Percutaneous Thermal Ablation with Ultrasound Guidance. Fusion Imaging Guidance to Improve Conspicuity of Liver Metastasis

  • Antoine Hakime
  • Steven Yevich
  • Lambros Tselikas
  • Frederic Deschamps
  • David Petrover
  • Thierry De Baere
Clinical Investigation

Abstract

Purpose

To assess whether fusion imaging-guided percutaneous microwave ablation (MWA) can improve visibility and targeting of liver metastasis that were deemed inconspicuous on ultrasound (US).

Materials and Methods

MWA of liver metastasis not judged conspicuous enough on US was performed under CT/US fusion imaging guidance. The conspicuity before and after the fusion imaging was graded on a five-point scale, and significance was assessed by Wilcoxon test. Technical success, procedure time, and procedure-related complications were evaluated.

Results

A total of 35 patients with 40 liver metastases (mean size 1.3 ± 0.4 cm) were enrolled. Image fusion improved conspicuity sufficiently to allow fusion-targeted MWA in 33 patients. The time required for image fusion processing and tumors’ identification averaged 10 ± 2.1 min (range 5–14). Initial conspicuity on US by inclusion criteria was 1.2 ± 0.4 (range 0–2), while conspicuity after localization on fusion imaging was 3.5 ± 1 (range 1–5, p < 0.001). Technical success rate was 83% (33/40) in intention-to-treat analysis and 100% in analysis of treated tumors. There were no major procedure-related complications.

Conclusions

Fusion imaging broadens the scope of US-guided MWA to metastasis lacking adequate conspicuity on conventional US. Fusion imaging is an effective tool to increase the conspicuity of liver metastases that were initially deemed non visualizable on conventional US imaging.

Keywords

Fusion imaging Liver metastases Thermal ablation 

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  1. 1.Interventional Radiology DepartmentGustave Roussy - Cancer CampusVillejuifFrance
  2. 2.Imagerie Médicale Paris Centre, IMPCParisFrance
  3. 3.University of Texas MD Anderson Cancer CenterHoustonUSA

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