CAScination Cases - Blog

CAScination Cases presents cases performed with CAScination's stereotactic navigation systems. They support diagnosis, treatment and palliative therapy of cancer. CAS-One navigation systems enable the precise localization, puncture and ablation of tumors in liver, kidney and lung. All CAScination Cases follow the same structure: After the presentation of the treating experts and their institution, age, sex and initial condition of the patient are described. The following section outlines the treatment, followed by a final evaluation. Scans and images illustrate the different stages of planning and intervention and give a more vivid impression of the challenges and benefits of the chosen treatment.

    Ablation of a malignant cancer of the liver

    Stereotactic CT-guided microwave ablation of a large hepatocellular carcinoma (HCC) by 3 projected overlapping ablation zones

    Name: PD Dr. med. Anja Lachenmayer & Dr. med. Carlo Tappero

    Institution: Inselspital, Bern, Switzerland

    Patient age and sex: 79 years, female

    Initial condition: 

    • Single HCC suspicious lesion in a NASH patient with multiple co-morbidities.
    • Due to age and co-morbidities no resection or transplantation possible.
    • BCLC A, Child-Pugh B
    • Increasing size over time, 35 mm at the time of intervention
    • AFP 42.5 IU/ml

    Treatment: Minimal invasive percutaneous stereotactic CT-guided biopsy and microwave ablation of a single HCC

    Conclusion: Successful and complete ablation achieved by the planning of 3 overlapping ablation zones in a conventionally unablatable liver lesion (due to close proximity to vasculature, location in the liver dome and size) and unresectable (due to co-morbidities of the patient) lesion.

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    1. Axial view of 3 overlapping ablation zones (green), with tumor segmentation (red) 



    2. Needle view of 3 overlapping ablation zones (green), and tumor segmentation (red) 



    3. Needle navigation procedure with CAS-One IR 



    4. Validation of the ablation zone, with tumor segmentation MPR view 



    5. Validation of the ablation zone, with tumor segmentation needle view 


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