---
title: Fused Microwave Ablation of an 'Invisible' Lesion in Segment VI
description: "CAS-One IR multi-modality fusion enabled microwave ablation of an HCC suspected lesion. Biopsy was performed, as lesion was not visible on ultrasound. 
 "
---

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# [Fused Microwave Ablation of an 'Invisible' Lesion in Segment VI](https://www.cascination.com/en/blog/fused-microwave-ablation-segment-vi)

 Written by [Summar Yunas](https://www.cascination.com/en/blog/author/summaryunas) | May 28, 2021 5:55:33 AM Z

 

CAS-One IR multi-modality fusion enabled a Microwave Ablation of an HCC suspected lesion. A biopsy was also performed using CT guidance, since the lesion was not visible on ultrasound.

 

 

Video showing the fusion of CT and MRI imaging

 

**Name: **Dr. Hans Martin Gissler, Dr. Christophe Hälg, Dr. Tim Ohletz and Dr. Irene Winzeler-Jörger

**Institution: [Kantonsspital Aarau](https://www.ksa.ch/) (Switzerland)**

**Patient age and sex: **77 years, male

**Initial condition:**

- Patient with a history of cryptogene liver cirrhosis, Child A, MELD 8, arterial hypertonia and diabetes mellitus type 2
- During routine monitoring in May 2020, there was a suspicious lesion detected in a sonogram in Segment VI
- This was followed by an MRI in June 2020, which showed a malignant (HCC) suspected lesion
- In a follow up sonogram intended to biopsy the lesion, it could not be detected, declared 'invisible', and therefore was not biopsied
- However, the tumour board decided to perform a percutaneous ablation treatment with curative intend and to get the biopsy during the intervention

**Treatment:** 

- For this lesion that is invisible on CE-CT as well, ablation and biopsy was not possible because of the lack of anatomical landmarks
- Treatment was conducted with the support of CAS-One IR and its ability to fuse MRI (and CT) images
- Patient was treated with MWA after taking a biopsy over the same track

**Result:**

****Left: Planning scan with fused MRI (50/50 view), Middle: Needle verification scan, Right: CE-Control Scan after the ablation

- Quality Ablation with CAS-One IR showcases a complete ablation on post-ablation scan with a sufficient safety margin
- Follow-up sonogram one day post-ablation does not show any abnormalities 
- The biopsy of the lesion revealed chronic, partially active hepatitis with cirrhosis without malignancy
- Control MRI in 6 months is indicated, but not yet conducted

Learn more about the stereotactic navigation system [CAS-One IR](https://www.cascination.com/en/quality-ablation?hsLang=en).

 

 

[View full post](https://www.cascination.com/en/blog/fused-microwave-ablation-segment-vi)

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