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.

    Tissue-sparing tumor treatment in a patient with  a single kidney

    In a patient with a single, functioning kidney, the advantages of navigated microwave ablations that allow the destruction of the tumor while protecting surrounding tissue and preserving the health of the remaining organ are particularly pertinent.

    Clinical benefits of the method include:

    • Minimized risk of the intervention through pinhole treatment
    • Rapid patient recovery and discharge within 1-2 days

    Here we show that CAS-One enables the minimally invasive and targeted treatment of kidney tumors. 

    1. MRI scan of the kidney with tumor before intervention
    2. CT scan before ablation with tumor (red), safety margin (yellow) and planned ablation volume (green)
    3. CT scan directly after ablation with ablation zone (hypodens) and planned safety margin (yellow)
    4. CT scan after ablation with complete tumor treatment

    Name: MD Levent Kara (EBIR, FCIRSE) 

    Institution: Municipal Hospital Triemli, Zürich

    Patient age and sex:  42 years, male

    Initial condition:

    • S/P tumor nephrectomy right 1.4.2016 pT2Nx
    • S/P partial kidney resection left because of swelling kidney left on 5.11.2016
    • Wedger resection of 2 pulmonary metastases July 2018
    • Current: Recurrent lesion on the left kidney
    • High surgical risk for the patient during a conventional procedure. Sacrifice of significant healthy tissue with resection
    • Navigated microwave ablation is less invasive and tissue-sparing treatment
    Ablation preparation:

    The kidney’s location inside a layer of adipose tissue makes the organ highly mobile in normal, physiological states during a minimally invasive intervention, compared to an open procedure.

    To mitigate against these procedural risks, these steps should be considered:.
    • Patient positioning - Stable positioning must be ensured. The patient must be secured on the vacuum mattress to allow orthogonal access to the lesion. This avoids the risk of slipping off the kidney capsule with the ablation needle.
    • Ablation needle – Thin needles be chosen to facilitate easier penetration through the kidney capsule.
    • Precise, navigated microwave ablation of recurrence at the left kidney 


    • Good clinical outcome directly after ablation
    • No adverse effects or recurrences during follow-up inspection



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


    Subscribe to our newsletter