Invisible HCC lesion treated with curative intent

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, steatohepatitis 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.


  • 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 chosen
  • An angulated trajectory was chosen, with easy insertion and precise needle placement


  • 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

Learn more about the stereotactic navigation system CAS-One IR.

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