| There are two parts in our study.Part 1. Accuracy and safety of puncture using intelligent guiding deviceunder computed tomography guidance: a phantom studyObject: To evaluate the applied value of CT-guided puncture of abdominal phantoms with intelligent guiding device.Materials and methods: The 12 simulated specimen of different sizes in the abdominal phantoms inside were punctured twice under helical CT-guided by the same resident doctor with the intelligent guiding device and freehand technique Different puncture directions including vertical and oblique were designed. The successful rates at first puncture,the mean puncture time, the mean dose of ionizing radiation and the mean dose of ionizing radiation were compared between the two methods.Results: With vertical needle insertion, the successful rates at first puncture of the guiding method and freehand group were 100% and 58.3% respectively, the difference was statistically significant(P<0.05); while the mean puncture time were 9.5±1.1min and14.4±3.8min respectively, average error were 2.8±1.3mm and 6.5±3.7mm, mean puncture time were 1.0±0 and 1.6±0.9 times, the mean dose of ionizing radiation were 507.1±6.5and 745.8±156.5m Gy * cm respectively, which the difference were all statistically significant(P <0.05). With oblique needle insertion, the successful rates at first puncture of the guiding method and freehand group were 91.7% and 41.7%, respectively the difference was statistically significant(P<0.05); while the mean puncture time were 10.3±1.7min and 16.2±4.3min respectively, average error were 3.0 ±1.9mm and 7.7±3.6mm, mean puncture time were 1.08±0.29 and 2.0±0.9times, the mean dose of ionizing radiation were521.2±51.9 and 818.5±160.9m Gy * cm respectively, which the difference were all statistically significant(P <0.05).Conclusion: Using intelligent guiding device can improve needle puncture accuracy,it can increase the success rate of the first puncture and also reduce the number of probe passes, overall procedure time and decrease the radiation exposure. The intelligent guiding device is compact and easy to be operated, which leads the less experienced residents to learn quickly and overcomes the impact of differences in the puncture accuracy due to the experience.Part 2.Preliminary application of CT-guided radiofrequency ablationunder contrast-enhanced ultrasound combined with intelligent guidingdevice in malignant liver tumorsObject:Computer tomography(CT)-compatible robots have been developed with the intention of increasing the accuracy of needle placement and reducing clinical staff and patient exposure to radiation during CT fluoroscopy. To estimate the clinical value of contrast-enhanced ultrasound(CEUS) before and after CT-guided radiofrequency ablation(RFA) combined with intelligent guiding device called MAXIO in the treatment of liver tumors.Materials and Methods : We preliminary report our preliminary experience of performing RFA using the MAXIO CT –guided positioning system on 17 malignant liver tumor patients(22 lesions). CEUS were performed and compared on all patients before and after RFA procedures. We also retrospectively analyzed 13 malignant liver tumor patients(17 lesions) who experienced RFA procedures under the conventional CT to be the contrast group. The CT scan times, radiation dose(Dose-length product, DLP) and the incidence of complications were compared between the two groups.Results:RFA was successfully completed in 16 patients with 21 lesions confirmed on CEUS. The remaining one received once more RFA owing to partial residual, and then achieved complete ablation. Only 2 mild procedure related complications were noted in this study. Compared to the routine RFA group, average scan times and DLP values were lower in MAXIO CT –guided RFA group which the difference were statistically significant(P<0.05), but there was no statistically significant of the incidence of complications between the two groups.Conclusion:MAXIO CT –guided positioning system appears to be safe and with highaccuracy in the treatment of percutaneous RFA on using liver tumors. It has lower radiation dose to both patient and clinical staff during the procedure. CEUS can be used promptly to evaluate the RFA efficacy by compared the results before and after procedures. |
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