Evaluation of a robotic system for irreversible electroporation (IRE) of malignant liver tumors: initial results

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

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Correspondence to L. P. Beyer.

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The 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 amendments or comparable ethical standards. This study was evaluated retrospectively. For this type of study, formal consent is not required.

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Beyer, L.P., Pregler, B., Michalik, K. et al. Evaluation of a robotic system for irreversible electroporation (IRE) of malignant liver tumors: initial results. Int J CARS 12, 803–809 (2017). https://doi.org/10.1007/s11548-016-1485-1

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Keywords

  • Interventional radiology
  • Robotic assistance
  • Irreversible electroporation
  • Liver tumor
  • CT-guided