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Abdom Radiol (NY). 2018 Dec;43(12):3279-3287. doi: 10.1007/s00261-018-1608-y.

Additional value of contrast-enhanced ultrasonography for fusion-guided, percutaneous biopsies of focal liver lesions: prospective feasibility study.

Author information

1
Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Korea.
2
Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul, 110-744, Korea. jhkim2008@gmail.com.
3
Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea. jhkim2008@gmail.com.
4
Department of Radiology, Hallym University Sacred Heart Hospital, Anyang, Korea.
5
Department of Medical Imaging, Toronto General Hospital, University of Toronto, Toronto, Canada.
6
Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE:

To determine the value of CEUS for real-time, fusion-guided, percutaneous biopsies of focal liver lesions.

MATERIALS AND METHODS:

Institutional review board approval and written informed consents were obtained for this study. Forty patients with focal liver lesions identified on CT/MRI were prospectively enrolled. For biopsy planning, real-time fusion of CT/MRI with USG (USG-Fusion) was performed, and subsequently real-time CEUS was fused with CT/MRI (CEUS-Fusion). We evaluated lesion visibility, confidence level of technical success before the procedure, and safety route accessibility on USG-Fusion and CEUS-Fusion. Occurrence of change in the biopsy target was also assessed.

RESULTS:

Among 40 target lesions, nine (22.5%) lesions were invisible on USG-Fusion. After applying CEUS-Fusion, seven of nine (77.8%) lesions were visualized. Confidence level of technical success of procedure was significantly increased on CEUS-Fusion compared USG-Fusion (pā€‰=ā€‰0.02), and presumed target lesions were changed in 16 (40%) patients after CEUS-Fusion. As the lesion is necrotic, presumed target was more frequently changed after CEUS-Fusion (50.0% and 25.0%). Confirmative diagnostic results were reported in 39 (97.5%) patients. Accessibility of the safety route to target lesions did not reach statistical differences.

CONCLUSION:

Applying a new, real-time CEUS-Fusion with CT/MRI improved tumor visibility and viable portion assessment, thus leading to higher operator confidence and diagnostic yield, when compared with conventional USG-Fusion.

KEYWORDS:

Biopsy; Contrast agent; Liver; Neoplasm; Ultrasound imaging

PMID:
29671007
DOI:
10.1007/s00261-018-1608-y

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