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Updated: Nov 20, 2025

Robotic-Guided Stereoelectroencephalography for Invasive Epilepsy Monitoring
Published on: June 13, 2025
Accuracy of Electrode Placement in IRE Treatment with Navigated Guidance
David Stillström1,2, Raluca-Maria Sandu3, Jacob Freedman4,5
1Division of Surgery, Department of Clinical Sciences, Karolinska Institutet at Danderyd Hospital, Stockholm, Sweden. david.stillstrom@ki.se.
Purpose:
Evaluate the accuracy of multiple electrode placements in IRE treatment of liver tumours using a stereotactic CT-based navigation system.
Method:
Analysing data from all IRE treatments of liver tumours at one institution until 31 December 2018. Comparing planned with validated electrode placement. Analysing lateral and angular errors and parallelism between electrode pairs RESULTS: Eighty-four tumours were treated in 60 patients. Forty-six per cent were hepatocellular carcinoma, and 36% were colorectal liver metastases. The tumours were located in all segments of the liver. Data were complete from 51 treatments. Two hundred and six electrodes and 336 electrode pairs were analysed. The median lateral and angular error, comparing planned and validated electrode placement, was 3.6 mm (range 0.2-13.6 mm) and 3.1° (range 0°-16.1°). All electrodes with a lateral error >10 mm were either re-positioned or excluded before treatment. The median angle between the electrode pairs was 3.8° (range 0.3°-17.2°). There were no electrode placement-related complications.
Conclusion:
The use of a stereotactic CT-based system for navigation of electrode placement in IRE treatment of liver tumours is safe, accurate and user friendly.
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