Ablation of a malignant cancer of the liver

Stereotactic CT-guided microwave ablation of a large hepatocellular carcinoma (HCC) by 3 projected overlapping ablation zones

Name: PD Dr. med. Anja Lachenmayer & Dr. med. Carlo Tappero

Institution: Inselspital, Bern, Switzerland

Patient age and sex: 79 years, female

Initial condition: 

• Single HCC suspicious lesion in a NASH patient with multiple co-morbidities.
• Due to age and co-morbidities no resection or transplantation possible.
• BCLC A, Child-Pugh B
• Increasing size over time, 35 mm at the time of intervention
• AFP 42.5 IU/ml

Treatment: Minimal invasive percutaneous stereotactic CT-guided biopsy and microwave ablation of a single HCC

Conclusion: Successful and complete ablation achieved by the planning of 3 overlapping ablation zones in a conventionally unablatable liver lesion (due to close proximity to vasculature, location in the liver dome and size) and unresectable (due to co-morbidities of the patient) lesion.

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1. Axial view of 3 overlapping ablation zones (green), with tumor segmentation (red) 

2. Needle view of 3 overlapping ablation zones (green), and tumor segmentation (red) 

3. Needle navigation procedure with CAS-One IR 

4. Validation of the ablation zone, with tumor segmentation MPR view 

5. Validation of the ablation zone, with tumor segmentation needle view 

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