Austria can be considered the home of stereotactic percutaneous tumor ablations, owing to the two decades of pioneering clinical and developmental work by Reto Bale, Joachim Kettenbach, Michael Vogele among many others.
In this setting and on November 18, 2014, a team led by Prof. Dr. Hannes Deutschmann and Prof. Dr. Rupert Portugaller (Universitätsklinukum Graz) treated a first patient with CAS-One IR. At the time, CAS-One IR already offered trajectory planning and navigational assistance using a combination of mechanical guidance and optical tracking (see figure below). However, the system was far away from its modern treatment planning and outcome assessment functionalities.
In 2018, the late Prof. Dr. Joachim Kettenbach, who had extensive experience with CAS-One IR from his tenure at the University Hospital in Bern, Switzerland, brought it to the Landesklinikum in Wiener Neustadt. Prof. Kettenbach implemented the approach with great enthusiasm.
In 2021, Universitätsklinikum AKH Wien also joined the group of Quality Ablation Centers and adopted CAS-One IR under the direction of Prof. Dr. Christian Loewe and Dr. Fredrik Wanek as primary clinical users.
Fast forward to 2023, when Sanova and CASCINATION joined forces to enhance their presence in the Austrian market, guided by the vision that the best technology must be made available to more Austrian centers by the best local sales partners. The progress since then is remarkable. Other clinics have started their clinical routine using CAS-One IR, such as:
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Krankenhaus der Barmherzigen Brüder Wien
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Klinik Favoriten Wien
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Krankenhaus der Barmherzigen Schwestern Wien
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Klinikum Wels-Grieskirchen
Below are images of their clinical usage:
Krankenhaus der Barmherzigen Brüder Wien
Prof. Dr. Christian Neumann and Dr. Gerhard Gruber performing the first liver and kidney CAS-One IR cases in March 2024.
Prim. Dr. Christian Krestan and Dr. Michael Kriegisch performing their first kidney case with CAS-One IR, placing one biopsy and six cryoablation needles.
Krankenhaus der Barmherzigen Schwestern Wien
Prof. Dr. Wolfgang Schima and Dr. Helmut Kopf introduced Quality Ablation in May 2024. The current focus on using CAS-One IR is for the treatment of liver tumors.
Prof. Dr. René Müller-Wille, Dr. Siegfried Funk, and Dr. Barnabas Hideg introduced CAS-One IR in April 2024. They started with the treatment of liver patients, and plan to extend into other organs.
The users are highly convinced of the application and its clinical benefits. This sentiment is exemplified by the following statements:
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Dr. Christian Neumann (Barmherzige Brüder Wien): “We are excited about the initial experience with the system. We had a short learning curve owing to the systems intuitive use and the great support for our team, Sanova and CASCINATION. The system will enable us in treat more patients through a minimally-invasive ablation approach, standardizing our workflow, and improving treatment outcomes.”
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Dr. Siegfried Funk and Dr. Barnabás Hideg (Klinikum Wels-Grieskirchen): “The system opens up entirely new possibilities in treating patients through percutaneous ablation, ensuring the necessary safety and confidence. We can safely treat invisible or hard-to-reach lesions and immediately confirm margins in all of our treatments, ensuring complete tumor coverage and reducing the need for re-treatments due to recurrence.”
Today, over 300 Quality Ablations using CAS-One IR have been performed since 2014. Currently, the treatment is regularly performed in seven Austrian hospitals with even more hospitals to adopt CAS-One IR in the coming months.
Let’s have a word for Manfred Menges, Head of Medical Systems of Sanova, leading CAS-ONE IR distribution in Austria.
Why did you decide to take CAS-One IR into your product portfolio?
CAS-One IR is the most comprehensive and widely used decision support system for percutaneous tumor ablation on the market. Sanova has previously distributed a navigation system for ablation and therefore has relevant experience in this clinical domain. But CAS-One IR goes beyond pure navigation of ablation needles. Multi-needle procedures can be planned in 2D and 3D views, ablation zones can be simulated, CT images can be fused with MRI images, ablation needles can be safely and precisely placed in target structures in complex settings and the ablation results can be immediately assessed. This brings important benefits for physicians and patients.
What benefits do you refer to specifically?
With CAS-One IR, more patients can be treated with ablation and benefit from a minimally invasive treatment. In addition, numerous studies show that the system leads to more standardized treatments and better outcomes compared to conventional free-hand approaches. These are important benefits for patients but also for the healthcare system, because minimally invasive treatments with good outcomes increase quality of life for patients
and cost-efficiency of patient care.
What are the challenges introducing a technology like CAS-One IR?
In the field of radiology, typically there are either large-scale recurring purchases of imaging equipment such as CTs and MRIs or purchases for daily routine operations. CAS-One IR is in between. Additionally, there is no separate reimbursement in Austria for the use of such innovative technologies. Therefore, it is important that clinicians see the clinical benefits and that strategic buyers understand the clinical and economic benefits. In collaboration with CASCINATION, we have succeeded in doing this very well so far.
How many clinics will use CAS-One IR in 3 years in Austria?
We started the partnership with CASCINATION in September 2023. Since then, we have presented the solution to numerous clinicians, and they show great interest in using CAS-One IR. We expect that at least 10 clinics in Austria will be using the system in 3 years, including university hospitals and larger state hospitals.
It seems Quality Ablation with CAS-One IR is moving towards standard of care in Austria! We are excited to see what happens next.