Robotic-assisted CT-guided percutaneous thermal ablation of abdominal tumors: An analysis of 41 patients

IF 4.9 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Diagnostic and Interventional Imaging Pub Date : 2024-06-01 DOI:10.1016/j.diii.2024.01.005

Baptiste Bonnet , Thierry de Baère , Paul Beunon , Adlane Feddal , Lambros Tselikas , Frédéric Deschamps

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引用次数: 0

Abstract

Purpose

Robotic assistance is rapidly evolving and may help physicians optimize needle guidance during percutaneous interventions. The purpose of the study was to report feasibility, safety, accuracy, immediate clinical success and short-term local tumor control after robotic-assisted computed tomography (CT)-guided thermal ablation of abdominal tumors.

Materials and methods

Forty-one patients who underwent percutaneous thermal ablation of abdominal tumors using robotic-assisted CT-guided were included. All ablations were performed with robotic assistance, using an optically-monitored robotic system with a needle guide sent to preplanned trajectories defined on three-dimensional-volumetric CT acquisitions with respiration monitoring. Endpoints were technical success, safety, distance from needle tip to planned trajectory and number of needle adjustments, and complete ablation rate.

Results

Forty-one patients (31 men; mean age, 66.7 ± 9.9 [standard deviation (SD)] years [age range: 41–84 years]) were treated for 48 abdominal tumors, with 79 planned needles. Lesions treated were located in the liver (23/41; 56%), kidney (14/41;34%), adrenal gland (3/41; 7%) or retroperitoneum (1/41; 2%). Technical success was achieved in 39/41 (95%) patients, and 76/79 (96%) needle insertions. The mean lateral distance between the needle tip and planned trajectory was 3.2 ± 4.5 (SD) mm (range: 0–20 mm) before adjustments, and the mean three-dimensional distance was 1.6 ± 2.6 (SD) mm (range: 0–13 mm) after 29 manual depth adjustments (29/78; 37%) and 33 lateral adjustments (33/78; 42%). Two (2/79; 3%) needles required complete manual reinsertion. One grade 3 complication was reported in one patient (1/41; 2%). The overall clinical success rate was 100%. The 3-month local tumor control rate (progression free survival) was 95% (38/41).

Conclusion

These results provide further evidence on the use of robotic-assisted needle insertion regarding feasibility, safety, and accuracy, resulting in effective percutaneous thermal ablation of abdominal tumors.

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机器人辅助 CT 引导下的腹部肿瘤经皮热消融术：对41名患者的分析。

目的：机器人辅助技术发展迅速，可帮助医生优化经皮介入治疗过程中的针引导。本研究旨在报告机器人辅助计算机断层扫描（CT）引导腹部肿瘤热消融术的可行性、安全性、准确性、即时临床成功率和短期局部肿瘤控制率：纳入了41名在机器人辅助CT引导下接受腹部肿瘤经皮热消融术的患者。所有消融手术都是在机器人辅助下进行的，使用的是光学监控机器人系统，其针导器是根据三维容积 CT 采集的预规划轨迹发送的，并带有呼吸监测功能。终点是技术成功率、安全性、针尖到计划轨迹的距离和针头调整次数以及完全消融率：41 名患者（31 名男性；平均年龄为 66.7 ± 9.9 [标准差 (SD)] 岁 [年龄范围：41-84 岁]）接受了 48 例腹部肿瘤的治疗，计划针数为 79 针。治疗的肿瘤位于肝脏（23/41；56%）、肾脏（14/41；34%）、肾上腺（3/41；7%）或腹膜后（1/41；2%）。39/41（95%）例患者获得了技术成功，76/79（96%）例针头插入成功。调整前针尖与计划轨迹之间的平均侧向距离为 3.2 ± 4.5 (SD) mm（范围：0-20 mm），经过 29 次手动深度调整（29/78；37%）和 33 次侧向调整（33/78；42%）后，平均三维距离为 1.6 ± 2.6 (SD) mm（范围：0-13 mm）。有两枚针（2/79；3%）需要完全手动重新插入。一名患者（1/41；2%）出现了 3 级并发症。总体临床成功率为 100%。3个月的局部肿瘤控制率（无进展生存期）为95%（38/41）：这些结果进一步证明了使用机器人辅助穿刺针插入的可行性、安全性和准确性，从而有效地对腹部肿瘤进行经皮热消融。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostic and Interventional Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

8.50

自引率

29.10%

发文量

126

审稿时长

11 days

期刊介绍： Diagnostic and Interventional Imaging accepts publications originating from any part of the world based only on their scientific merit. The Journal focuses on illustrated articles with great iconographic topics and aims at aiding sharpening clinical decision-making skills as well as following high research topics. All articles are published in English. Diagnostic and Interventional Imaging publishes editorials, technical notes, letters, original and review articles on abdominal, breast, cancer, cardiac, emergency, forensic medicine, head and neck, musculoskeletal, gastrointestinal, genitourinary, interventional, obstetric, pediatric, thoracic and vascular imaging, neuroradiology, nuclear medicine, as well as contrast material, computer developments, health policies and practice, and medical physics relevant to imaging.