Multimodal Quality Ablation treatment of two HCC recurrences in liver segments IVa & VIII with Irreversible Electroporation and Microwave Ablation in one continuous session.
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Name: Dr. Lukas Lürken
Institution: University Hospital Regensburg (Germany)
Patient age and sex: 59 years, male
Initial condition:
- 10/2017: Diagnosis HCC
- 11/2017: R0-resection in Seg. VI
- Pathology: HCC G1/BCLC A
- 2018: Followed by Antiviral Hep-C-therapy that showed the patient maintained good liver function and no transplantation was necessary
- 02/2020: HCC recurrence, atypical resection Seg. III & II
- 02/2021: MRI shows HCC suspect recurrence in Seg. IVa (1,6 x 1,1 cm) and Seg. VIII (0,7 x 0,5 cm)
- Tumour board decision: Radiologic Interventional Oncology-Treatment
Treatment:
- Due to the proximity to the bile duct and portal venous vessel inclusion in Seg. IVa, a decision for stereotactic navigated IRE procedure with 4 planned needle trajectories was taken
- A 5th trajectory to take a biopsy prior to treatment was planned
- CAS-One IR guided Microwave Ablation in Seg. VIII during the same session
Top row: IRE planning scan and post-ablation scan
Bottom row: MWA planning scan and post-ablation scan
Result:
In this case, the use of stereotactic navigation was mandatory:- IRE requires precise needle placement taking anatomical structures in account. With the help of CAS-One IR, planning and placement of the probes was possible in one step
- Implementing multimodal treatment (IRE/MWA/Biopsy) options in one session is a great advantage and prevents further sessions
- Initial post-ablation scan shows technical success in both lesions
- A total of 6 needles were planned, navigated and validated
- Total procedure time: 2:30h
