Multi-Modality (MRI-CT) Fusion enabled tissue sparing MWA of a HCC Segment IVa lesion for local-regional treatment with curative intent.
Video of the Multi-Modality (MRI-CT) Fusion
Planning of the MWA fusing CT and MRI
Post-Ablation confirmation of the ablation zone, showcasing complete tumour destruction, including safety margin and histogram using AblaSure
Name: Dr. Nando Mertineit
Institution: Bürgerspital, Solothurn (Switzerland)
Patient age and sex: 78, female
Initial condition:
- Initial diagnosis in December 2019:
Two suspected HCC lesions were biopsied and treated with MWA in January 2020 Confirmed recurring HCC , stage A (BCLC Staging) , liver cirrhosis child - pugh - stage A6 , s teatohepatitis with portal hypertension
- Followed by CT-Guided MWA and biopsy of the lesion in segment VII in June 2020 and another CT-Guided MWA of the lesion in segment VI in September 2020
January 2022: discovered a new lesion in segment IVa at the border to segment VIII . Diffusion restriction.
Treatment:
February 2022: Multi-Modality fusion of the planning CT with the MRI DWI sequence was used to fuse where lesion was only clearly visible Inter-costal, caudo - cranial access was cho sen An angulated trajectory was chosen , with easy insertion and precise needle placement
Conclusion:
- Very good coverage of the lesion including safety margin confirmed with AblaSure technology
- Multi-Modality image fusion enabled a tissue-sparing treatment option for this patient
DWI fusion was the best option for good visibility of the tumour and enabled a fast, effective procedure End of May 2022: follow up MRI planned
