1 All authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea.
AJR Am J Roentgenol. 2013 Nov;201(5):1141-7. doi: 10.2214/AJR.13.10532.
The objective of our study was to assess whether fusion imaging of conventional ultrasound and liver CT or MR images can improve the conspicuity of lesions and feasibility of percutaneous radiofrequency ablation (RFA) for the treatment of hepatocellular carcinomas (HCCs) not visible on ultrasound. Whether peritumoral anatomic landmarks can be used for the placement of an electrode in HCCs not visible on ultrasound even after image fusion was also evaluated.
Planning ultrasound for percutaneous RFA was performed using conventional ultrasound first and then using fusion imaging later during the same session. The visibility of HCCs and feasibility of RFA on conventional ultrasound and on fusion imaging were assessed. We evaluated how many HCCs initially not visible on conventional ultrasound could be visualized and ablated after applying the fusion imaging technique. One hundred twenty HCCs not visible on conventional ultrasound in 96 patients were included.
When fusion imaging was applied, 38 of the 120 (31.7%) HCCs that were initially not visible could be seen and RFA was feasible. Among the remaining 82 HCCs still not visible after image fusion, 26 (31.7%) were ablated under the guidance of fusion imaging the technique based on peritumoral anatomic landmarks. Overall, 64 of 120 (53.3%) HCCs (59.4%, 57 of 96 patients) not visible on conventional ultrasound could be ablated under the guidance of the fusion imaging technique.
Fusion imaging can improve the conspicuity of HCCs and the feasibility of percutaneous RFA of HCCs not visible on conventional ultrasound. Peritumoral anatomic landmarks can be used for electrode placement in HCCs that are still not visible even after image fusion.
本研究旨在评估常规超声与肝脏 CT 或 MR 图像融合是否能提高超声不可见的肝细胞癌（HCC）病灶的显影程度，并提高经皮射频消融（RFA）的可行性。评估即使在进行图像融合后，超声仍不可见的 HCC 能否使用肿瘤周围解剖学标志来放置电极。
在同一时段内，首先使用常规超声进行经皮 RFA 计划超声，然后使用融合成像。评估常规超声和融合成像上 HCC 的可见性和 RFA 的可行性。我们评估了多少个初始在常规超声上不可见的 HCC 在应用融合成像技术后可以被可视化和消融。共纳入 96 例患者的 120 个在常规超声上不可见的 HCC。
应用融合成像后，38 个（31.7%）初始不可见的 HCC 可被看见且 RFA 可行。在图像融合后仍不可见的剩余 82 个 HCC 中，有 26 个（31.7%）在基于肿瘤周围解剖学标志的融合成像技术引导下被消融。总体而言，在常规超声上不可见的 120 个 HCC 中有 64 个（53.3%）可在融合成像技术引导下被消融（59.4%，96 例患者中有 57 例）。
融合成像可以提高超声不可见的 HCC 的显影程度和经皮 RFA 的可行性。即使在进行图像融合后仍不可见的 HCC，肿瘤周围解剖学标志也可用于电极放置。
