Department of Biomedical Imaging and University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia,
Eur Radiol. 2015 Jan;25(1):246-57. doi: 10.1007/s00330-014-3391-7. Epub 2014 Sep 5.
This study aimed to assess the technical success, radiation dose, safety and performance level of liver thermal ablation using a computed tomography (CT)-guided robotic positioning system.
Radiofrequency and microwave ablation of liver tumours were performed on 20 patients (40 lesions) with the assistance of a CT-guided robotic positioning system. The accuracy of probe placement, number of readjustments and total radiation dose to each patient were recorded. The performance level was evaluated on a five-point scale (5-1: excellent-poor). The radiation doses were compared against 30 patients with 48 lesions (control) treated without robotic assistance.
Thermal ablation was successfully completed in 20 patients with 40 lesions and confirmed on multiphasic contrast-enhanced CT. No procedure related complications were noted in this study. The average number of needle readjustment was 0.8 ± 0.8. The total CT dose (DLP) for the entire robotic assisted thermal ablation was 1382 ± 536 mGy.cm, while the CT fluoroscopic dose (DLP) per lesion was 352 ± 228 mGy.cm. There was no statistically significant (p > 0.05) dose reduction found between the robotic-assisted versus the conventional method.
This study revealed that robotic-assisted planning and needle placement appears to be safe, with high accuracy and a comparable radiation dose to patients.
• Clinical experience on liver thermal ablation using CT-guided robotic system is reported. • The technical success, radiation dose, safety and performance level were assessed. • Thermal ablations were successfully performed, with an average performance score of 4.4/5.0. • Robotic-assisted ablation can potentially increase capabilities of less skilled interventional radiologists. • Cost-effectiveness needs to be proven in further studies.
本研究旨在评估使用计算机断层扫描（CT）引导机器人定位系统进行肝脏热消融的技术成功率、辐射剂量、安全性和性能水平。
在 CT 引导机器人定位系统的辅助下，对 20 名患者（40 个病灶）进行射频和微波消融治疗。记录探头放置的准确性、调整次数和每位患者的总辐射剂量。使用五点量表（5-1：优秀-差）评估性能水平。将辐射剂量与未使用机器人辅助治疗的 30 名患者（对照组）的 48 个病灶进行比较。
在 20 名患者的 40 个病灶中成功完成了热消融，并在多期增强 CT 上得到证实。本研究未发现与手术相关的并发症。平均需要调整针的次数为 0.8±0.8 次。整个机器人辅助热消融的总 CT 剂量（DLP）为 1382±536 mGy·cm，每个病灶的 CT 透视剂量（DLP）为 352±228 mGy·cm。与传统方法相比，机器人辅助与常规方法之间的剂量减少没有统计学意义（p＞0.05）。
本研究表明，机器人辅助规划和针放置似乎是安全的，具有高精度和与患者相当的辐射剂量。
报告了使用 CT 引导机器人系统进行肝脏热消融的临床经验。
评估了技术成功率、辐射剂量、安全性和性能水平。
成功进行了热消融，平均性能评分为 4.4/5.0。
机器人辅助消融有可能增强技能较低的介入放射科医生的能力。
需要进一步研究证明成本效益。
