CT-guided ablation of a deep seated hepatic tumor in segment VIII

Biopsy and ablation of a deep lesion in the liver in segment VIII via an angulated trajectory. Diagnosis of the lesion in an MRI of the liver. Accurate biopsy with subsequent ablation treatment thanks to the ability to fuse CT and MR imaging modalities in CAS-One IR. In the first postinterventional examination no indication of residual tumor.

Case_Basel_September_2019_Overview
 
1. CT scan showing planned needle trajectory and planned ablation area (green)
2. Controll CT scan with various views to validate precise needle positioning in liver segment VIII
3. Axial view zoom: Ablation of tumor incl. safety margin (orange)
4. Sagital, coronal and axial view: Ablation of tumor incl. safety margin (orange)
 

Name: Prof. Dr. med. Martin Hoffmann 


Institution: St. Claraspital, Basel


Patient age and sex:  51 years, male


Initial condition:

  • 09/2017: Primary hepatic metastatic adenocarcinoma of the sigmoid, ypT3 ypN1b ypM1a
  • 10/2017: Neoadjuvant chemotherapy
  • 01/2018: Open cholecystectomy, atypical liver resection in segment III and segment V, left hemicolectomy
  • 01/2019: MRI liver: Liver lesion in segment VI is now increasingly contrasted in the marginal area and progressive in size (1.1 cm)
  • 01/2019: Tumor board decision: laparoscopic resection of liver lesion
  • 02/2019: Metastasectomy liver: Histology: completely vital metastasis of the adeno-Ca of the sigmoid, max diameter 9mm, tumor-free resection margin
  • 04/2019: MRI liver: progressive to 1 cm new metastasis aspects focal liver lesion urgently central in liver segment VIII (previously point-shaped indeterminate)

Treatment: 
  • 05/2019: CT-guided microwave ablation of the hepatic lesion
  • Fusion of CT and MR imaging modalities allowed successful biopsy and ablation of the lesion (equipement used: Bard 15G coaxial needle for biopsy and Newave 17G antenna for microwave ablation)

Result:

CT abdomen: Previous metastasis in liver segment VIII completely covered by the MWA ablation zone. In the first postinterventional examination no indication of residual tumor

 

 

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

 

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