Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system
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May 28, 2020
About this article
Article Category: Research Article
Published Online: May 28, 2020
Page range: 295 - 300
Received: Feb 17, 2020
Accepted: May 03, 2020
DOI: https://doi.org/10.2478/raon-2020-0033
Keywords
© 2020 Jan Schaible, Benedikt Pregler, Niklas Verloh, Ingo Einspieler, Wolf Bäumler, Florian Zeman, Andreas Schreyer, Christian Stroszczynski, Lukas Beyer, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Influence of tumor characteristics on primary efficacy
| Predictor | Estimate | Std.err | Wald | p-value | |
|---|---|---|---|---|---|
| Long axis, mm | ≤ 30 | Reference | 0.3657 | 5.68 | |
| Guidance | Freehand | Reference | 0.3256 | 6.13 | |
| HCC | Reference | ||||
| Tumor entity | CRC | 0.2922 | 0.4483 | 0.42 | 0.5145 |
| Other | 0.0832 | 0.5228 | 0.03 | 0.8736 | |
| I | Reference | ||||
| II | − 0.3956 | 1.0798 | 0.13 | 0.7141 | |
| III | − 0.0449 | 1.1025 | 0.00 | 0.9675 | |
| IVa | 0.2688 | 1.1180 | 0.06 | 0.8100 | |
| Liver segment | IVb | − 0.2539 | 1.1597 | 0.05 | 0.8267 |
| V | 0.5961 | 1.1285 | 0.28 | 0.5974 | |
| VI | 0.9036 | 1.1736 | 0.59 | 0.4413 | |
| VII | 0.0656 | 1.1090 | 0.00 | 0.9528 | |
| VIII | − 0.1069 | 1.0929 | 0.01 | 0.9221 |
Monte Carlo simulation of primary technique efficacy rate depending on tumor size and antenna guidance
| Long axis, mm | Guidance | CI-2.5% | Median | CI-97.5% |
|---|---|---|---|---|
| ≤ 30 | Freehand | 0.60 | 0.75 | 0.86 |
| > 30 | Freehand | 0.34 | 0.55 | 0.76 |
| ≤ 30 | Robotic | 0.78 | 0.87 | 0.92 |
| > 30 | Robotic | 0.55 | 0.74 | 0.87 |
Tumors treated using freehand and robotic guidance
| Ablation technique | Long axis, mm | Liver segment, n (%) | Device, n (%) | Primary efficacy, n (%) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Min | Mean (SD) | Max | I | II | III | IVa | IVb | V | VI | VII | VIII | Acculis | Emprint | Complete | Incomplete | |
| Freehand (n = 119) | 4 | 19.79 | 85 | 1 | 10 | 16 | 16 | 9 | 13 | 17 | 15 | 22 | 65 | 54 | 9 | 28 |
| Robotic guidance (n = 249) | 3 | 18.78 | 64 | 6 | 24 | 20 | 26 | 16 | 38 | 36 | 36 | 47 | 143 | 106 | 219 | 30 |
Patient characteristics
| Age, years | Sex, n, (%) | Treated tumors per patient, n | Tumor entity, n (%) | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Min. | Mean (SD) | Median (IQR) | Max. | Male | Female | Median (IQR) | Max. | HCC | CRC | CCC | Other | |
| Patients (n = 192) | 15 | 65.03 | 64.00 | 83 | 156 | 36 | 1.00 | 9 | 139 (72) | 29 | 7 | 17 |