# Less contrast, more clarity, innovative visualization technique for management of multiple colorectal liver metastases using microwave ablation through a portal venous access

## TL;DR

This paper introduces a new visualization technique for microwave ablation of liver metastases using less contrast dye, improving treatment efficiency.

## Contribution

A novel microwave ablation technique using minimal IV contrast for treating multiple liver metastases in one session.

## Key findings

- Used only 25 cc of IV contrast instead of the typical 100-150 cc for successful ablation of 6 metastases.
- The technique allows simultaneous treatment of multiple lesions in a single session.
- Reduces contrast volume and optimizes treatment efficiency for patients ineligible for surgery.

## Abstract

Colorectal cancer, a leading cause of cancer-related deaths, often results in liver metastases, with about half of patients affected. For those ineligibles for surgery, percutaneous microwave ablation (MWA) offers a viable alternative. Conventionally, visualizing liver lesions prior to MWA demands significant IV contrast, often needing repeated sessions. We introduce a technique using minimal IV contrast to treat multiple metastatic lesions simultaneously. A case of a 47-year-old male with stage 4 colorectal adenocarcinoma and multiple liver metastases is presented. Instead of the typical 100-150 cc of IV contrast, our method used just 25 cc, successfully ablating 6 hepatic metastases in 1 session. This approach not only reduces contrast volume but also optimizes treatment efficiency.