Fusion Imaging and Virtual Navigation to Guide Percutaneous Thermal Ablation of Hepatocellular Carcinoma: A Review of the Literature

Calandri, Marco; Mauri, Giovanni; Yevich, Steven; Gazzera, Carlo; Basile, Domenico; Gatti, Marco; Veltri, Andrea; Fonio, Paolo

doi:10.1007/s00270-019-02167-z

Cited by 51 publications

(39 citation statements)

References 52 publications

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“…The MRI signs will depend on the blood supply pattern of the liver cancer foci, which may in turn depend on the degree of differentiation and tissue composition of the liver cancer. 11 This suggests that the type of liver cancer may be initially judged according to the blood supply mode in MRI images. For example, sclerotic liver cancer shows less marked but more widely distributed enhancement over time.…”

Section: Discussionmentioning

confidence: 99%

Atypical magnetic resonance imaging features and differential diagnosis of hepatocellular carcinoma

Wang

et al. 2020

J Int Med Res

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Objective Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver. We aimed to summarize and analyze the atypical magnetic resonance imaging (MRI) features of HCC to improve its diagnostic accuracy. Methods We retrospectively analyzed MRI data for 66 patients with HCC with atypical MRI features confirmed by operation and pathology. Results Twelve patients had high signals and 18 patients had significant decreases in opposed phase signals in T1WI plain scans. Nine patients had high signals and six patients had large cystic lesions in apparent diffusion coefficient images. Dynamic enhancement showed progressive enhancement in 15 patients, ring enhancement in three, irregular patchy enhancement in three, ‘nodule-in-nodule’ enhancement in six, delayed central patchy enhancement in six, delayed central ‘star-like aristate scars’ (T2WI revealed high signal intensity) in 21, and poor blood supply in three patients. Conclusions MRI can make a clear diagnosis of typical HCC, and atypical cases can also be distinguished from other tumors or tumor-like lesions by MRI. The analysis of atypical signs may improve the diagnostic accuracy of MRI for HCC.

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Section: Discussionmentioning

confidence: 99%

Atypical magnetic resonance imaging features and differential diagnosis of hepatocellular carcinoma

Wang

et al. 2020

J Int Med Res

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“…Image fusion techniques that incorporate separate modalities or generate real-time biologic feedback of ablation and cavity formation are now available and can be useful in select patients, although careful preoperative alignment is critical as this technology may be susceptible to misregistration. 116 In addition to the aforementioned strategies, TEA and radioembolization are extremely versatile and can be safely used near critical intrahepatic anatomy, subcapsular and other difficult to reach locations, or in transplant patients where tract seeding precludes transplantation. Ablative radioembolization is particularly useful for tumors which may require the ablation of larger margins.…”

Section: Anatomical Considerations Intrahepatic Anatomymentioning

confidence: 99%

Individualized Ablation of Hepatocellular Carcinoma: Tailored Approaches across the Phenotype Spectrum

Devcic

Elboraey

Vidal

et al. 2019

Semin intervent Radiol

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Ablation is now recommended by international guidelines for the definitive treatment of hepatocellular carcinoma (HCC). Extensive clinical studies have demonstrated outcomes comparable to surgical resection with shorter hospital stays, decreased costs, and improved quality of life. Successful ablation requires complete treatment of both tumor and margin while preserving critical adjacent structures. HCC exhibits highly variable presentations in both anatomic involvement and biology which have significant implications on choice of ablative therapy. There are now abundant ablation modalities and adjunctive techniques which can be used to individualize ablation and maximize curative results. This article provides a patient-centered summary of approaches to HCC ablation in the context of patient performance, hepatic reserve, tumor phenotype and biology, intra- and extrahepatic anatomy, and ablation technology.

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“…The success rate of CEUS in identifying the lesions varies widely in the literature series (42-89%). 11,[28][29][30] Missing lesions that are not visible and therefore not treatable with US/CEUS guidance can be detected through FI with EM tracking technology, and thus FI can be used to increase the number of nodules treatable percutaneously. For instance, after the introduction of US/CECT FI in their clinical practice, Makino et al 31 reported an increase from 1.7 to 15.4% in the number of nodules with low visibility ablated, while maintaining unchanged the complete ablation rate.…”

Section: Us (Ceus)/ct (Cect)-mri (Cemri)mentioning

confidence: 99%

“…38 During ablation, FI can be performed as in the preoperative planning. 30 In case of patients being treated under general anesthesia, intraoperative FI-guided ablation might be even easier to perform due to more precise targeting through better respiratory control. Once precise fusion has been achieved, ablation can be performed with direct US visualization of the ablative device, or with the assistance of a virtual needle, that can be displayed on the US and/or on reference CT/MRI images (►Fig.…”

Section: Us (Ceus)/ct (Cect)-mri (Cemri)mentioning

confidence: 99%

Fusion Imaging in the Guidance of Thermal Ablations

et al. 2019

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Image-guided thermal ablations are having an increasingly widespread effect on the treatment of several different abdominal conditions, and particularly on the treatment of liver and kidney tumors. In other conditions, such as in the case of pancreatic cancers, image-guided thermal ablations are still under investigation, but some studies showed promising results. Regardless the target organ to be treated, imaging represents one of the most important aspects for a safe and effective application of these techniques. To improve the image guidance in thermal ablations, some systems have been developed to fuse together two or more imaging modalities, providing the operator a real-time visualization of different information during the treatment. In the present review, the principles of fusion imaging will be described, and the principal application in the abdomen will be illustrated.

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Fusion Imaging and Virtual Navigation to Guide Percutaneous Thermal Ablation of Hepatocellular Carcinoma: A Review of the Literature

Cited by 51 publications

References 52 publications

Atypical magnetic resonance imaging features and differential diagnosis of hepatocellular carcinoma

Atypical magnetic resonance imaging features and differential diagnosis of hepatocellular carcinoma

Individualized Ablation of Hepatocellular Carcinoma: Tailored Approaches across the Phenotype Spectrum

Fusion Imaging in the Guidance of Thermal Ablations

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