--- title: A fast-growing NSCLC metastasis in segment VI description: CAS-One IR guided percutaneous tumor ablation of an NSCLC metastasis in segment VI of the liver from Aarhus University Hospital image: https://www.cascination.com/hubfs/Skjermbilde%202026-04-15%20161802.png --- Monday, 20 April 2026 # A fast-growing NSCLC metastasis in segment VI A fast-growing NSCLC metastasis in segment VI 3:53  An 79-year-old male with a complex oncologic history of non-small cell lung carcinoma, treated with chemotherapy and SBRT,  was referred for evaluation of a progressively enlarging liver lesion consistent with metastatic disease. Given the isolated hepatic involvement and limited treatment options, a minimally invasive, image-guided ablation approach was considered to treat this 3.8cm lesion in segment VI requiring multiple needles.   ![Skjermbilde 2026-04-15 161556](https://www.cascination.com/hs-fs/hubfs/Skjermbilde%202026-04-15%20161556.png?width=1240&height=773&name=Skjermbilde%202026-04-15%20161556.png)Planning scan of the 4-needle ablation of the large lesion   ![Skjermbilde 2026-04-15 161802](https://www.cascination.com/hs-fs/hubfs/Skjermbilde%202026-04-15%20161802.png?width=1240&height=771&name=Skjermbilde%202026-04-15%20161802.png) 3D of the planned trajectories, vascular structures, and other relevant anatomy    Video of the multiple trajectories planned    ![Screenshot 2026-04-20 113444](https://www.cascination.com/hs-fs/hubfs/Screenshot%202026-04-20%20113444.png?width=1240&height=763&name=Screenshot%202026-04-20%20113444.png)  Needle placement of one out of four trajectories, showcasing minimal lateral deviation    ![Skjermbilde 2026-04-15 161513](https://www.cascination.com/hs-fs/hubfs/Skjermbilde%202026-04-15%20161513.png?width=1908&height=1184&name=Skjermbilde%202026-04-15%20161513.png) Automatic segmentation of the lesion was challenging due to the large ablation zone as well as excessive fatty tissue that was ablated, and therefore the spherical boundary was used   --- **Name: **Dr. Laurynas Kazlas  --- **Institution:  **Aarhus Univeristy Hospital, Denmark --- **Patient age and sex:  **Male, 79 --- Initial condition and Imaging:   - In December 2021, the patient was diagnosed with non-small cell lung cancer (NSCLC), stage T0 N3 M0, harboring a BRAF mutation and was treated with curative intended chemotherapy followed by SBRT - In January 2022, a 15mm gastrointestinal stromal tumor (GIST) of the esophagus was incidentally identified, for which no treatment was initiated - In November 2023, recurrence of NSCLC was detected with cervical lymph node metastasis, and palliative immunotherapy was started - During follow-up in July 2025, a CT scan revealed a 14mm lesion in liver segment VII. By October 2025, the lesion had progressed to 24mm, and a CT-guided biopsy confirmed metastatic disease. PET-CT and MRI demonstrated no additional extrahepatic lesions - At MDT discussion, the patient had a performance status of 2, and progression of the liver lesion had occurred during a temporary pause in palliative immunotherapy. The consensus decision was to proceed with MWA if technically feasible. Given the lesion size and challenging subdiaphragmatic location, stereotactic MWA using the CAS-One system with MRI fusion made it feasible, and therefore was planned --- Treatment:  - Pre-procedural contrast-enhanced CT confirmed progression of the segment VII metastasis, measuring just under 4cm in axial diameter and slightly over 4cm in the craniocaudal direction. The previously identified small satellite lesion at the S6/S7 junction remained non-visible on CT - Using stereotactic navigation with MRI fusion, an Medtronic Emprint MWA antenna was first placed in the small metastasis, measuring only a few millimeters, and ablation was performed at 45 W for 2.5 minutes - Subsequently, the larger metastasis was targeted using two MWA antennas. The caudal portion of the lesion was ablated simultaneously at 150 W and 100 W for 10 minutes using two Emprint generators - The antennas were then repositioned cranially, followed by an additional ablation at 150 W and 100 W for 10 minutes to achieve complete coverage of the lesion --- Result and Conclusion   - Follow-up imaging 4 months after ablation showed complete ablation of both lesions - No complications occurred, and the patient was discharged from the hospital the day after ablation Dr. Laurynas Kazlas said of the case: "There were many challenges with this case - size, visibility, proximity to critical structures, but the innovative features of CAS-One IR helped enable this treatment. Before we had the device - treating this patient with ablation would not have been possible" Learn more about [CAS-One IR](https://www.cascination.com/products/cas_one_ir?hsLang=en).   [![Subscribe to our newsletter](https://no-cache.hubspot.com/cta/default/4661825/741ee7e3-4f56-4ba9-9f5e-b9e9e3395c13.png)](https://cta-redirect.hubspot.com/cta/redirect/4661825/741ee7e3-4f56-4ba9-9f5e-b9e9e3395c13) ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Margrethe Rasmussen", "url" : "https://www.cascination.com/en/blog/author/margrethe-rasmussen" }, "dateModified" : "2026-05-22T09:18:01.669Z", "datePublished" : "2026-04-20T09:54:26.000Z", "headline" : "A fast-growing NSCLC metastasis in segment VI", "image" : [ "https://www.cascination.com/hubfs/Skjermbilde%202026-04-15%20161802.png" ], "mainEntityOfPage" : { "@id" : "https://www.cascination.com/en/blog/a-fast-growing-nsclc-metastasis-in-segment-vi", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://www.cascination.com/hubfs/CASCINATION_Logo_2021_Website.png" }, "name" : "CASCINATION AG" } } ``` ```json { "@context" : "https://schema.org", "@type" : "VideoObject", "contentUrl" : "https://4661825.fs1.hubspotusercontent-na1.net/hubfs/4661825/video_assets/211148054547/inherited/web_optimized.mp4", "dateModified" : "2026-04-16T08:48:11.418Z", "duration" : "PT25S", "height" : 1186, "name" : "Aarhus Top Case 2026", "thumbnailUrl" : "https://api-na1.hubspot.com/filemanager/api/v3/files/thumbnail-redirect/211148054547?portalId=4661825&size=medium", "uploadDate" : "2026-04-16T08:48:00.677Z", "width" : 1906 } ```