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Thermal treatment is commonly performed interstitially in either surgical or percutaneous procedures, using microwave
antenna sources at 915 or 2540 MHz. There are a number of tools or aids as well as challenges for clinicians performing
these procedures in the course of patient treatment. These challenges will be present whether the procedure is surgical,
laparoscopic, or percutaneous, and include treatment planning, image guidance, navigation, coregistration in 3D, and
treatment assessment. Treatment planning has been used historically in hyperthermia for microwave antenna arrays, but
has yet to be properly applied in thermal ablation. Image assessment of thermal treatment is not typically performed in
real time, although these tools will provide the clinician with further information to understand the extent of treatment
and whether further treatment is needed. 3D imaging is available, but not coregistered to patient space. Navigation has
been used in many medical specialties, but is also not in the clinician's toolbox in thermal treatment. Although treatment
planning will lay out the skin entry and trajectory for each antenna placed, subsequently, each antenna needs to be
tracked to accurately show placement in the patient and overlaid in patient space, along with the tumor target location.
Some patient treatments may consist of multiple, but sequential single placements of an antenna, and guidance is even
more critical to track positions and plan for the next insertion. Lastly, real-time image assessment will show the extent
and shape of the coagulated lesion and which targets may have been undertreated. If used synchronously in arrays, MW
power steering may also aid in filling in the ablation as the treatment progresses. This paper will analyze the present
state-of-the art as well as a strategy to incorporate the various facets of planning, guidance, and assessment of treatment.
The integration of thermal treatment planning, navigation and guidance, robotics, and treatment assessment continues to
evolve to provide better assistance for clinicians in order to provide targeting optimization with the goal of improved
treatment for the patient. Ultimately, the effect on patient outcomes will determine the value of the technology.
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