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

PurposeThis study was designed to assess feasibility of US-CT/MRI fusion-guided ablation in liver tumors undetectable with US.MethodsFrom 2002 to 2012, 295 tumors (162 HCCs and 133 metastases; mean diameter 1.3 ± 0.6 cm, range 0.5–2.5 cm) detectable on contrast-enhanced CT/MRI, but completely undetectable with unenhanced US and either totally undetectable or incompletely conspicuous with contrast-enhanced US (CEUS), were treated in 215 sessions using either internally cooled radiofrequency or microwave with standard ablation protocols, guided by an image fusion system (Virtual Navigation System, Esaote S.p.A., Genova, Italy) that combines US with CT/ MRI images. Correct targeting and successful ablation of tumor were verified after 24 hours with CT or MRI.ResultsA total of 282 of 295 (95.6 %) tumors were correctly targeted with successful ablation achieved in 266 of 295 (90.2 %). Sixteen of 295 (5.4 %) tumors were correctly targeted, but unsuccessfully ablated, and 13 of 295 (4.4 %) tumors were unsuccessfully ablated due to inaccurate targeting. There were no perioperative deaths. Major complications were observed in 2 of the 215 treatments sessions (0.9 %).ConclusionsReal-time virtual navigation system with US-CT/MRI fusion imaging is precise for targeting and achieving successful ablation of target tumors undetectable with US alone. Therefore, a larger population could benefit from ultrasound guided ablation procedures.
Authors:
;  [1] ;  [2] ; ; ;  [1] ;  [3] ;  [1]
  1. Azienda Ospedaliera Ospedale di Circolo di Busto Arsizio, Unit of Interventional Oncologic Radiology, Department of Diagnostic Imaging (Italy)
  2. Esaote SpA (Italy)
  3. Hadassah Hebrew University Medical Center, Image-guided Therapy and Interventional Oncology Unit, Department of Radiology (Israel)
Publication Date:
OSTI Identifier:
22470103
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 38; Journal Issue: 1; Conference: IROS 2015: Interventional Radiological Olbert Symposium, Berlin (Germany), 15-17 Jan 2015; Other Information: Copyright (c) 2015 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABLATION; BIOMEDICAL RADIOGRAPHY; COMPUTERIZED TOMOGRAPHY; DEATH; IMAGES; ITALY; LIVER; METASTASES; MICROWAVE RADIATION; NEOPLASMS; NMR IMAGING; POPULATIONS; RADIOWAVE RADIATION; STANDARDS