Contrast-enhanced ultrasonography-CT/MRI fusion guidance for percutaneous ablation of inconspicuous, small liver tumors: improving feasibility and therapeutic outcome

• Published in: Cancer imaging 2024-01, Vol.24 (1), p.4-4, Article 4
• Main Authors: Lee, Yuna, Yoon, Jeong Hee, Han, Seungchul, Joo, Ijin, Lee, Jeong Min
• Format: Article
• Language: English
• Subjects: Ablation; Ablation (Surgery); Cancer; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Catheter Ablation - methods; Clinical outcomes; Computed tomography; Contrast Media; Development and progression; Feasibility Studies; Fusion imaging; Health aspects; Humans; Liver cancer; Liver malignancies; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Liver tumors; Localization; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medical imaging; Medical research; Medicine, Experimental; Metastasis; Prospective Studies; Radio frequency; Registration; Technology assessment; Tomography, X-Ray Computed - methods; Treatment Outcome; Tumors; Ultrasonic imaging; Ultrasonography - methods; Ultrasound; Ultrasound imaging; Veins & arteries; Visibility
• ISSN: 1470-7330; 1740-5025; 1470-7330
• DOI: 10.1186/s40644-023-00650-y

Percutaneous radiofrequency ablation (RFA) is pivotal for treating small malignant liver tumors, but tumors often remain inconspicuous on B-mode ultrasound (US). This study evaluates the potential of CEUS-CT/MRI fusion imaging (FI) to improve tumor visibility and the associated RFA outcomes for small (≤ 3 cm) malignant liver tumors that were inconspicuous on US. Between January 2019 and April 2021, a prospective study enrolled 248 patients with liver malignancies (≤ 3 cm) that were poorly visible on B-mode US. Tumor visibility and ablation feasibility were assessed using B-mode US, US-CT/MRI FI, and CEUS-CT/MRI FI, and graded on a 4-point scale. CEUS was employed post-registration of US and CT/MRI images, utilizing either SonoVue or Sonazoid. Comparisons between US-based and CEUS-based fusion visibility and feasibility scores were undertaken using the Friedman test. Moreover, rates of technical success, technique efficacy, local tumor progression (LTP), and major complications were assessed. The cohort included 223 hepatocellular carcinomas (HCCs) (89.9%) and 23 metastases (9.3%), with an average tumor size of 1.6 cm. CEUS-CT/MRI FI demonstrated a significant advantage in tumor visibility (3.4 ± 0.7 vs. 1.9 ± 0.6, P