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

  • Marco CalandriEmail author
  • Giovanni Mauri
  • Steven Yevich
  • Carlo Gazzera
  • Domenico Basile
  • Marco Gatti
  • Andrea Veltri
  • Paolo Fonio


As medical imaging advancements have improved the detectability of hepatocellular carcinoma (HCC) in early stages, the approach to percutaneous thermal ablation for curative treatment has concomitantly advanced. Although many centers are adopting cross-sectional imaging to guide percutaneous ablation, the majority of procedures are still performed under ultrasound (US) guidance worldwide. Challenges to ultrasound guidance may present due to relatively poor resolution particularly with small or isoechoic lesions, or due to intervening structures such as the bowel or diaphragm that obstruct lesional visualization. Fusion imaging (FI) systems have been employed to address these challenges. By merging or synchronizing the real-time images from US with a previously obtained cross-sectional study, FI mitigates the inherent limitations of each individual imaging modality and expands procedural feasibility and technical outcomes. This manuscript reviews the current literature on the use of FI during percutaneous thermal ablation of HCC.


Hepatocellular carcinoma Fusion imaging Ultrasound Contrast-enhanced ultrasound (CEUS) Computed tomography Magnetic resonance imaging 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and Animal Rights

This study was not supported by any funding and does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study, formal consent is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Radiology Unit, Department of Oncology, San Luigi Gonzaga Hospital, Orbassano (Torino)University of TorinoTurinItaly
  2. 2.Division of Interventional RadiologyIstituto Europeo di Oncologia IRCCSMilanItaly
  3. 3.Department of Interventional RadiologyMD Anderson Cancer CenterHoustonUSA
  4. 4.Department of Surgical Sciences, Radiology Institute, Città della Salute e della Scienza, TorinoUniversity of TorinoTurinItaly

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