Tumor Ablation Using 3-Dimensional Electromagnetic-Guided Ultrasound Versus Standard Ultrasound in a Porcine Model

Area of Science:

• Minimally Invasive Surgery
• Medical Imaging
• Interventional Radiology

Background:

• Accurate needle placement is crucial for effective ablation therapies in treating tumors.
• Traditional ultrasound guidance can be challenging for precise targeting in laparoscopic procedures.
• 3-dimensional electromagnetic-guided ultrasound offers potential for enhanced navigation.

Purpose of the Study:

• To compare the efficacy of 3-dimensional electromagnetic-guided ultrasound versus standard ultrasound for ablation needle placement.
• To evaluate targeting accuracy and needle manipulation frequency in both laparoscopic and open surgery settings.
• To assess the impact of guided ultrasound on procedure efficiency and potential complications.

Main Methods:

• A porcine model was utilized with fiducial markers placed in the kidney and liver to simulate tumors.
• Procedures were performed using either standard ultrasound or 3-dimensional electromagnetic-guided ultrasound for navigation.
• Needle placement attempts, withdrawals, reorientations, and final ablation zone accuracy were meticulously recorded by experienced surgeons.

Main Results:

• Guided ultrasound required 50% fewer needle placement attempts overall compared to standard ultrasound (P = .01).
• A significant 62% reduction in attempts was observed for guided laparoscopic ablation (P = .006), particularly for liver lesions.
• No significant difference in targeting accuracy was found between guided (91.3%) and standard (95.4%) ultrasound (P = .58).

Conclusions:

• 3-dimensional electromagnetic-guided ultrasound significantly reduces the number of targeting attempts needed for laparoscopic ablation, especially in the liver.
• This improved efficiency suggests guided ultrasound can potentially minimize complications associated with repeated needle manipulations.
• The technology shows promise for enhancing precision and safety in image-guided percutaneous tumor ablation.