Tumor Ablation Treatment Planning Coupled to Robotic Implementation: A Feasibility Study

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The technical development described herein was undertaken to create a tumor ablation treatment system that consists of a software component and a robotic hardware component. First, the software treatment planning system enables applicator placement planning before tumor ablation. For example, it allows creation of overlapping ablations with the goal of treating larger tumors. Second, the robotic hardware system allows accurate applicator placement. The combined treatment system integrates treatment planning with treatment execution by taking the coordinates dictated by the planning system and feeding them to the robotic system for implementation. The feasibility of this system was tested in two patients with large hepatic metastases that required overlapping ablations

Section snippets

Treatment Planning Software

Customized software was developed that enables the user to overlay the predicted zones of ablation from two commercially available RF ablation applicators on CT images of a patient's tumor. These planning CT images are acquired while the patient is on the table for the procedure. Conversely, if images obtained earlier were to be used, these images would have to be registered with the patient's current table position, which was not performed in the current study. Two LeVeen needle electrodes

RESULTS

Two patients with metastatic hepatic malignancies larger than 3.0 cm were included in this feasibility study. The treatment planning system was used to develop an overlapping ablation treatment plan, which was then implemented by a single physician, with two overlapping ablation zones for each patient performed. In both cases, the overlapping ablations could be performed through the same skin entry site. In each patient, both applicator positions were used with a single pass, even though

DISCUSSION

Although percutaneous tumor ablation has shown great promise, several challenges still exist. Two such challenges are treatment of intermediate and large tumors (>3.0 cm in diameter) and accurate applicator placement. The development described herein aimed to meet these two challenges by using overlapping ablations to create larger ablations and by using robotic control to permit accurate applicator placement for the overlapping plan. The current study demonstrated the use of a treatment

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None of the authors have identified a conflict of interest

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