CASCINATION Cases - Blog

CT-Guided Cryoablation of a Renal Cell Carcinoma

Written by Summar Yunas | June 23, 2020 6:53:38 AM Z

 

Complex percutaeous intervention with six needles and long trajectories. Cryoablation of a renal cell carcinoma close to pancreatic tail and spleen. CT-guidance and CAS-One IR allowed a very precise placement of all six needles and in result a complete ablation of the entire tumour.   

 
1. Planning view of the intervention (Axial)
2. Planning view of the intervention (MPR view)
3. Needle Placement Control showing high accuracy of probe placement
4. Confirmation of the cryoablation (Axial)
 

Name: Prof. Dr. Tze Wah & Dr. Jon Smith

Institution: St. James's Hospital, Leeds, United Kingdom

Patient age and sex:  67 years, male

Initial condition:

  • The patient is an ex-smoker with a history of IHD, obesity, COPD, claudication
  • Had a femoral stent inserted 17 years ago
  • This is a co-morbid patient, not fit for surgery
  • Patient presents with a 4.2cm Renal Cell Carcinoma, close to pancreatic tail and spleen
  • Upon arrival, an ASA Physical Status Classification of 3 was recorded

Treatment: 
  • 6 ICE force probe needles (18cm trajectories) were planned using CAS-One IR. Additionally, a tumour biopsy was performed. Once inserted, needle validation showed that needles 1-4 had a lateral error of 2mm and needle 5-6 had a lateral error of 6mm. The 6mm lateral error was due to the difficulty in inserting needles because of needle crowding

Result:

  • This was considered a complex case as the tumour was in close proximation to spleen and pancreas. However, overall needle planning and insertion was facilitated using CAS-One IR

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