Role of Fusion Imaging in Image-Guided Thermal Ablations

Carriero, Serena; Pepa, Gianmarco Della; Monfardini, Lorenzo; Vitale, Renato; Rossi, D; Masperi, Andrea; Mauri, Giovanni

doi:10.3390/diagnostics11030549

Cited by 20 publications

(17 citation statements)

References 58 publications

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“…US is one of the most readily available imaging modalities used for guiding percutaneous ablation devices. It is relatively easy to operate, does not impart ionizing radiation, and provides real-time, multiplanar guidance at a low cost [ 10 , 11 ]. However, the use of US is limited by significant operator dependency, difficulty targeting deep structures in patients with obesity, limited visualization of air containing organs (e.g., intestinal loops), and limited utility for the visualization of tumors such as hepatic or iso-echoic renal tumors [ 9 , 10 , 11 , 12 , 13 ].…”

Section: Imaging Modalities For Guiding Percutaneous Ablation Devicesmentioning

confidence: 99%

“…It is relatively easy to operate, does not impart ionizing radiation, and provides real-time, multiplanar guidance at a low cost [ 10 , 11 ]. However, the use of US is limited by significant operator dependency, difficulty targeting deep structures in patients with obesity, limited visualization of air containing organs (e.g., intestinal loops), and limited utility for the visualization of tumors such as hepatic or iso-echoic renal tumors [ 9 , 10 , 11 , 12 , 13 ]. Contrast-enhanced ultrasound (CEUS), in which microbubble contrast agents are used as acoustic enhancers, is an alternative modality that enhances procedure guidance and pre- and post-procedural evaluation [ 14 , 15 ].…”

Section: Imaging Modalities For Guiding Percutaneous Ablation Devicesmentioning

confidence: 99%

“…Contrast-enhanced ultrasound (CEUS), in which microbubble contrast agents are used as acoustic enhancers, is an alternative modality that enhances procedure guidance and pre- and post-procedural evaluation [ 14 , 15 ]. While CEUS can enhance the visibility of small tumors at a relatively low-cost, it cannot detect all lesions (e.g., deeply seated lesions in the hepatic dome), requires specific operator experience, is limited by the number of contrast injections during each session, and is not widely available [ 10 , 16 ].…”

Section: Imaging Modalities For Guiding Percutaneous Ablation Devicesmentioning

confidence: 99%

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Image-Guided Percutaneous Ablation for Primary and Metastatic Tumors

et al. 2022

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Image-guided percutaneous ablation methods have been further developed during the recent two decades and have transformed the minimally invasive and precision features of treatment options targeting primary and metastatic tumors. They work by percutaneously introducing applicators to precisely destroy a tumor and offer much lower risks than conventional methods. There are usually shorter recovery periods, less bleeding, and more preservation of organ parenchyma, expanding the treatment options of patients with cancer who may not be eligible for resection. Image-guided ablation techniques are currently utilized for the treatment of primary and metastatic tumors in various organs including the liver, pancreas, kidneys, thyroid and parathyroid, prostate, lung, bone, and soft tissue. This article provides a brief review of the various imaging modalities and available ablation techniques and discusses their applications and associated complications in various organs.

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Section: Imaging Modalities For Guiding Percutaneous Ablation Devicesmentioning

confidence: 99%

Section: Imaging Modalities For Guiding Percutaneous Ablation Devicesmentioning

confidence: 99%

Section: Imaging Modalities For Guiding Percutaneous Ablation Devicesmentioning

confidence: 99%

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Image-Guided Percutaneous Ablation for Primary and Metastatic Tumors

et al. 2022

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“…Second, it provides accurate guidance for ablation treatments such as RFA, microwave ablation, and cryotherapy, allowing a precise positioning of the probe into the lesions when poorly evaluable on the conventional US, and is a readily usable tool for treatment effectiveness assessment [ 51 ], as the persistence of post-ablation residual vascularity indicates the need for further ablation and detection of hemorrhagic complications [ 2 ]. CEUS can also be used for lesion follow-up to avoid the administration of any nephrotoxic contrast media and radiation exposure.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Precision Imaging Guidance in the Era of Precision Oncology: An Update of Imaging Tools for Interventional Procedures

Floridi

Cellina

Irmici

et al. 2022

JCM

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Interventional oncology (IO) procedures have become extremely popular in interventional radiology (IR) and play an essential role in the diagnosis, treatment, and supportive care of oncologic patients through new and safe procedures. IR procedures can be divided into two main groups: vascular and non-vascular. Vascular approaches are mainly based on embolization and concomitant injection of chemotherapeutics directly into the tumor-feeding vessels. Percutaneous approaches are a type of non-vascular procedures and include percutaneous image-guided biopsies and different ablation techniques with radiofrequency, microwaves, cryoablation, and focused ultrasound. The use of these techniques requires precise imaging pretreatment planning and guidance that can be provided through different imaging techniques: ultrasound, computed tomography, cone-beam computed tomography, and magnetic resonance. These imaging modalities can be used alone or in combination, thanks to fusion imaging, to further improve the confidence of the operators and the efficacy and safety of the procedures. This article aims is to provide an overview of the available IO procedures based on clinical imaging guidance to develop a targeted and optimal approach to cancer patients.

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“…Advancements in computer graphics, 3D image processing technology, and the emergence of fusion imaging (FI) have all improved RFA ( 11 ). FI, which overlaps images from different image sources and combines real-time images of ultrasound with the high resolution of CT/MRI ( 9 ), has been developed.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Fusion Imaging in Radiofrequency Ablation of Hepatocellular Carcinoma Compared to Ultrasound: A Meta-Analysis

et al. 2021

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Background: Radiofrequency ablation (RFA), generally performed under real-time guidance of ultrasound which is safe and effective, is a common minimally invasive therapy for treating hepatocellular carcinoma. Fusion imaging (FI) is a newly developed imaging method, which integrates CT/MRI accurate imaging and matches the characteristics of real-time ultrasound imaging, thereby providing a new approach to guide tumor ablation therapy. However, the efficacy and safety of FI as opposed to ultrasound in tumor ablation remains unclear.Objective: The present study sought to evaluate the difference in the efficacy and safety between FI and ultrasound in radiofrequency surgery for the treatment of hepatocellular carcinoma through a metaanalysis.Materials and Methods: Searching for studies comparing the efficacy and safety of FI and ultrasound in radiofrequency of hepatocellular carcinoma in PubMed, Embase, and Cochrane Library databases for articles published until April 2021. Random or fixed effect models were used for statistical analysis. Metaanalysis and sensitivity analysis were used on the included studies.Results: A total of six studies met predefined inclusion criteria, and were finally included in the analysis. Sensitivity and subgroup analyses, based on predetermined patient characteristics, allowed minimization of bias. In the RFA of hepatocellular carcinoma, FI decreased 1-year overall survival (OS) when compared with ultrasound. But FI was not significantly different from ultrasound in terms of technical efficiency, 1-, 2-, and 3-year local tumor progression (LTP), complications, as well as 2-year OS. Subgroup analysis, based on tumor mean diameter, showed that FI reduced the rate of 1- and 2-year LTP in patients with tumors of mean diameter ≥15 mm when compared with ultrasound. Moreover, operative complications could be reduced in patients with tumor mean diameter <15 mm using FI, compared with ultrasound.Conclusion: Overall, these results showed that FI may have some effects on improving efficacy and safety of thermal ablation in HCC patients, relative to ultrasound. However, it may be a more effective method for managing large lesions, as well as those that are difficult to ablate. Further large-scale and well-designed randomized controlled trials are needed to validate these findings.

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Role of Fusion Imaging in Image-Guided Thermal Ablations

Cited by 20 publications

References 58 publications

Image-Guided Percutaneous Ablation for Primary and Metastatic Tumors

Image-Guided Percutaneous Ablation for Primary and Metastatic Tumors

Precision Imaging Guidance in the Era of Precision Oncology: An Update of Imaging Tools for Interventional Procedures

Efficacy and Safety of Fusion Imaging in Radiofrequency Ablation of Hepatocellular Carcinoma Compared to Ultrasound: A Meta-Analysis

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