title: Image-guided microwave thermoablation of hepatic tumours using novel robotic guidance: an early experience.
abstract: OBJECTIVE
  To evaluate and compare novel robotic guidance and manual approaches based on procedural accuracy, procedural time, procedural performance, image quality as well as patient dose during image-guided microwave thermoablation.
  
  
  METHODS
  The study was prospectively performed between June 2013 and December 2013 using 70 patients. Forty randomly selected patients (group 1) were treated with manual guidance and 30 patients (group 2) were treated using a novel robotic guidance. Parameters evaluated were procedural accuracy, total procedural time, procedural performance, quantitative/qualitative image quality and patient dose. Two-sided Student's t test and Wilcoxon rank-sum test were used to test the significance of the data and p values less than 0.05 were considered statistically significant.
  
  
  RESULTS
  Accuracy parameters were significantly higher in group 2 (all p < 0.05). Total procedural time showed a mean time difference of 3 min (group 2 > group 1; p = 0.0008). Volume CT dose index and dose-length product were significantly lower for group 2 compared to group 1 (all p < 0.05) for CT fluoroscopy imaging. Total procedural performance score was higher for group 2 compared to group 1 (p = 0.0001). Image quality parameters were insignificant between examined groups.
  
  
  CONCLUSIONS
  The novel robotic guided approach improved the accuracy of targeting the target tumour, reduced patient dose and increased procedural performance (which influences the procedural safety) during ablation.
  
  
  CONCLUSIONS
  • Few reports are available in the literature regarding robotic-assisted liver microwave ablation. • The robotic guided approach improved accuracy of localizing the target tumour. • Radiation dose on patients was reduced with the robotic guidance. • Numbers of insertions and readjustments were reduced, lowering chances of complications.
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Klinikum Bad Salzungen, Lindigalle 3, 36433, Bad Salzungen, Germany, embalisike@yahoo.com.
authors.forename: Emmanuel C
authors.initials: EC
authors.lastname: Mbalisike
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: Stefan
authors.initials: S
authors.lastname: Zangos
authors.forename: Katrin
authors.initials: K
authors.lastname: Eichler
authors.forename: Prakash
authors.initials: P
authors.lastname: Balakrishnan
authors.forename: Jijo
authors.initials: J
authors.lastname: Paul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003972:Diathermy / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome