title: Targeting accuracy of CT-guided stereotaxy for radiofrequency ablation of liver tumours.
abstract: The targeting accuracy during CT-guided stereotactic radiofrequency ablation (SRFA) of liver tumours was evaluated in a clinical study. Patients under general anaesthesia were immobilized using a vacuum cushion and respiratory motion control was based on temporary disconnections of the endotracheal tube. An optical-based navigation system was used for 3D trajectory planning and needle placement via a stereotactic aiming device. A control CT with the needles in place was fused with the planning CT for accuracy evaluation. Sub-analysis was performed for "location" (liver segments II-VIII), "approach" (intercostal or transabdominal), "properties" (clear parenchymal, subcapsular, subphrenic, fat, and subphrenic plus fat), and "path length". In 20 patients with 35 liver lesions, a total of 145 needles were placed with mean (±SD) lateral errors of 3.6 ± 2.5 mm at the needle tip, angular errors of 1.3° ± 1.2°, and longitudinal errors at the needle tip of -7.4 ± 6.2 mm. No puncture-related complications were noted. No significant differences of angular errors between segments, approach and properties were recorded. Long paths correlated with smaller angular errors. CT-guided stereotaxy can be considered safe and provided precise multiple needle placement for SRFA of liver lesions at arbitrary trajectories in various segments and locations.
authors.affiliation: Department of Microinvasive Therapy, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Gerlig
authors.initials: G
authors.lastname: Widmann
authors.forename: Peter
authors.initials: P
authors.lastname: Schullian
authors.forename: Marion
authors.initials: M
authors.lastname: Haidu
authors.forename: Martin
authors.initials: M
authors.lastname: Fasser
authors.forename: Reto
authors.initials: R
authors.lastname: Bale
mesh_terms: D017115:Catheter Ablation / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D015641:Radiography, Interventional / Q000379:methods; D013238:Stereotaxic Techniques / Q000009:adverse effects; D014057:Tomography, X-Ray Computed / Q000379:methods*