title: Evaluation of a robotic system for irreversible electroporation (IRE) of malignant liver tumors: initial results.
abstract: OBJECTIVE
  Comparison of conventional CT-guided manual irreversible electroporation (IRE) of malignant liver tumors and a robot-assisted approach regarding procedural accuracy, intervention time, dose, complications, and treatment success.
  
  
  METHODS
  A retrospective single-center analysis of 40 cases of irreversible electroporation of malignant liver tumors in 35 patients (6 females, 29 males, average age 60.3 years). Nineteen of these ablation procedures were performed manually and 21 with robotic assistance. A follow-up (ultrasound, CT, and MRI) was performed after 6 weeks in all patients.
  
  
  RESULTS
  The time from the planning CT scan to the start of the ablation as well as the dose-length product were significantly lower under robotic assistance (63.5 vs. 87.4 min, [Formula: see text]; 2132 vs. 4714 mGy cm, [Formula: see text]). The procedural accuracy, measured as the deviation of the IRE probes with respect to a defined reference probe, was significantly higher using robotic guidance (2.2 vs. 3.1 mm, [Formula: see text]). There were no complications. There was one incomplete ablation in the manual group.
  
  
  CONCLUSIONS
  Robotic assistance for IRE of liver tumors allows for faster procedure times with higher accuracy while reducing radiation dose as compared to the manual placement of IRE probes.
authors.affiliation: Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany. lukas@lukasbeyer.com.
authors.forename: L P
authors.initials: LP
authors.lastname: Beyer
authors.affiliation: Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Pregler
authors.affiliation: Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Michalik
authors.affiliation: Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Niessen
authors.affiliation: Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Dollinger
authors.affiliation: Department of Internal Medicine I, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Müller
authors.affiliation: Department of Surgery, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: H J
authors.initials: HJ
authors.lastname: Schlitt
authors.affiliation: Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Stroszczynski
authors.affiliation: Department of Radiology, University Medical Center Regensburg, 93053, Regensburg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Wiggermann
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D004566:Electrodes; D018274:Electroporation; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D015203:Reproducibility of Results; D012107:Research Design; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: CT-guided; Interventional radiology; Irreversible electroporation; Liver tumor; Robotic assistance