Stereotactic ablation: A game changer?

Abstract

SummaryFor both primary and metastatic liver cancer, thermal ablation represents an interesting alternative to surgery. However, except for a small fraction of patients, conventional ultrasound‐ and CT‐guided single‐probe approaches have not achieved oncologic outcomes comparable with surgery. In this overview, we describe our stereotactic ablation workflow and discuss the short‐ and long‐term results of stereotactic radiofrequency ablation (SRFA) and stereotactic microwave ablation (SMWA) for the treatment of primary and secondary liver tumours. The advantages of this method are discussed together with a summary of the existing stereotactic techniques for thermal ablation and the clinical data that support them. Stereotactic ablation is based on an optical navigation system and a specialized aiming tool. The workflow includes advanced three‐dimensional planning, precise needle/probe placements according to the plan and intraoperative image fusion to check the needle positions and the ablation margins. Stereotactic ablation offers all the advantages of a minimally invasive procedure while producing oncological results comparable with surgery. The number of locally treatable liver cancers may be significantly expanded with these cutting‐edge instruments and methods. We firmly believe that it can become a cornerstone in the treatment of liver cancers.

Navigation and Robotics in Interventional Oncology: Current Status and Future Roadmap

“…By combining optical navigation systems with a rigid aiming device, the accuracy of needle/probe placement can even be improved [ 43 ]. This stereotactic approach has been successfully applied in various anatomical regions, including liver [ 44 , 45 , 46 ].…”