Abstract
The ultrasound (US) imaging technology, including contrast-enhanced US (CEUS) and fusion imaging, has experienced radical improvement, and advancement in technology thus overcoming the problem of poor conspicuous hepatocellular carcinoma (HCC). On CEUS, the presence or absence of enhancement distinguishes the viable portion from the ablative necrotic portion. Using volume data of computed tomography (CT) or magnetic resonance imaging (MRI), fusion imaging enhances the three-dimensional relationship between the liver vasculature and HCC. Therefore, CT/MR-US fusion imaging provides synchronous images of CT/MRI with real-time US, and US-US fusion imaging provides synchronous US images before and after ablation. Moreover, US-US overlay fusion can visualize the ablative margin because it focuses the tumor image onto the ablation zone. Consequently, CEUS and fusion imaging are helpful to identify HCC with little conspicuity, and with more confidence, we can perform ablation therapy. CEUS/fusion imaging guidance has improved the clinical effectiveness of ablation therapy in patients with poor conspicuous HCCs. Therefore; this manuscript reviews the status of CEUS/fusion imaging guidance in ablation therapy of poor conspicuous HCC.
Highlights
Ablation therapy is a minimally invasive treatment option, and percutaneous ultrasound (US)guided ablative treatments, including radiofrequency ablation (RFA), and microwave ablation (MWA), have successfully managed hepatocellular carcinoma (HCC) [1,2,3,4,5,6]
Review of contrast-enhanced ultrasound (CEUS)/Fusion Imaging Guidance percutaneous ablation therapies primarily depends on correct targeting through an imaging technique and the suitable placement of the needle electrode into the target tumor thereby optimizing local tumor control
On CEUS, we can distinguish the viable portion of HCC from the ablative necrotic one by the presence or absence of enhancement, and we can perform an image-guided ablation of this viable HCC
Summary
Ablation therapy is a minimally invasive treatment option, and percutaneous ultrasound (US)guided ablative treatments, including radiofrequency ablation (RFA), and microwave ablation (MWA), have successfully managed hepatocellular carcinoma (HCC) [1,2,3,4,5,6]. The success of Abbreviations: CEUS, contrast-enhanced ultrasound; CT, computed tomography; HCC, hepatocellular carcinoma; MPR, multiplanar reconstruction; MRI, magnetic resonance imaging; MWA, microwave ablation; RFA, radiofrequency ablation; US, ultrasound; 2D, two-dimensional; 3D, three-dimensional. Review of CEUS/Fusion Imaging Guidance percutaneous ablation therapies primarily depends on correct targeting through an imaging technique and the suitable placement of the needle electrode into the target tumor thereby optimizing local tumor control. This article reviews the principles, clinical applications, and techniques of US image-guidance in ablation therapy including CEUS and fusion imaging
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