title: Stereotactic CT-Guided Percutaneous Microwave Ablation of Liver Tumors With the Use of High-Frequency Jet Ventilation: An Accuracy and Procedural Safety Study.
abstract: OBJECTIVE
  The purpose of the present study is to evaluate the accuracy and safety of antenna placement performed with the use of a CT-guided stereotactic navigation system for percutaneous ablation of liver tumors and to assess the safety of high-frequency jet ventilation for target motion control.
  
  
  METHODS
  Twenty consecutive patients with malignant liver lesions for which surgical resection was contraindicated or that were not readily visible on ultrasound or not accessible by ultrasound guidance were included in the study. Patients were treated with percutaneous microwave ablation performed using a CT-guided stereotactic navigation system. High-frequency jet ventilation was used to reduce liver motion during all interventions. The accuracy of antenna placement, the number of needle readjustments required, overall safety, and the radiation doses were assessed.
  
  
  RESULTS
  Microwave ablation was completed for 20 patients (28 lesions). Performance data could be evaluated for 17 patients with 25 lesions (mean [± SD] lesion diameter, 14.9 ± 5.9 mm; mean lesion location depth, 87.5 ± 27.3 mm). The antennae were placed with a mean lateral error of 4.0 ± 2.5 mm, a depth error of 3.4 ± 3.2 mm, and a total error of 5.8 ± 3.2 mm in relation to the intended target. The median number of antenna readjustments required was zero (range, 0-1 adjustment). No major complications were related to either the procedure or the use of high-frequency jet ventilation. The mean total patient radiation dose was 957.5 ± 556.5 mGy × cm, but medical personnel were not exposed to irradiation.
  
  
  CONCLUSIONS
  Percutaneous microwave ablation performed with CT-guided stereotactic navigation provides sufficient accuracy and requires almost no repositioning of the needle. Therefore, it is technically feasible and applicable for safe treatments.
authors.affiliation: 1 Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Danderyd Hospital AB, SE-182 88 Stockholm, Sweden.
authors.forename: Jennie
authors.initials: J
authors.lastname: Engstrand
authors.affiliation: 2 ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Toporek
authors.affiliation: 1 Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Danderyd Hospital AB, SE-182 88 Stockholm, Sweden.
authors.forename: Piotr
authors.initials: P
authors.lastname: Harbut
authors.affiliation: 1 Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Danderyd Hospital AB, SE-182 88 Stockholm, Sweden.
authors.forename: Eduard
authors.initials: E
authors.lastname: Jonas
authors.affiliation: 1 Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Danderyd Hospital AB, SE-182 88 Stockholm, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Nilsson
authors.affiliation: 1 Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Danderyd Hospital AB, SE-182 88 Stockholm, Sweden.
authors.forename: Jacob
authors.initials: J
authors.lastname: Freedman
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006611:High-Frequency Jet Ventilation / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use; D061214:Patient Safety; D000069079:Radiation Exposure / Q000032:analysis / Q000517:prevention & control; D011856:Radiographic Image Enhancement / Q000379:methods; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: accuracy; interventional radiology; liver; microwave ablation; stereotaxy