Stereotaxy: breaking the limits of current radiofrequency ablation techniques

Abstract

Radiofrequency ablation (RFA) allows for local curative tumor treatment by inducing coagulation necrosis with high-frequency alternating current. However, the tumor size is the major limiting factor due to a mismatch of the tumor volume and the induced necrotic zone. RFA probes have to be optimally distributed in and around the tumor in order to produce overlapping ablation zones. Due to different guidance and ablation strategies the result is strongly operator dependent and there is a lack of reliability. These challenges can be managed by 3D-planning using a frameless stereotactic navigation system, allowing for the simultaneous display of multiple trajectories. The spatial information gained from 3D imaging is available in coordinates and thus forms an accurate input for performing the intervention. Stereotaxy enables highly accurate probe positioning. Stereotactic radiofrequency ablation (SRFA) may substantially improve the safety and efficacy in clinical practice, especially in the treatment of large and irregularly shaped tumors. The proposed methods may also be used for similar percutaneous local tumor treatments.