An experienced user's first lung case with CAS-One IR: a standardized workflow with predictable procedure time and reliable outcomes

Following a standardized workflow, a solitary metastatic lung lesion was treated with CAS-One IR guided ablation. A lateral patient position was consistently maintained throughout, providing easy probe access to this posterior lobe lesion. The ablation was efficiently planned and placed deliberately in one entire insertion depth advancement, with high accuracy. Post ablation analysis confirmed complete ablation of the tumour. The procedure was done in less than one hour. The success of this users first CAS-One IR lung ablation is a confirmation of the adaptability of this workflow that consistently produces accurate and successful results in multiple organs.

Single needle trajectory plan in MPR and 3D reconstruction views.
MicrosoftTeams-image (14)
Needle verification showing planned needle position (light blue) vs actual needle position (dark blue).
Planning scan vs post ablation scan - ablation was a technical success. 

Name: Dr. Shaheen Noorani

Institution: Basingstoke and North Hampshire Hospital 

Patient age and sex: 61, F

Initial condition:

  • Patient was initially diagnosed with metastatic colorectal cancer. Preoperative chemotherapy with prescribed with Folfox/Bevacizumab, followed by liver resection and resection of primary lesion in 2020.
  • Patient completed three months of post-operative 5FU Chemotherapy.
  • Multiple bilateral lung nodules were seen on follow up scan – PET positive.
  • The MDT decision was to resect right upper lobe lung nodule and ablate left lower lobe lung nodule.
  • Patient also underwent right VATS lobectomy in August 2022, which demonstrated metastatic colorectal adenocarcinoma.
  • CT scan prior to ablation demonstrated increased size of left lower lobe lung nodule from 5 to 9mm.
  • Navigated ablation to be performed using CAS-One IR.


  • Patient was positioned laterally (fixated using CASCINATION vacuum cushion), with left side up and feet to gantry - in order to better access the posteriorly positioned lesion.
  • The trajectory and ablation zone was planned on the initial planning scan in order to provide coverage of the tumour and clinical margin.
  • Navigation and placement of the probe resulted in accurate positioning with the just one deliberate advancement to the full depth.
  • Post-ablation analysis confirmed a successful and complete ablation.
  • Pneumothorax from lung puncture with needle was observed on CT and treated immediately after ablation confirmation.


  • Patient was successfully treated in just under an hour.
  • Physician was happy with the overall result of this first CAS-One IR guided lung ablation. 
  • CAS-One IR can provide the user with the same level of consistency, accuracy and success across all supported organs.

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

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