<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2020-0033_s_005_w2aab3b7c33b1b6b1aab1c16b1Aa"><h3>Background</h3><p>The aim of the study was to assess the primary efficacy of robot-assisted microwave ablation and compare it to manually guided microwave ablation for percutaneous ablation of liver malignancies.</p></sec><sec id="j_raon-2020-0033_s_006_w2aab3b7c33b1b6b1aab1c16b2Aa"><h3>Patients and methods</h3><p>We performed a retrospective single center evaluation of microwave ablations of 368 liver tumors in 192 patients (36 female, 156 male, mean age 63 years). One hundred and nineteen ablations were performed between 08/2011 and 03/2014 with manual guidance, whereas 249 ablations were performed between 04/2014 and 11/2018 using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and magnetic resonance imaging) was performed on all patients.</p></sec><sec id="j_raon-2020-0033_s_007_w2aab3b7c33b1b6b1aab1c16b3Aa"><h3>Results</h3><p>The primary technique efficacy outcome of the group treated by robotic guidance was significantly higher than that of the manually guided group (88% <italic>vs</italic>. 76%; p = 0.013). Multiple logistic regression analysis indicated that a small tumor size (≤ 3 cm) and robotic guidance were significant favorable prognostic factors for complete ablation.</p></sec><sec id="j_raon-2020-0033_s_008_w2aab3b7c33b1b6b1aab1c16b4Aa"><h3>Conclusions</h3><p>In addition to a small tumor size, robotic navigation was a major positive prognostic factor for primary technique efficacy.</p></sec></abstract>

BackgroundThe aim of the study was to assess the primary efficacy of robot-assisted microwave ablation and compare it to manually guided microwave ablation for percutaneous ablation of liver malignancies.Patients and methodsWe performed a retrospective single center evaluation of microwave ablations of 368 liver tumors in 192 patients (36 female, 156 male, mean age 63 years). One hundred and nineteen ablations were performed between 08/2011 and 03/2014 with manual guidance, whereas 249 ablations were performed between 04/2014 and 11/2018 using robotic guidance. A 6-week follow-up (ultrasound, computed tomography and magnetic resonance imaging) was performed on all patients.ResultsThe primary technique efficacy outcome of the group treated by robotic guidance was significantly higher than that of the manually guided group (88% vs. 76%; p = 0.013). Multiple logistic regression analysis indicated that a small tumor size (≤ 3 cm) and robotic guidance were significant favorable prognostic factors for complete ablation.ConclusionsIn addition to a small tumor size, robotic navigation was a major positive prognostic factor for primary technique efficacy.

Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundThe aim of the study was to assess the primary efficacy of robot-assisted microwave ablation and compare it to manually guided microwave ablation for...

Predictor		Estimate	Std.err	Wald	p-value
Long axis, mm	≤ 30 > 30	Reference − 0.8717	0.3657	5.68	0.0171
Guidance	Freehand Robotic	Reference 0.8064	0.3256	6.13	0.0133
	HCC	Reference
Tumor entity	CRC CCC	0.2922 0.0665	0.4483 0.6524	0.42 0.01	0.5145 0.9188
	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

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

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 (12.42)	85	1 (1)	10 (8)	16 (13)	16 (13)	9 (8)	13 (11)	17 (14)	15 (13)	22 (18)	65 (55)	54 (45)	9 (76)	28 (24)
Robotic guidance (n = 249)	3	18.78 (10.78)	64	6 (2)	24 (10)	20 (8)	26 (10)	16 (6)	38 (15)	36 (14)	36 (14)	47 (19)	143 (57)	106 (43)	219 (88)	30 (12)

	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 (23.56)	64.00 (57.75, 72.00)	83	156 (81)	36 (19)	1.00 (1.00, 2.00)	9	139 (72)	29 (15)	7 (4)	17 (9)

Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system

Article Category: Research Article

Data publikacji: 28 maj 2020

Zakres stron: 295 - 300

Otrzymano: 17 lut 2020

Przyjęty: 03 maj 2020

DOI: https://doi.org/10.2478/raon-2020-0033

© 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

Monte Carlo simulation of primary technique efficacy rate depending on tumor size and antenna guidance

Tumors treated using freehand and robotic guidance

Patient characteristics