A 77-year-old patient diagnosed in 2014 with metastatic colorectal cancer underwent resection of two liver metastases in 2014 and another resection in 2017 and RFA in 2019. A new lesion was treated by MWA in 2021. In 2023 PET-CT showed 2 new lesions hardly seen on CT or MRI and invisible on US.
MWA with CAS-One IR was chosen as a treatment option because of its ability to fuse the planning CT with MRI and partially with PET-CT. The dome lesion was challenging due to its mandatory ascending access, and AI-driven segmentation proved very useful for the second lesion adjacent to the middle hepatic vein and portal branch. Sub-millimeter accuracy was achieved in needle placement, as well as 100% tumor and margin coverage in the post-ablation scan. No complications were observed.
Planning scan video showing the two challenging trajectories close to the liver dome and hepatic/portal veins with PET-CT showing the lesions.
Verification CT showing a 0.1mm lateral displacement with an ascending trajectory avoiding the lung.
Name: Dr. Jose Maria Abadal, Dra. Esther Galvez
Institution: Hospital Universitario Severo Ochoa, Madrid, Spain
Patient age, sex: 77, Female
Initial condition:
PET-CT in 2023 revealed 2 new lesions, one 20mm in segment VIII adjacent to middle hepatic vein. Second 18mm lesion in the dome of segment VIII.
Treatment:
Result:
Learn more about the stereotactic navigation system CAS-One IR.