title: Clinical experience with cone-beam CT navigation for tumor ablation.
abstract: OBJECTIVE
  To describe clinical use and potential benefits of cone-beam computed tomography (CT) navigation to perform image-guided percutaneous tumor ablation.
  
  
  METHODS
  All ablations performed between February 2011 and February 2013 using cone-beam CT navigation were included. There were 16 patients who underwent 20 ablations for 29 lesions. Cone-beam CT ablation planning capabilities include multimodality image fusion and tumor segmentation for visualization, depiction of the predicted ablation zones for intraprocedural planning, and segmentation of the ablated area for immediate verification after treatment. Number and purpose of cone-beam CT scans were examined. The initial ablation plan, defined as number of probes and duration of energy delivery, was recorded for the 20 of the 29 lesions ablated. Technical success and local recurrences were recorded. Primary and secondary effectiveness rates were calculated.
  
  
  RESULTS
  Image fusion was used for 16 lesions, and intraprocedural ultrasound was used for 4 lesions. Of the 20 ablations, where the ablation plans were recorded, there was no deviation from the plan in 14 ablations. In the remaining 6 ablations, iterative planning was needed for complete tumor coverage. An average of 8.7 cone-beam CT scans ± 3.2 were performed per procedure, including 1.3 ± 0.5 for tumor segmentation and planning, 1.7 ± 0.7 for probe position confirmation, and 3.9 ± 2 to ensure complete coverage. Mean follow-up time was 18.6 months ± 6.5. Ablations for 28 of 29 lesions were technically successful (96.5%). Of ablations performed with curative intent, technical effectiveness at 1 month was 25 of 26 lesions (96.1%) and 22 of 26 lesions (84.6%) at last follow-up. Local tumor progression was observed in 11.5% (3 of 26 lesions).
  
  
  CONCLUSIONS
  Cone-beam CT navigation may add information to assist and improve ablation guidance and monitoring.
authors: Department of Radiology and Imaging Sciences, National Institutes of Health, Room 1C365 Building 10 MSC 1182, 9000 Rockville Pike, Bethesda, MD 20892. Electronic address: naj@mail.nih.gov.
authors: Nadine
authors: N
authors: Abi-Jaoudeh
authors: Department of Radiology and Imaging Sciences, National Institutes of Health, Room 1C365 Building 10 MSC 1182, 9000 Rockville Pike, Bethesda, MD 20892.
authors: Aradhana M
authors: AM
authors: Venkatesan
authors: iXR Division, Philips Healthcare, Best, The Netherlands.
authors: William
authors: W
authors: Van der Sterren
authors: iXR Division, Philips Healthcare, Best, The Netherlands.
authors: Alessandro
authors: A
authors: Radaelli
authors: iXR Division, Philips Healthcare, Best, The Netherlands.
authors: Bart
authors: B
authors: Carelsen
authors: Department of Radiology and Imaging Sciences, National Institutes of Health, Room 1C365 Building 10 MSC 1182, 9000 Rockville Pike, Bethesda, MD 20892.
authors: Bradford J
authors: BJ
authors: Wood
mesh_terms: D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000517:prevention & control*; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
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