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 are designed in user-friendly way: 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.

    Stereotactic IRE of a maglignant liver lesion

    SIRE – Stereotactic percutaneous Irreversible Electroporation of a malignant liver lesion using a computer-assisted navigation system

    Overview_neu_01
    1. Pre-operative MRI showing lesion
    2. Planning Scan
    3. CT with 5 electrodes and planned trajectories
    4. Post-operative MRI showing ablation zone
     

    Name: PD Dr. Lukas Beyer 


    Institution: University Hospital Regensburg, Centre for  Radiological Interventional Oncology, Regensburg, Germany 


    Patient age and sex: 54 years, male


    Initial condition:

    • Singular inoperable hepatocellurar carcinoma (HCC) in liver segment VIII
    • Child-B cirrhosis with portal hypertension
    • According to tumor board decision local ablation by means of irreversible electroporation (IRE / NanoKnife, Angiodynamics)

    Treatment: 

    Stereotactic IRE with CAS-One IR

    • IRE with 5 electrodes
    • Planning of parallel needles at 20mm distance
    • Accurate needle placement
    • Needle control and measurement of distances between needles using CAS-One IR
    • IRE using Nanoknife 

     

    Time for treatment

    • 23 minutes set-up time for navigation system and planning of needles
    • Workflow facilitates efficient intervention
    • Measuring tools allow control of accurate distance between all electrodes
    • 18 minutes for placement of all 5 needles (one go needle placement)
    • No repositioning of needles required

     

    IRE Regensburg

    The aiming device allows accurate positioning of multiple electrodes in one go

     


    Conclusion:

    The clinical study comparing SIRE to CIRE (conventional IRE) shows a marked reduction of procedure length and high accuracy compared to CIRE (Conventional IRE).

    Stereotactic navigation has the potential to reduce radiation dose for the patient without increasing the risk of complications or impaired technical success compared to CIRE.

    Due to the high accuracy and focal nonthermal ablation mechanism, SIRE might have the potential to be translated into the treatment of deep-seated tumors in other anatomical regions, e.g., pancreatic cancer.


     

    Learn more about the stereotactic navigation system CAS-One IR.

     

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