Value of four-dimensional ultrasonography in ultrasonographically guided biopsy of hepatic masses.
OBJECTIVE
To assess the value of four-dimensional ultrasonography (dynamic three-dimensional ultrasonography with the added dimension of time) in ultrasonographically guided biopsy procedures of focal hepatic masses.


METHODS
Four-dimensional ultrasonographically guided biopsy experiments using a freehand technique were performed in phantoms that simulated human liver tissue and had target material. After the protocol was determined and Institutional Review Board approval was obtained, 12 patients underwent four-dimensional ultrasonographically guided biopsy of focal hepatic masses by informed consent. Planar images using 3 orthogonal planes plus a volume-rendered image were used for real-time guidance during the biopsy procedure.


RESULTS
Four-dimensional ultrasonography improved visualization of biopsy devices in all 12 patients (100%) regardless of minor changes in transducer position during the biopsy procedures. Four-dimensional ultrasonography allowed more intuitive apprehension of the spatial relationship of the needle and the target lesion and thus helped in adjusting the needle to an optimal prefiring position in 8 patients (67%). With regard to procedure time, four-dimensional ultrasonographically guided biopsy was comparable with standard two-dimensional ultrasonographically guided techniques.


CONCLUSIONS
Compared with standard two-dimensional ultrasonographically guided biopsy, four-dimensional ultrasonography provides improved visualization of biopsy devices and more perceptible information on the spatial relationship between the biopsy needle and the target lesion.
Won
Hyung Jin
HJ
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, South Korea.
Han
Joon Koo
JK
Do
Kyung-Hyun
KH
Lee
Kyoung Ho
KH
Kim
Kyoung Won
KW
Kim
Se Hyung
SH
Yoon
Chang Jin
CJ
Kim
Yoon Jun
YJ
Park
Chang Min
CM
Choi
Byung Ihn
BI
D001707:Biopsy, Needle / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019047:Phantoms, Imaging; D014463:Ultrasonography / Q000379:methods*