Purpose: To determine the value of CEUS for real-time, fusion-guided, percutaneous biopsies of focal liver lesions. Materials and methods: Institutional review board approval and written informed consents were obtained for this study. Forty patients with focal liver lesions identified on CT/MRI were prospectively enrolled. For biopsy planning, real-time fusion of CT/MRI with USG (USG-Fusion) was performed, and subsequently realtime CEUS was fused with CT/MRI (CEUS-Fusion). We evaluated lesion visibility, confidence level of technical success before the procedure, and safety route accessibility on USG-Fusion and CEUS-Fusion. Occurrence of change in the biopsy target was also assessed. Results: Among 40 target lesions, nine (22.5%) lesions were invisible on USG-Fusion. After applying CEUS-Fusion, seven of nine (77.8%) lesions were visualized.Confidence level of technical success of procedure was significantly increased on CEUS-Fusion compared USG-Fusion (p = 0.02), and presumed target lesions were changed in 16 (40%) patients afterCEUS-Fusion. As the lesion is necrotic, presumed target wasmore frequently changed afterCEUS-Fusion (50.0%and 25.0%). Confirmative diagnostic results were reported in 39 (97.5%) patients. Accessibility of the safety route to target lesions did not reach statistical differences. Conclusion: Applying a new, real-time CEUS-Fusion with CT/MRI improved tumor visibility and viable portion assessment, thus leading to higher operator confidence and diagnostic yield, when compared with conventional USG-Fusion.
- Contrast agent
- Ultrasound imaging