Targeting liver lesions for radiofrequency ablation: an experimental feasibility study using a CT-US fusion imaging system
- PMID: 18097275
- DOI: 10.1097/RLI.0b013e31815597dc
Targeting liver lesions for radiofrequency ablation: an experimental feasibility study using a CT-US fusion imaging system
Abstract
Purpose: To investigate the feasibility and validity of real-time guidance using a fusion imaging system that combines ultrasound (US) and computed tomography (CT) in the targeting and subsequent radiofrequency (RF) ablation of a liver target inconspicuous on US.
Methods and materials: The study was designed as an experimental ex vivo study in calf livers with radiopaque internal targets, inconspicuous at US, simulating a focal liver lesion. The study included 2 phases. The initial phase was to examine the feasibility of matching preprocedural volumetric CT data of the calf livers with real-time US using a commercially available multimodality fusion imaging system (Virtual Navigator System, Esaote SpA, Genoa, Italy), and to assess the accuracy of targeting using a 22 gauge cytologic needle. The second phase of the study was to validate such a technique using a 15 gauge RF multitined expandable needle (RITA Medical Systems, Mountain View, CA) and to examine the accuracy of the needle placement relative to the target. The tip of the trocar of the RF needle had to be placed 1 cm from the target and then the hooks had to be deployed to 3 cm. Unenhanced CT of the liver and multiplanar reconstructions were performed to calculate accuracy of positioning, ie, the lateral distance between the needle and the target, the distance between the tip of the trocar of the RF electrode and the target, and the lateral distance between the central tine of the RF electrode and the target.
Results: All calf livers underwent successful CT-US registration with a mean registration error of 3.0 +/- 0.1 mm and 2.9 +/- 0.1 mm in the initial and second phase of the study, respectively. In the initial phase an overall number of 24 insertions were performed after the US-CT guidance. The mean needle to target distance was 1.9 +/- 0.7 mm (range, 0.8-3.0 mm). In the second phase an overall number of 12 ablations were performed. The mean target-trocar distance was 10.3 +/- 2.6 mm. The mean target-central tine lateral distance was 3.9 +/- 0.7 mm (range, 2.9-5.1 mm). After the dissection of the specimen the target was found unchanged in the center of the ablation zone in all cases.
Conclusion: Real-time registration and fusion of preprocedure CT volume images with intraprocedure US is feasible and accurate. The study was however conducted in an ideal experimental setting, without patient movements and breathing, and further studies are warranted to validate the system under clinical conditions.
Similar articles
-
Microwave ablation assisted by a computerised tomography-ultrasonography fusion imaging system for liver lesions: an ex vivo experimental study.Int J Hyperthermia. 2011;27(2):172-9. doi: 10.3109/02656736.2010.515649. Int J Hyperthermia. 2011. PMID: 21314335
-
Volume comparison of radiofrequency ablation at 3- and 5-cm target volumes for four different radiofrequency generators: MR volumetry in an open 1-T MRI system versus macroscopic measurement.Biomed Tech (Berl). 2015 Dec;60(6):521-31. doi: 10.1515/bmt-2014-0174. Biomed Tech (Berl). 2015. PMID: 26057213
-
Evaluation of an electromagnetic image-fusion navigation system for biopsy of small lesions: assessment of accuracy in an in vivo swine model.Acad Radiol. 2013 Feb;20(2):209-17. doi: 10.1016/j.acra.2012.09.020. Acad Radiol. 2013. PMID: 23395242
-
Real-time image fusion for successful percutaneous radiofrequency ablation of hepatocellular carcinoma.J Ultrasound Med. 2014 Nov;33(11):2005-10. doi: 10.7863/ultra.33.11.2005. J Ultrasound Med. 2014. PMID: 25336489 Review.
-
Usefulness of the multimodality fusion imaging for the diagnosis and treatment of hepatocellular carcinoma.Dig Dis. 2012;30(6):580-7. doi: 10.1159/000343070. Epub 2012 Dec 13. Dig Dis. 2012. PMID: 23258098 Review.
Cited by
-
Phantom Study Investigating the Accuracy of Manual and Automatic Image Fusion with the GE Logiq E9: Implications for use in Percutaneous Liver Interventions.Cardiovasc Intervent Radiol. 2017 Jun;40(6):914-923. doi: 10.1007/s00270-017-1607-3. Epub 2017 Feb 15. Cardiovasc Intervent Radiol. 2017. PMID: 28204959 Free PMC article.
-
Real-time virtual sonography visualization and its clinical application in biliopancreatic disease.World J Gastroenterol. 2013 Nov 14;19(42):7419-25. doi: 10.3748/wjg.v19.i42.7419. World J Gastroenterol. 2013. PMID: 24259973 Free PMC article.
-
Estimated effective dose of CT-guided percutaneous cryoablation of liver tumors.Eur J Radiol. 2012 Aug;81(8):1702-6. doi: 10.1016/j.ejrad.2011.04.067. Epub 2011 Jun 8. Eur J Radiol. 2012. PMID: 21645981 Free PMC article. Clinical Trial.
-
CT-guided versus laparoscopic radiofrequency ablation in recurrent small hepatocellular carcinoma against the diaphragmatic dome.Sci Rep. 2017 Mar 14;7:44583. doi: 10.1038/srep44583. Sci Rep. 2017. PMID: 28291254 Free PMC article.
-
Value-assessment of computer-assisted navigation strategies during percutaneous needle placement.Int J Comput Assist Radiol Surg. 2022 Oct;17(10):1775-1785. doi: 10.1007/s11548-022-02719-8. Epub 2022 Aug 7. Int J Comput Assist Radiol Surg. 2022. PMID: 35934773 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical