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Ultrasound-navigated radiofrequency ablation of thyroid nodules with integrated electromagnetic tracking: comparison with conventional ultrasound guidance in gelatin models

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

A thyroid-like gelatin model was used to determine potential superiority of a new navigation system for ultrasound (US)-guided electrode insertion called EchoTrack, featuring a US probe with an integrated electromagnetic field generator, in comparison with conventional US when performing radiofrequency ablation.

Methods

In order to compare 20 navigated ablations with 20 ablations under conventional US guidance, a thyroid-like gelatin model was used. In each group, 10 in-plane and 10 out-of-plane punctures were performed. Metal seeds measuring 8.5 \(\times \) 1.8 mm served as ablation targets. The number of redirections until final electrode placement, targeting accuracy and electrode placement time were measured.

Results

The number of redirections could be significantly (\(p{<}0.0001\)) reduced from 2.7 ± 1.3 in the conventional group to 0.2 ± 0.5 in the EchoTrack group. Accuracy increased from 3.9 ± 4.7 to 2.0 ± 1.9 mm. The total placement time increased from 39 ± 20.5 to 79.2 ± 26 s.

Conclusions

EchoTrack is able to reduce the redirections needed to place the electrode in comparison with conventional US and provides high placement accuracy. Our new navigation system has high potential to reduce the risk of harming critical structures and to improve guidance during ablation of difficult nodules, as treatment planning as well as the safety of out-of-plane punctures are improved.

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Abbreviations

CT:

Computed tomography

EM:

Electromagnetic

FG:

Field generator

RFA:

Radiofrequency ablation

US:

Ultrasound

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Funding

This study was carried out with the support of the German Research Foundation (DFG) as part of project A02, SFB/TRR 125 Cognition-Guided Surgery.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany

    Christian Erbelding, Konstantin Kohlhase & Frank Grünwald

  2. Department of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany

    Alfred Franz, Alexander Seitel, Nasrin Bopp & Lena Maier-Hein

Authors
  1. Christian Erbelding
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  2. Alfred Franz
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  3. Alexander Seitel
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  4. Nasrin Bopp
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  5. Konstantin Kohlhase
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  6. Frank Grünwald
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  7. Lena Maier-Hein
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Corresponding author

Correspondence to Christian Erbelding.

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Conflict of interest

Christian Erbelding, Konstantin Kohlhase and Prof. Dr. Frank Grünwald from the Department of Nuclear Medicine, University Hospital Frankfurt/Main, Germany, have nothing to disclose. Dr. Alfred Franz, Dr. Alexander Seitel, Ms. Nasrin Bopp and Prof. Dr. Lena Maier-Hein, as members of the Junior Group Computer-assisted Interventions, German Cancer Research Center, DKFZ, Heidelberg, Germany, were supported by the German Research Foundation (DFG) as part of project A02, SFB/TRR 125 Cognition-Guided Surgery.

Human and animal rights statement

There were no human participants and/or animals involved in this study.

Informed consent

As there were no patients in this study, no informed consent was obtained in the course of this study.

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Erbelding, C., Franz, A., Seitel, A. et al. Ultrasound-navigated radiofrequency ablation of thyroid nodules with integrated electromagnetic tracking: comparison with conventional ultrasound guidance in gelatin models. Int J CARS 12, 1635–1642 (2017). https://doi.org/10.1007/s11548-017-1544-2

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  • DOI: https://doi.org/10.1007/s11548-017-1544-2

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