Upgrading Ablation, Targeting Technologies Minimizes Operator Dependency
The introduction of computer assisted targeting solutions and efficient ablation modalities helped one high-volume center achieve excellent reproducible results as well as minimize operator dependency, according to an article published in the European Journal of Radiology Open.
This retrospective study collected prospective data from patients undergoing ablative treatment. The main target organ was the liver and the main indications were ablation of hepatocellular carcinomas and colorectal liver metastases. All treatments were performed from 2010 when microwave ablation was introduced until the 1000 treatment in November 2017. Follow-up data was collected until September 15, 2018 with complete follow-up on mortality except for one foreign national.
Procedural data, complications within 30 days, recurrences, retreatments, and survival were recorded. Choice of energy and brand were also noted. All patients were followed for at least six months.
When possible, technical success was evaluated immediately after ablation. If it was not possible, it was evaluated within 1 day. Local recurrence was defined as a new tumor within 1 cm of the ablation zone within 6 months of the ablative treatment.
The study authors found that at the high-volume center, with the assistance of computer assisted targeting, the local recurrence rate dropped from 30% to near 10% within 6 months.
“The incorporation of computer assisted targeting technologies for ultrasound-, CT guided- and laparoscopic tumor ablation has been very successful and without a noticeable learning curve. The same is true for switching from radiofrequency energies to microwave generators and irreversible electroporation,” the authors concluded. “It is well worthwhile upgrading ablation and targeting technologies to achieve excellent and reproducible results and minimizing operator dependency.”
Beermann M, Lindeberg J, Engstrand J, et al. 1000 consecutive ablation sessions in the era of computer assisted image guidance - Lessons learned. Eur J Radiol Open. 2018;6:1-8. doi: 10.1016/j.ejro.2018.11.002. eCollection 2019.