An 85 year-old female was initially diagnosed with rectal cancer in November 2023. Over the next two years, several treatments were performed including resections and chemotherapy. In June 2025 several lesions appeared on a routine MRI and it was decided to perform a ablation with CAS-One IR and intra-arterial contrast on the five remaining lesions.
The planning, and navigation functions of CAS-One IR aided in the complex locations and trajectories needed to treat, as multiple lesions were subcapsular or close to critical structures. Hydrodissection was also performed to distance one lesion from the gallbladder - which was easily visible in the 3D reconstruction.
Ablation confirmation with AblaSure showed excellent coverage of all 5 lesions and the team was confidence there would not be recurrence. At the first follow-up the patient still showed no signed of local tumor progression.
Name: Dr. Christian Weiergang, Dr. Pontus Zaar and Dr. Adriana Montealegre Angarita
Institution: Sahlgrenska University Hospital, Sweden
Patient age and sex: 85, Female
Initial condition:
- The patient was initially diagnosed with rectal caner with liver metastasis in November 2023. No record or previous diseases except from atrial fibrillation.
- During the time frame of February 2024 to February 2025, the patient had several rounds of surgical resection of liver metastasis combined with chemotherapy and intra-operative ablation.
- The last resection of one recurrent metastasis, three news one, and one previously untreated was performed in February 2025. After this resection, chemotherapy treatment started and a MRI revealed partial response in 3 metastasis, but patient still has a total of 5 metastasis that were not completely treated.
- The MDT decided to perform a CAS-One IR guided ablation of the five remaining metastasis due to all of the complexities of the case
- A pre-operative CT scan showed only two visible lesions, and the decision was made to use intra-arterial contrast during the procedure to increase visibility of the remaining lesions.
Treatment:
- The procedure were performed under general anesthesia with High-frequent JET ventilation.
- An intra-arterial catheter was placed in hepatica communis, and contrast was injected for planning, needle verification and assessment scans.
- Hydrodissection was also performed near the gallbladder to protect it from heat during the ablation.
- All ablations were performed with Medtronic Emprint needles.
Result:
- After the ablations were verified as successful with AblaSure, the hepatic catheter was removed.
- All lesions were successfully treated with no complications.
- The patient remained hospitalized overnight and was discharged the following day.
- 1 month follow up CT shows no signs of complications or recurrence.
- Another follow-up CT/MRI is scheduled in 6 months.
Learn more about the stereotactic navigation system CAS-One IR.
