title: Robotic-assisted thermal ablation of liver tumours.
abstract: OBJECTIVE
  This study aimed to assess the technical success, radiation dose, safety and performance level of liver thermal ablation using a computed tomography (CT)-guided robotic positioning system.
  
  
  METHODS
  Radiofrequency and microwave ablation of liver tumours were performed on 20 patients (40 lesions) with the assistance of a CT-guided robotic positioning system. The accuracy of probe placement, number of readjustments and total radiation dose to each patient were recorded. The performance level was evaluated on a five-point scale (5-1: excellent-poor). The radiation doses were compared against 30 patients with 48 lesions (control) treated without robotic assistance.
  
  
  RESULTS
  Thermal ablation was successfully completed in 20 patients with 40 lesions and confirmed on multiphasic contrast-enhanced CT. No procedure related complications were noted in this study. The average number of needle readjustment was 0.8 ± 0.8. The total CT dose (DLP) for the entire robotic assisted thermal ablation was 1382 ± 536 mGy.cm, while the CT fluoroscopic dose (DLP) per lesion was 352 ± 228 mGy.cm. There was no statistically significant (p > 0.05) dose reduction found between the robotic-assisted versus the conventional method.
  
  
  CONCLUSIONS
  This study revealed that robotic-assisted planning and needle placement appears to be safe, with high accuracy and a comparable radiation dose to patients.
  
  
  CONCLUSIONS
  • Clinical experience on liver thermal ablation using CT-guided robotic system is reported. • The technical success, radiation dose, safety and performance level were assessed. • Thermal ablations were successfully performed, with an average performance score of 4.4/5.0. • Robotic-assisted ablation can potentially increase capabilities of less skilled interventional radiologists. • Cost-effectiveness needs to be proven in further studies.
authors.affiliation: Department of Biomedical Imaging and University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia, basrij@ummc.edu.my.
authors.forename: Basri Johan Jeet
authors.initials: BJ
authors.lastname: Abdullah
authors.forename: Chai Hong
authors.initials: CH
authors.lastname: Yeong
authors.forename: Khean Lee
authors.initials: KL
authors.lastname: Goh
authors.forename: Boon Koon
authors.initials: BK
authors.lastname: Yoong
authors.forename: Gwo Fuang
authors.initials: GF
authors.lastname: Ho
authors.forename: Carolyn Chue Wai
authors.initials: CC
authors.lastname: Yim
authors.forename: Anjali
authors.initials: A
authors.lastname: Kulkarni
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome