Fusion imaging of contrast-enhanced ultrasound and contrast-enhanced CT or MRI before radiofrequency ablation for liver cancers

Bo, Xiao-Wan; Xu, Hui‐Xiong; Wang, Dan; Guo, Le‐Hang; Sun, Liping; Li, Xiaolong; Zhao, Chong‐Ke; He, Yaping; Liu, Bo-Ji; Li, Dandan; Zhang, Kun

doi:10.1259/bjr.20160379

Cited by 40 publications

(46 citation statements)

References 45 publications

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“…In addition to conventional US, contrast enhanced US (CEUS) and enhanced magnetic resonance (MR) have also been considered to be valuable tools in the follow-up monitoring of RFA (5)(6)(7)(8). In previous studies, the feasibility of using contrast enhanced US and enhanced MR in evaluating the results of liver RFA has been investigated (9)(10)(11). In a previous study by the current authors, CEUS was used to evaluate the short-term results of prostate RFA (12).…”

Section: Introductionmentioning

confidence: 99%

Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation

Cao

Hu²,

Hu³

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to evaluate and compare the effectiveness of different imaging methods during follow-up of prostatic radiofrequency ablation. Prostatic radiofrequency ablation (RFA) was performed in 20 healthy beagle dogs. Various imaging examinations were used to monitor the results of RFA, including conventional ultrasound (US), contrast enhanced ultrasound (CEUS) and enhanced magnetic resonance (MR). Imaging exams were performed at five phases: Immediately following RFA, one week later, one month later, three months later and six months later. The morphology for each imaging test and histological results were recorded and compared in each phase. Based on the actual results from autopsy, the accuracy of those imaging exams was evaluated. The canine prostate gland demonstrated typical coagulative necrosis immediately following RFA. The lesion would develop into stable cyst if no other complications occurred within the six-month follow-up. Regarding the RFA lesion volume measurement and the reflection of pathological changes, conventional US was not able to accurately measure the volume of RFA lesion and missed many more details concerning the RFA-treated area than CEUS and MR during the three months. The results from CEUS exhibited comparable accuracy to those from enhanced MR at each phase. However, there were no significant differences in the results from US, CEUS and MR at six months, which may contribute to the complete formation of lesion cyst. In the early phase, conventional US was not sufficient for evaluating the efficacy of RFA. Enhanced US and MR provided clear images and accurate information. However, CEUS has the advantage of being more economical, using more convenient equipment and faster scanning, thus identifying it as the more feasible choice. Furthermore, no notable advantages were observed among any image examinations in the long-term follow-up. IntroductionThe worldwide incidence of prostate cancer has been rising in recent years and prostate cancer has become a major threat for aged male populations. Each year, ~914,000 new cases are diagnosed, and 258,000 cases lead to mortality (1). At present, radical prostatectomy is the standard treatment for localized prostate cancer; however, this surgical procedure may have a notable negative impact on patients, such as incontinence or erectile dysfunction (2). Radiofrequency ablation (RFA) is gaining popularity as a method of treating prostate diseases, as it is an interventional therapy that causes less trauma, quicker recovery and fewer complications (3).In order to obtain results from RFA, the use of a real-time prostatic imaging monitor is necessary. At present, conventional transrectal ultrasound (US) is typically used for guiding prostate RFA, allowing the procedure to be visualized in real time. However, the indication of RFA is vague and the accuracy of imaging results is not reliable (3,4). In addition to conventional US, contrast enhanced US (CEUS) and enhanced magnetic resonance (MR) have also been considered ...

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Section: Introductionmentioning

confidence: 99%

Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation

Cao

Hu²,

Hu³

et al. 2017

Experimental and Therapeutic Medicine

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“…Fusion image guidance combining MRI or CT with US imaging has been used clinically, including EM needle tracking for liver lesions . Conventional US and contrast‐enhanced MRI image fusion improves liver lesion visibility, which would otherwise be invisible on conventional US images . Image fusion using EM tracking requires plane and point registration to align MR and US images based on either external fiducial markers or internal anatomical landmarks.…”

