Surgical resection has traditionally been considered as the first line treatment for primary liver cancer and liver metastases. But with only 10% to 20% of cases being suitable for resection (Tanis et al, 2014), alternatives are sorely needed. Improvements in ablation techniques over the last decade have led to an increased number of procedures, and a positive impact progression-free and overall survival in patients has been demonstrated (Ruers et al, 2012, Engstrand et al, 2014). In spite of this, ablation is not without its challenges, which is why CAScination developed CAS-One IR stereotactic support for percutaneous ablation, ensuring precision, efficacy and successful outcomes.
When performing ablation using freehand techniques, the operator is faced with a number of challenges. Firstly, ablation needle placement should be very precise to ensure complete procedural success in clearing the tumour and to avoid repositioning. Secondly, the operator must avoid critical structures such as organs, hepatic arteries, portal veins, bile ducts around the needle trajectory (Wallach et al, 2014). This can be a long and complicated process involving several punctures and potentially damaging healthy organ structures.
Solution: CAS-One IR
CAS-One IR navigation system provides efficient and reliable planning and navigation tools to take care of these complexities for you. Designed to handle cases of any clinical complexity, CAS-One IR is clinically proven to improve needle placement accuracy by 33% (Beyer et al, 2016), helping to improve outcomes for patients.
Ablation procedures can be lengthy, especially in complex cases. Procedures with off-plane needle access or multiple probe placement require several positioning-imaging cycles which are time- consuming. This can make IR suite planning problematic and conflicts with the diagnostic use of the equipment.
With CAS-One IR, ablations can be carried out significantly faster than with conventional techniques. Placement time per electrode is reduced by 69% and the overall procedure time is reduced by 47% (Beyer et al, 2016). Furthermore, with CAS-One IR, the procedure length can be predicted, regardless of case complexity – in Beyer et al variance in procedure length for CAS-One IR was just 9 minutes, compared to 28 minutes for conventional therapy.
Conventional ablation therapy uses CT-fluoroscopy for real-time tracking of patient motion and verification of needle advancement towards the target lesion. This can result in long periods of exposure to radiation, which may cause long-term health risks to operator and patient.
Solultion: CAS-One IR
As CAS-One IR’s technology does not use CT-fluoroscopy for real-time tracking of patient motion and needle advancement, radiation exposure is reduced dramatically. A recent clinical trial demonstrated a decrease in DLP (dose-length product) of 28% with CAS-One IR versus traditional therapy (Beyer et al, 2016, Engstrand et al, 2016).