Real-Time US-CT/MRI Image Fusion for Guidance of Thermal Ablation of Liver Tumors Undetectable with US: Results in 295 Cases
Real-Time US-CT/MRI Image Fusion for Guidance of Thermal Ablation of Liver Tumors Undetectable with US: Results in 295 Cases
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DOI：
10.1007/s00270-014-0897-y
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发表时间：
2015-02-01
影响因子：
2.9
通讯作者：
Solbiati, Luigi
中科院分区：
文献类型：
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作者：
Mauri, Giovanni;Cova, Luca;Solbiati, Luigi
本研究旨在评估US-CT/MRI融合引导消融治疗超声无法检测到的肝脏肿瘤的可行性。肝癌162例，转移瘤133例;平均直径1.3 +/- A 0.6 cm，范围0.5-2.5 cm），可在对比增强CT/MRI上检测到，但是用未增强的US完全检测不到并且用对比增强的US（CEUS）完全检测不到或不完全明显，在215次治疗中，使用内部冷却射频或微波与标准消融方案，由图像融合系统（虚拟导航系统，Esaote S.p.A.，热那亚，意大利），结合了US和CT/ MRI图像。24 h后CT或MRI证实靶向正确，消融成功，282/295（95.6%）肿瘤靶向正确，266/295（90.2%）肿瘤消融成功。295个肿瘤中有16个（5.4%）被正确靶向，但未成功消融，295个肿瘤中有13个（4.4%）由于靶向不准确而未成功消融。无围手术期死亡。在215次治疗中，有2次（0.9%）观察到严重并发症。实时虚拟导航系统与US-CT/MRI融合成像可精确定位并成功消融仅使用US无法检测到的靶肿瘤。因此，更多的人群可以从超声引导消融手术中受益。
This study was designed to assess feasibility of US-CT/MRI fusion-guided ablation in liver tumors undetectable with US.From 2002 to 2012, 295 tumors (162 HCCs and 133 metastases; mean diameter 1.3 +/- A 0.6 cm, range 0.5-2.5 cm) detectable on contrast-enhanced CT/MRI, but completely undetectable with unenhanced US and either totally undetectable or incompletely conspicuous with contrast-enhanced US (CEUS), were treated in 215 sessions using either internally cooled radiofrequency or microwave with standard ablation protocols, guided by an image fusion system (Virtual Navigation System, Esaote S.p.A., Genova, Italy) that combines US with CT/ MRI images. Correct targeting and successful ablation of tumor were verified after 24 hours with CT or MRI.A total of 282 of 295 (95.6 %) tumors were correctly targeted with successful ablation achieved in 266 of 295 (90.2 %). Sixteen of 295 (5.4 %) tumors were correctly targeted, but unsuccessfully ablated, and 13 of 295 (4.4 %) tumors were unsuccessfully ablated due to inaccurate targeting. There were no perioperative deaths. Major complications were observed in 2 of the 215 treatments sessions (0.9 %).Real-time virtual navigation system with US-CT/MRI fusion imaging is precise for targeting and achieving successful ablation of target tumors undetectable with US alone. Therefore, a larger population could benefit from ultrasound guided ablation procedures.