Virtual navigator real-time ultrasound fusion imaging with positron emission tomography for liver interventions

Abstract

Real-time fusion imaging technologies are increasingly being used among interventional radiologists, mostly Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) dataset, fused with Ultrasound (US) imaging. In addition, fusion of Positron Emission Tomography (PET) and CT is increasingly diffused in clinical practice, due to the wide availability of PET scanners and the capability to make either a direct (acquisitions performed within the same system) or an indirect (procedure performed on an external workstation, merging the two different sets of acquired data) fusion with CT data. The present work describes the feasibility of real-time fusion imaging directly between PET data and US imaging, with CT scans being used only for PET-US fusion registration. Data on multimodality registration precision and clinical applications are presented as well.

Real-Time US-CT/MRI Image Fusion for Guidance of Thermal Ablation of Liver Tumors Undetectable with US: Results in 295 Cases

“…Accordingly, there is a growing interest for guidance methods that combine the advantages of different imaging modalities. Although systems for real-time image fusion of US and CT have been commercially available for some years, only recently reports of their accuracy and efficacy have been published, most often in mixed populations of patients [25][26][27][28][29][30][31][32][33][34][35][36][37]. In our study, we fused real-time US and CT/MRI scans in the interventional room using one reference axial plane and increasingly fewer internal anatomical marker and less and less manual fine tuning.…”

“…Some papers dealing with thermal ablation of liver tumors guided by real-time virtual navigation systems have been published [25][26][27][28][29][30][31][32][33][34][35][36][37]. Few of them deal with ablation of tumors undetectable with US.…”

“…However, there are some cases in which even with CEUS the tumor cannot be visualized or its conspicuity is incomplete rendering the target only partially assessable, for example in the case of small HCCs, which often are not sufficiently hypoechoic in the delayed phase of contrastenhanced US to enable safe and accurate targeting. Accordingly, the use of a virtual navigation system that combines real-time procedural US with reconstructed CT or MRI or even FDG-PET images can potentially increase detectability and conspicuity of tumors and allow more precise targeting and monitoring [25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Moreover, validation of this technique has been reported for small series of patients [26,28,[33][34][35][36].…”

Application of imaging fusion combining contrast‐enhanced ultrasound and magnetic resonance imaging in detection of hepatic cellular carcinomas undetectable by conventional ultrasound

“…Also, the GPS feature can mark the HCC lesion on the CEUS image and the dynamic MRI simultaneously. [31][32][33] In our current research, during the registration procedure, we used the right portal vein as anatomic landmarks in 45 HCC lesions and umbilical segment of the left portal vein in four lesions. The technical success rate of image fusions was 100%.…”

Magnetic Resonance Imaging-Ultrasound Fusion-Guided Prostate Biopsy: Review of Technology, Techniques, and Outcomes

“…Both platforms enable real-time fusion imaging between ultrasound and a second reference imaging modality (PET/CT, MRI, 3D ultrasound) (51). These two platforms have been more commonly used in other interventional applications, including hepatobiliary interventions (52). The utility in prostate biopsy/treatment is sparse with very limited data available.…”