- 10.Jiang C, Davalos RV, Bischof JC (2015) A review of basic to clinical studies of irreversible electroporation therapy. IEEE Trans Biomed Eng 62:4–20. doi: 10.1109/TBME.2014.2367543
- 14.Scheffer HJ, Melenhorst MCAM, Vogel JA, van Tilborg AAJM, Nielsen K, Kazemier G, Meijerink MR (2015) Percutaneous irreversible electroporation of locally advanced pancreatic carcinoma using the dorsal approach: a case report. Cardiovasc Intervent Radiol 38:760–5. doi: 10.1007/s00270-014-0950-x CrossRefPubMedGoogle Scholar
- 16.Ben-David E, Ahmed M, Faroja M, Moussa M, Wandel A, Sosna J, Appelbaum L, Nissenbaum I, Goldberg SN (2013) Irreversible electroporation: treatment effect is susceptible to local environment and tissue properties. Radiology 269:738–47. doi: 10.1148/radiol.13122590 CrossRefPubMedPubMedCentralGoogle Scholar
- 17.van den Bos W, Scheffer HJ, Vogel JA, Wagstaff PGK, de Bruin DM, de Jong MC, van Gemert MJC, de la Rosette JJMCH, Meijerink MR, Klaessens JH, Verdaasdonk RM (2016) Thermal energy during irreversible electroporation and the influence of different ablation parameters. J Vasc Interv Radiol 27:433–443. doi: 10.1016/j.jvir.2015.10.020 CrossRefPubMedGoogle Scholar
- 19.Beyer LP, Pregler B, Niessen C, Dollinger M, Graf BM, Müller M, Schlitt HJ, Stroszczynski C, Wiggermann P (2015) Robot-assisted microwave thermoablation of liver tumors: a single-center experience. Int J Comput Assist Radiol Surg 11:253–259. doi: 10.1007/s11548-015-1286-y CrossRefPubMedGoogle Scholar