Clinical Experience with Cone-Beam CT Navigation for Tumor Ablation

Purpose: To describe clinical use and potential benefits of cone-beam -computed tomography (CT) navigation to perform image-guided percutaneous tumor.ablation. Materials and Methods: All ablations performed between February 2011 and February 2013 using cone-bearn CT navigation Were included. There Were 16 Patients who uriderWent 20 ablations for 29 lesions. Cone-beam. CT ablation planning Cap a bilities include multimodality image fusion and tumor segmentation for visualization, depiction of the predicted ablation zones for intraprocedural planning, and segmentation of the ablated area for immediate verification after treatment Number and purpose of cone-beam CT scans were, examined. The, initial ablation plan, defined as number of probes and duration of energy delivery, was recorded for the 26 of the 29 lesions ablated. Technical success and local recurrenCes were recotded: Primary and secondary effectiVeness rates were calculated. Results: Image fusion was Used. for 16 lesions, and inttaprocedural ultrasound was used for 4 lesions. Of the 20 ablations, where the ablation plans Were recorded, there was no deviation from the plan in 14 ablations. In the remaining 6 ablations, iterative planning was needed for Coinplete tumot coverage. An. average of 8:7 cone-beam CT scans +/- 3.2 were performed per procedure, including 1.3 +/- 0.5 for tumot segmentation and planning, 1.7 +/- 0.7 for probe position confirmation, and 3.9 +/- 2 to ensure complete coverage. Mean follow-up time was 18,6, months +/- 6.5. Ablations for 28, of 29 lesions were technically successful (96.5%). Of ablations performed with curative intent, technical effectiveness at 1 month was 25 of 26, lesions (96.1%) and 22 of 26 lesions (84.6%) at last follow up Local tumor progression was observed in 11.5% (3 of 26 lesions). Conclusions: Cone-beam CT navigation may add information to assist and improve ablation guidance and monitoring.