title: Fusion imaging-guided percutaneous biopsy of focal hepatic lesions with poor conspicuity on conventional sonography.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effectiveness of real-time fusion imaging (sonography combined with computed tomography or magnetic resonance imaging) for percutaneous sonographically guided biopsy of focal hepatic lesions with poor sonographic conspicuity.
  
  
  METHODS
  This study was conducted as a retrospective analysis of a prospective database and was approved by the Institutional Review Board. Patients who had target lesions with poor conspicuity on B-mode sonography for percutaneous biopsy were enrolled in the study. Lesion conspicuity was assessed by conventional B-mode sonography first and then by fusion imaging later in the same session. We compared lesion conspicuity and detection rates between B-mode sonography and fusion imaging and evaluated how many cases of initially invisible lesions on B-mode sonography became visible on fusion imaging. The technical success rate was evaluated on the basis of the final diagnoses, which were established by pathologic examination of the biopsy specimens as well as follow-up clinical and radiologic examinations.
  
  
  RESULTS
  A total of 22 patients were enrolled in the study. On fusion imaging, lesion conspicuity was increased in 63.6% of focal hepatic lesions (14 of 22). Moreover, 66.7% of lesions (6 of 9) that were invisible on B-mode sonography became visible on fusion imaging. The true-positive detection rate was significantly different between B-mode sonography and fusion imaging (9 of 22 versus 19 of 22; P = .0044). Percutaneous biopsy was performed for all lesions, including 3 target lesions that were invisible even on fusion imaging. The technical success rate was 95.5% (21 of 22).
  
  
  CONCLUSIONS
  Fusion imaging is effective for percutaneous biopsy of focal hepatic lesions with poor sonographic conspicuity.
authors: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea..
authors: Hyun Jeong
authors: HJ
authors: Park
authors: Min Woo
authors: MW
authors: Lee
authors: Mi Hee
authors: MH
authors: Lee
authors: Jiyoung
authors: J
authors: Hwang
authors: Tae Wook
authors: TW
authors: Kang
authors: Sanghyeok
authors: S
authors: Lim
authors: Hyunchul
authors: H
authors: Rhim
authors: Hyo K
authors: HK
authors: Lim
mesh_terms: D000328:Adult; D000368:Aged; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013382:Subtraction Technique / Q000706:statistics & numerical data*; D014463:Ultrasonography / Q000706:statistics & numerical data*
keywords: biopsy; conspicuity; fusion imaging; liver; sonography