title: The first clinical application of planning software for laparoscopic microwave thermosphere ablation of malignant liver tumours.
abstract: BACKGROUND
  Liver tumour ablation is an operator-dependent procedure. The determination of the optimum needle trajectory and correct ablation parameters could be challenging. The aim of this study was to report the utility of a new, procedure planning software for microwave ablation (MWA) of liver tumours.
  
  
  METHODS
  This was a feasibility study in a pilot group of five patients with nine metastatic liver tumours who underwent laparoscopic MWA. Pre-operatively, parameters predicting the desired ablation zones were calculated for each tumour. Intra-operatively, this planning strategy was followed for both antenna placement and energy application. Post-operative 2-week computed tomography (CT) scans were performed to evaluate complete tumour destruction.
  
  
  RESULTS
  The patients had an average of two tumours (range 1-4), measuring 1.9 ± 0.4 cm (range 0.9-4.4 cm). The ablation time was 7.1 ± 1.3 min (range 2.5-10 min) at 100W. There were no complications or mortality. The patients were discharged home on post-operative day (POD) 1. At 2-week CT scans, there were no residual tumours, with a complete ablation demonstrated in all lesions.
  
  
  CONCLUSIONS
  This study describes and validates pre-treatment planning software for MWA of liver tumours. This software was found useful to determine precisely the ablation parameters and needle placement to create a predicted zone of ablation.
authors.affiliation: Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Eren
authors.initials: E
authors.lastname: Berber
mesh_terms: D055011:Ablation Techniques; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012986:Software Validation; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden