Department of Radiology, Interdisciplinary Ultrasound Center, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Radiologe. 2021 Dec;61(Suppl 1):11-18. doi: 10.1007/s00117-021-00893-5. Epub 2021 Jul 29.
Ultrasound (US)-guided biopsy is widely used for the diagnostic confirmation of focal lesions. For sampling of prostate tissue, magnetic resonance imaging (MRI)/US fusion-guided biopsy has already been implemented in routine clinical practice and has shown a superior detection rate of significant prostate cancer in risk assessment compared with standard systematic biopsy. Newer three-dimensional software tools with volumetric mapping of the prostate and biopsy core channels provide a better overview of systematic biopsy and thus contribute to more accurate treatment planning. Automatic fusion is a time-saver and can reduce potential examiner errors through greater standardization of the fusion process itself.
In abdominal pathologies, US fusion biopsy can improve the rate of successful tissue sampling by using fused imaging to target lesions that are barely visible or difficult to delineate on B‑mode US scans. In addition, solid portions within larger tumors with enhancement on contrast-enhanced US can be targeted selectively, thereby avoiding sampling of necrotic areas and improving the quality of tissue cores for histopathological work-up.
Especially in complex situations, use of US fusion not only saves time but also improves sampling accuracy, which in turn reduces the rate of insufficient tissue specimens that necessitate repeat biopsy.
超声(US)引导活检广泛用于局灶性病变的诊断确认。对于前列腺组织的取样,磁共振成像(MRI)/US 融合引导活检已经在常规临床实践中实施,并且与标准系统活检相比,在风险评估中显示出更高的显著前列腺癌检出率。具有前列腺容积测绘和活检芯通道的新型三维软件工具提供了更好的系统活检概述,从而有助于更准确的治疗计划。自动融合是一种节省时间的方法,并且可以通过更大程度地标准化融合过程本身来减少潜在的检查者错误。
在腹部病变中,US 融合活检可以通过使用融合成像来靶向在 B 模式 US 扫描中几乎不可见或难以描绘的病变,从而提高组织取样的成功率。此外,可以有选择地靶向在对比增强 US 上增强的较大肿瘤内的实性部分,从而避免取样坏死区域并提高组织芯的质量,以便进行组织病理学检查。
特别是在复杂情况下,使用 US 融合不仅可以节省时间,还可以提高取样准确性,从而降低需要重复活检的组织标本不足的发生率。