title: Percutaneous Thermal Ablation with Ultrasound Guidance. Fusion Imaging Guidance to Improve Conspicuity of Liver Metastasis.
abstract: OBJECTIVE
  To assess whether fusion imaging-guided percutaneous microwave ablation (MWA) can improve visibility and targeting of liver metastasis that were deemed inconspicuous on ultrasound (US).
  
  
  METHODS
  MWA of liver metastasis not judged conspicuous enough on US was performed under CT/US fusion imaging guidance. The conspicuity before and after the fusion imaging was graded on a five-point scale, and significance was assessed by Wilcoxon test. Technical success, procedure time, and procedure-related complications were evaluated.
  
  
  RESULTS
  A total of 35 patients with 40 liver metastases (mean size 1.3 ± 0.4 cm) were enrolled. Image fusion improved conspicuity sufficiently to allow fusion-targeted MWA in 33 patients. The time required for image fusion processing and tumors' identification averaged 10 ± 2.1 min (range 5-14). Initial conspicuity on US by inclusion criteria was 1.2 ± 0.4 (range 0-2), while conspicuity after localization on fusion imaging was 3.5 ± 1 (range 1-5, p < 0.001). Technical success rate was 83% (33/40) in intention-to-treat analysis and 100% in analysis of treated tumors. There were no major procedure-related complications.
  
  
  CONCLUSIONS
  Fusion imaging broadens the scope of US-guided MWA to metastasis lacking adequate conspicuity on conventional US. Fusion imaging is an effective tool to increase the conspicuity of liver metastases that were initially deemed non visualizable on conventional US imaging.
authors.affiliation: Interventional Radiology Department, Gustave Roussy - Cancer Campus, Edouard Vaillant, 94805, Villejuif, France. thakime@yahoo.com.|Imagerie Médicale Paris Centre, IMPC, 135bis rue blomet, 75015, Paris, France. thakime@yahoo.com.
authors.forename: Antoine
authors.identifier: http://orcid.org/0000-0002-0546-9786
authors.initials: A
authors.lastname: Hakime
authors.affiliation: Interventional Radiology Department, Gustave Roussy - Cancer Campus, Edouard Vaillant, 94805, Villejuif, France.|University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Yevich
authors.affiliation: Interventional Radiology Department, Gustave Roussy - Cancer Campus, Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Lambros
authors.initials: L
authors.lastname: Tselikas
authors.affiliation: Interventional Radiology Department, Gustave Roussy - Cancer Campus, Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Deschamps
authors.affiliation: Imagerie Médicale Paris Centre, IMPC, 135bis rue blomet, 75015, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Petrover
authors.affiliation: Interventional Radiology Department, Gustave Roussy - Cancer Campus, Edouard Vaillant, 94805, Villejuif, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: De Baere
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery*; D008297:Male; D008872:Microwaves; D008875:Middle Aged; D064847:Multimodal Imaging; D011446:Prospective Studies; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
keywords: Fusion imaging; Liver metastases; Thermal ablation