A 87 year-old patient was diagnosed in 2022 with cirrhosis of the liver and 2 atypical nodules in segment VII and II. In January 2025 an MRI showed that one of these nodules had turned into an HCC lesion and the MDT decided on MWA. The treatment was initially scheduled for an ultrasound-guided MWA with hydrodissection of the stomach. However, the Quality Ablation program in the hospital started the same week and the decision was changed to do the treatment with CAS-One IR. The planning simulation allowed visualization that the stomach was a safe distance away from the ablation zone, and AblaSure® showed an immediate re-ablation was necessary. With the re-ablation workflow, a quick second ablation was planned and executed, and the subsequent AblaSure showed 100% tumor and margin coverage.
The planning scan showing the initial treatment plan
The first AblaSure result and immediate decision to re-ablate
Verify scans showing first and second probe positioning
Excellent AblaSure result after the second ablation - even with suboptimal fusion
Name: Dr. Marc-Antoine Jegonday
Institution: CHU Rennes - Hôpital Pontchaillou, France
Patient age and sex: Male, 87 years-old
- Diagnosed in 2022 with cirrhosis and two atypical nodules in segment II and VII with decision to watch and wait
- In January 2025, the MRI showed evolution of the nodule in segment II to an HCC lesion
- MDT Decided on MWA under ultrasound guidance and new MRI to assess the lesion
- In August 2025 the lesion was stable at 18mm and the patient was scheduled for ablation
- The patient was scheduled for MWA with CAS-One IR on the first day the device was in the hospital
- Patient was under general anesthesia
- Treatment was done in September 2025, using the HS Amica MW system
- CAS-One IR was used to properly plan the probes in order to avoid hydrodissection of the stomach
- AblaSure analysis showed an incomplete ablation after first treatment and re-ablation was immediately performed in under 15 minutes
- The second AblaSure® analysis showed complete coverage of the tumor and 5mm margin - even with a suboptimal fusion
- Both probes were accurately positioned with no correction needed and no need of hydrodissection
- The patient was discharged the following day without complications
- Follow-up imaging confirmed full coverage of the treated lesion at 3 months
- CAS-One IR shows that even on a user's first case, Quality Ablation is possible allowing quick and accurate ablation for patients
- Dr. Jegonday said about this case: "From the first case - the utilization of CAS-One IR was decisive and effective - starting with the simulation of the ablation to preserve the stomach, to the ablation confirmation with AblaSure, and the quick reablation ability which is built in to ensure 100% margin coverage"
