Inoperable 92 year old patient treated with Quality Ablation

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.

Planned trajectory with a 3D segmented visual of the abdomen, showcasing optimal simulation of the ablation zone between the gallbladder and colon

Needle verification shows sub-millimeter accuracy of the first needle

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