Improvement of the primary efficacy of microwave ablation of malignant liver tumors by using a robotic navigation system

	Age, years			Sex, n, (%)			Treated tumors per patient, n			Tumor entity, n (%)

	Min.	Mean (SD)	Median (IQR)	Max.	Male	Female	Median (IQR)	Max.	HCC	CRC	CCC	Other
Patients (n = 192)	15	65.03 (23.56)	64.00 (57.75, 72.00)	83	156 (81)	36 (19)	1.00 (1.00, 2.00)	9	139 (72)	29 (15)	7 (4)	17 (9)

[i] CCC = cholangiocellular carcinoma; CRC = colorectal liver metastasis; HCC = hepatocellular carcinoma; IQR = interquartile range; SD = standard deviation

Table 2

Tumors treated using freehand and robotic guidance

Ablation technique	Long axis, mm						Liver segment, n (%)						Device, n (%)		Primary efficacy, n (%)

	Min	Mean (SD)	Max	I	II	III	IVa	IVb	V	VI	VII	VIII	Acculis	Emprint	Complete	Incomplete
Freehand (n = 119)	4	19.79 (12.42)	85	1 (1)	10 (8)	16 (13)	16 (13)	9 (8)	13 (11)	17 (14)	15 (13)	22 (18)	65 (55)	54 (45)	9 (76)	28 (24)
Robotic guidance (n = 249)	3	18.78 (10.78)	64	6 (2)	24 (10)	20 (8)	26 (10)	16 (6)	38 (15)	36 (14)	36 (14)	47 (19)	143 (57)	106 (43)	219 (88)	30 (12)

[i] SD = standard deviation

Table 3

Influence of tumor characteristics on primary efficacy

Predictor		Estimate	Std.err	Wald	p-value
Long axis, mm	≤ 30 > 30	Reference − 0.8717	0.3657	5.68	0.0171
Guidance	Freehand Robotic	Reference 0.8064	0.3256	6.13	0.0133
	HCC	Reference
Tumor entity	CRC CCC	0.2922 0.0665	0.4483 0.6524	0.42 0.01	0.5145 0.9188
	Other	0.0832	0.5228	0.03	0.8736
	I	Reference
	II	− 0.3956	1.0798	0.13	0.7141
	III	− 0.0449	1.1025	0.00	0.9675
	IVa	0.2688	1.1180	0.06	0.8100
Liver segment	IVb	− 0.2539	1.1597	0.05	0.8267
	V	0.5961	1.1285	0.28	0.5974
	VI	0.9036	1.1736	0.59	0.4413
	VII	0.0656	1.1090	0.00	0.9528
	VIII	− 0.1069	1.0929	0.01	0.9221

[i] >CCC = cholangiocellular carcinoma; CRC = colorectal liver metastasis; HCC = hepatocellular carcinoma; Wald = χ2 test for the coefficients

Table 4

Monte Carlo simulation of primary technique efficacy rate depending on tumor size and antenna guidance

Long axis, mm	Guidance	CI-2.5%	Median	CI-97.5%
≤ 30	Freehand	0.60	0.75	0.86
> 30	Freehand	0.34	0.55	0.76
≤ 30	Robotic	0.78	0.87	0.92
> 30	Robotic	0.55	0.74	0.87

[i] CI-2.5% and CI-97.5% = the central interval bounds at the lower 2.5 and upper 97.5 percentiles, respectively; Median = the simulated distribution’s median

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DOI: https://doi.org/10.2478/raon-2020-0033 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 295 - 300

Submitted on: Feb 17, 2020

Accepted on: May 3, 2020

Published on: May 28, 2020

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

Interventional radiology,

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© 2020 Jan Schaible, Benedikt Pregler, Niklas Verloh, Ingo Einspieler, Wolf Bäumler, Florian Zeman, Andreas Schreyer, Christian Stroszczynski, Lukas Beyer, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 54 (2020): Issue 3 (September 2020)