Section: Discussionmentioning

confidence: 99%

“…[33][34][35] Conventional US and contrastenhanced MRI image fusion improves liver lesion visibility, which would otherwise be invisible on conventional US images. 36 Image fusion using EM tracking requires plane and point registration to align MR and US images based on either external fiducial markers or internal anatomical landmarks. However, achieving acceptable accuracy matching these points or planes requires considerable training and experience.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance and ultrasound image‐guided navigation system using a needle manipulator

et al. 2019

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Purpose Image guidance is crucial for percutaneous tumor ablations, enabling accurate needle‐like applicator placement into target tumors while avoiding tissues that are sensitive to injury and/or correcting needle deflection. Although ultrasound (US) is widely used for image guidance, magnetic resonance (MR) is preferable due to its superior soft tissue contrast. The objective of this study was to develop and evaluate an MR and US multi‐modal image‐guided navigation system with a needle manipulator to enable US‐guided applicator placement during MR imaging (MRI)‐guided percutaneous tumor ablation. Methods The MRI‐compatible needle manipulator with US probe was installed adjacent to a 3 Tesla MRI scanner patient table. Coordinate systems for the MR image, patient table, manipulator, and US probe were all registered using an optical tracking sensor. The patient was initially scanned in the MRI scanner bore for planning and then moved outside the bore for treatment. Needle insertion was guided by real‐time US imaging fused with the reformatted static MR image to enhance soft tissue contrast. Feasibility, targeting accuracy, and MR compatibility of the system were evaluated using a bovine liver and agar phantoms. Results Targeting error for 50 needle insertions was 1.6 ± 0.6 mm (mean ± standard deviation). The experiment confirmed that fused MR and US images provided real‐time needle localization against static MR images with soft tissue contrast. Conclusions The proposed MR and US multi‐modal image‐guided navigation system using a needle manipulator enabled accurate needle insertion by taking advantage of static MR and real‐time US images simultaneously. Real‐time visualization helped determine needle depth, tissue monitoring surrounding the needle path, target organ shifts, and needle deviation from the path.

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“…The median follow-up period was 14 (12)(13)(14)(15)(16)(17)(18)(19)(20) months. During the follow-up period, 8 patients (combination group: 2 patients, CT group: 2 patients, US group: 4 patients) experienced local recurrence and received repeat MWA, and the local recurrence rates were 5.9%, 6.7%, and 16.7% in the combination group, CT group, and US group, respectively.…”

Section: Clinical E Cacymentioning

confidence: 99%

Security and Efficiency of Percutaneous Microwave Ablation using Combined Computed Tomography and Ultrasound-Guided Imaging in Patients with Hepatocellular Carcinoma: A Prospective Study

Zhao

Guo

et al. 2020

Preprint

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Background: We prospectively evaluated the security and efficiency of percutaneous microwave ablation (MWA) using combined computed tomography (CT) and ultrasound (US)-guided imaging in patients with BCLC-A1-3 hepatocellular carcinoma (HCC) given that they have shortcomings when used alone.Methods: We included 88 consecutive patients with single HCC who were treated with transcatheter hepatic arterial chemoembolization (TACE). The patients were divided into 3 groups at random by using draw lots 1 week after TACE. The combination group (34 patients) received MWA under the guidance of CT and US, while the single group (CT group, 30 patients; US group, 24 patients) received MWA under the guidance of CT or US alone. Contrast-enhanced MRI or CT scans were performed in all patients 1, 3, 6 and 12 months after the procedure. The study endpoints included the treatment time, puncture time, local recurrence rate, and adverse events.Results: The median diameter of the lesions was 3.1 (1.5-4.2) cm. The median treatment time was 38.6 (30-45) min and 36.7 (30-47) min in the combination group and US group, respectively. The median puncture number was 1.2 (1-2) times and 1.1 (1-2) times, respectively. Both were significantly less than in the CT group (45.8 min and 4.2 times). The local recurrence rate was 5.9% in the combination group, which was significantly inferior to that in the US group (16.7%). The grade C complication rate in the combination group was 5.9%, while it was 13.3% and 8.3% in the CT group and US group, respectively. There was a statistically significant difference between the combination group and CT group.Conclusions: Using CT- and US-guided microwave ablation in patients with BCLC-A1-3 hepatocellular carcinoma appeared to be much better in terms of security and efficiency than the use of microwave ablation under the guidance of CT or US alone.

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Fusion imaging of contrast-enhanced ultrasound and contrast-enhanced CT or MRI before radiofrequency ablation for liver cancers

Cited by 40 publications

References 45 publications

Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation

Comparative study of conventional US, contrast enhanced US and enhanced MR for the follow-up of prostatic radiofrequency ablation

Magnetic resonance and ultrasound image‐guided navigation system using a needle manipulator

Security and Efficiency of Percutaneous Microwave Ablation using Combined Computed Tomography and Ultrasound-Guided Imaging in Patients with Hepatocellular Carcinoma: A Prospective Study

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