title: Characterization by biopsy or CEUS of liver lesions guided by image fusion between ultrasonography and CT, PET/CT or MRI.
abstract: OBJECTIVE
  The aim of this study was to show the number of cases in which the use of fusion-guided ultrasonography (US) provided conclusive diagnosis of lesions in the liver seen on CT or MRI or PET/CT. A lesion is defined as a region that has suffered damage due to injury or disease.
  
  
  METHODS
  Forty patients of whom 34 had confirmed neoplastic disease, referred to US evaluation or US-guided biopsy of liver lesions seen on CT (n = 35), MRI (n = 2) or PET/CT (n = 3), were prospectively included in the study. We used a LOGIQ prototype system with incorporated software for fusion imaging, and a convex-array 4 MHz transducer (GE Healthcare, Chalfont St. Giles, UK). All patients were initially examined with B-mode US, then by fusion-guided US and for some patients also with CEUS. All patients received follow-up after at least one year.
  
  
  RESULTS
  Twenty-six lesions were initially indistinguishable with US. Of these, 9 became visible with fusion-guided US and another 4 became visible with CEUS, which facilitated a final diagnosis in 11 of these 13 patients. The median tumor size for all lesions included in the study was 1.5 cm (interquartile range: 1.0 - 2.4). There was no statistically significant difference in tumor size between the groups.
  
  
  CONCLUSIONS
  We have successfully demonstrated an increase in the characterization of liver lesions by using fusion-guided US compared with conventional B-mode US.
authors.affiliation: Department of Radiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen OE, Denmark. caroline.ewertsen@dadlnet.dk
authors.forename: C
authors.initials: C
authors.lastname: Ewertsen
authors.forename: B M
authors.initials: BM
authors.lastname: Henriksen
authors.forename: S
authors.initials: S
authors.lastname: Torp-Pedersen
authors.forename: M
authors.initials: M
authors.lastname: Bachmann Nielsen
mesh_terms: D000328:Adult; D001706:Biopsy / Q000295:instrumentation* / Q000379:methods*; D003718:Denmark; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000295:instrumentation* / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000556:secondary*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012984:Software; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000295:instrumentation* / Q000379:methods*