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.
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 chosen
- 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
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