---
title: Inoperable 92 year old patient treated with Quality Ablation
description: MWA of three liver metastasis in segment II/III, IV and V/VIII for a patient that previously underwent acute surgery for a perforated tumor in the ascending colon and has now developed metastasis in the liver. Due to the age of the patient, a surgical solution was not an option, therefore Quality Ablation with CAS-One IR was chosen.
image: https://www.cascination.com/hubfs/thumbnail-1.jpg
---

 Thursday, 28 September 2023

# Inoperable 92 year old patient treated with Quality Ablation

Inoperable 92 year old patient treated with Quality Ablation

2:28

 

MWA of three liver metastasis in segment II/III, IV and V/VIII for a patient that previously underwent acute surgery for a perforated tumor in the ascending colon and has now developed metastasis in the liver. Due to the age of the patient, a surgical solution was not an option, therefore Quality Ablation with CAS-One IR was chosen.

![Planning-2](https://www.cascination.com/hs-fs/hubfs/Planning-2.jpg?width=1920&height=1259&name=Planning-2.jpg)Planned trajectory with a 3D segmented visual of the abdomen, showcasing optimal simulation of the ablation zone between the gallbladder and colon

![Needle_01-1](https://www.cascination.com/hs-fs/hubfs/Needle_01-1.jpg?width=1195&height=748&name=Needle_01-1.jpg)

Needle verification shows sub-millimeter accuracy of the first needle

![ABLASURE](https://www.cascination.com/hs-fs/hubfs/ABLASURE.jpg?width=1198&height=776&name=ABLASURE.jpg)

Ablation assessment of one of the tumours with AblaSure, showcasing 100% tumor coverage and 89% margin coverage

Overview of the planned and simulated trajectories in MPR view

Assessing the treatment with the support of AblaSure

---

Name: Dr. Waldemar Czekierda

---

Institution: Linköping University Hospital

---

Patient age, sex:  92, Female

---

Initial condition:

- Patient with a history of hypertonia, hyperlipidemia and hyperthyroidism
- Underwent acute surgery for a perforated tumor in the ascending colon (T4aN1a) in October 2022
- Recently three liver metastasis in segment II/III, IV and V/VIII were discovered
- Due to the age of the patient, she was not eligible for another surgical treatment 
- The multidisciplinary tumor board decided for a minimally invasive approach with MWA
- Quality Ablation with CAS-One IR is the standardized treatment option for these patients in Linköping

---

Treatment: 

- The procedure was performed under general anesthesia with high-frequency jet-ventilation (HFJV) for optimal respiratory motion control
- Three single-needle trajectories were planned, simulated and, navigated with the new interactive planning mode
- The ablation of the lesions was performed with the Medtronic Emprint system (15 cm. antenna)
- Needle placement control scans were performed for all three needles, with no manual repositioing needed
- After treatment of all three lesions, the AI driven AblaSure confirmed that no additional ablation was needed

---

Result:

- All three lesions were successfully treated with sufficient ablation margins between 5mm and 10mm as assessed by AblaSure.
- The patient was discharged the following day and showed a swift recovery
- A routine follow-up CT scan is planned within 3 months

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

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