Real-time US-CT/MR fusion imaging for percutaneous radiofrequency ablation of hepatocellular carcinoma

Ahn, Su Joa; Lee, Dong Hoon; Lee, Sang Min; Yoon, Jung Hwan; Kim, Yoon Jun; Yu, Su Jong; Han, Joon Koo

doi:10.1016/j.jhep.2016.09.003

Cited by 107 publications

(99 citation statements)

References 46 publications

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“…In addition, CT/MR‐CEUS FI can overlay the index tumor and the ablation zone, and also can produce a 3‐D reconstruction, displaying the tumor position and its proximity to vital structures, even if there are hyperechoic bubbles present on the ultrasound. Furthermore, the ablation needle can be more accurately arranged in accordance with the preoperative planning without interference by bubbles, even if the tumor is located in a challenging position . Accurate planning can not only lead to complete ablation, but also reduce the risk of off‐target ablative injuries.…”

Section: Discussionmentioning

confidence: 99%

Intraprocedural computed tomography/magnetic resonance–contrast‐enhanced ultrasound fusion imaging improved thermal ablation effect of hepatocellular carcinoma: Comparison with conventional ultrasound

Zeng

et al. 2019

Hepatology Research

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Aim To retrospectively compare the treatment effect of intraprocedural computed tomography/magnetic resonance–contrast‐enhanced ultrasound (CT/MR‐CEUS) fusion imaging (FI) with that of conventional ultrasound (US) in the guidance and assessment of thermal ablation of hepatocellular carcinoma (HCC). Methods The FI group (112 patients with 129 HCC) was treated between April 2010 and December 2012, whereas the US group (83 patients with 90 HCC) was treated between January 2008 and March 2010. Either CT/MR‐CEUS FI or US was used to guide puncture, provide immediate assessment, and guide supplementary ablation. Technical efficacy, cumulative local tumor progression rate (LTP), recurrence‐free survival (RFS), and overall survival (OS) were evaluated and compared during follow‐up. Technical success rate of CT/MR‐CEUS FI was also recorded. Results Technical efficacy was significantly higher in the FI group than in the US group (100% vs. 86.7%, P < 0.001). The 1‐, 2‐, 3‐, 4‐, 5‐, and 6‐year cumulative LTP rates in the FI group were significantly lower than in the US group (3.8%, 4.9%, 6.0%, 6.0%, 7.2%, and 7.2% vs. 16.9%, 20.1%, 25%, 25%, 25%, and 25%, respectively; P < 0.001); RFS and OS were significantly higher in the FI group than in the US group (P = 0.027 and P = 0.049, respectively). The technical success rate of FI was 85.3%. Conclusions Intraprocedural CT/MR‐CEUS FI improved the treatment effect of thermal ablation of HCC by immediately assessing treatment response and guiding supplementary ablation relative to those resulting from the use of conventional US.

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Section: Discussionmentioning

confidence: 99%

Intraprocedural computed tomography/magnetic resonance–contrast‐enhanced ultrasound fusion imaging improved thermal ablation effect of hepatocellular carcinoma: Comparison with conventional ultrasound

Zeng

et al. 2019

Hepatology Research

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“…If a US machine capable of fusion imaging is available, it can be utilized for localizing small inconspicuous tumors by using a reference dataset such as preacquired CT/MR images [158]. Many studies have reported that fusion imaging can improve tumor visibility and technical feasibility of RFA for small HCCs [159][160][161][162][163].…”

Section: Combined Fusion Imaging and Contrast-enhanced Ultrasoundmentioning

confidence: 99%

The AFSUMB Consensus Statements and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound using Sonazoid

et al. 2020

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The first edition of the guidelines for the use of ultrasound contrast agents was published in 2004, dealing with liver applications. The second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some nonliver applications. The third edition of the contrast-enhanced ultrasound (CEUS) guidelines was the joint World Federation for Ultrasound in Medicine and Biology-European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB-EFSUMB) venture in conjunction with other regional US societies such as Asian Federation of Societies for Ultrasound in Medicine and Biology, resulting in a simultaneous duplicate on liver CEUS in the official journals of both WFUMB and EFSUMB in 2013. However, no guidelines were described mainly for Sonazoid due to limited clinical experience only in Japan and Korea. The new proposed consensus statements and recommendations provide general advice on the use of Sonazoid and are intended to create standard protocols for the use and administration of Sonazoid in hepatic and pancreatobiliary applications in Asian patients and to improve patient management.

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“…In this setting, CEUS may facilitate radiofrequency ablation (RFA) electrode placement in hypervascular HCC, which is poorly depicted by B-mode US [65,66]. Newly developed techniques, such as fusion imaging between US and CT/MRI datasets, can further improve the conspicuity of HCCs and the feasibility of percutaneous RFA of HCCs not visible on conventional US, including even subcentimeter HCCs, thus increasing the success rate of percutaneous ablation therapy for HCC [67][68][69]. Furthermore, an accurate assessment of therapeutic response is of crucial importance, considering that complete tumor ablation significantly increases the likelihood of patient survival, whereas the presence of residual unablated tumor calls for additional treatment [70,71].…”

Section: Hcc: Ceus In the Assessment Of Therapeutic Responsementioning

confidence: 99%

Contrast-enhanced ultrasound of hepatocellular carcinoma: where do we stand?

et al. 2019

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Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in ultrasonography (US), and it is being increasingly used for the evaluation of focal liver lesions (FLLs). CEUS is unique in that it allows non-invasive assessment of liver perfusion in real time throughout the vascular phase, which has led to dramatic improvements in the diagnostic accuracy of US in the detection and characterization of FLLs, the choice of therapeutic procedures, and the evaluation of response. Currently, CEUS is included as a part of the suggested diagnostic work-up of FLLs, including in cirrhotic patients with hepatocellular carcinoma, resulting in better patient management and cost-effective delivery of therapy.

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Real-time US-CT/MR fusion imaging for percutaneous radiofrequency ablation of hepatocellular carcinoma

Cited by 107 publications

References 46 publications

Intraprocedural computed tomography/magnetic resonance–contrast‐enhanced ultrasound fusion imaging improved thermal ablation effect of hepatocellular carcinoma: Comparison with conventional ultrasound

Intraprocedural computed tomography/magnetic resonance–contrast‐enhanced ultrasound fusion imaging improved thermal ablation effect of hepatocellular carcinoma: Comparison with conventional ultrasound

The AFSUMB Consensus Statements and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound using Sonazoid

Contrast-enhanced ultrasound of hepatocellular carcinoma: where do we stand?

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