Added Value of Contrast-Enhanced Ultrasound on Biopsies of Focal Hepatic Lesions Invisible on Fusion Imaging Guidance

• Published in: Korean journal of radiology Vol. 18; no. 1; pp. 152 - 161
• Main Authors: Kang, Tae Wook, Lee, Min Woo, Song, Kyoung Doo, Kim, Mimi, Kim, Seung Soo, Kim, Seong Hyun, Ha, Sang Yun
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.01.2017; 대한영상의학회
• Subjects: Adult; Aged; Aged, 80 and over; Biopsy; Clinical Decision-Making; Communications systems; Contrast agents; Contrast Media - chemistry; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Female; Ferric Compounds - chemistry; Gastrointestinal Imaging; Humans; Iron - chemistry; Liver cancer; Liver Diseases - diagnosis; Liver Diseases - diagnostic imaging; Liver Diseases - pathology; Male; Middle Aged; Oxides - chemistry; Patients; Positron Emission Tomography Computed Tomography; Retrospective Studies; Skin; Ultrasonic imaging; Young Adult; 방사선과학; United States > US; Fusion imaging; Biopsy; Sonazoid; Contrast-enhanced ultrasonography; Liver
• ISSN: 1229-6929; 2005-8330
• DOI: 10.3348/kjr.2017.18.1.152

To assess whether contrast-enhanced ultrasonography (CEUS) with Sonazoid can improve the lesion conspicuity and feasibility of percutaneous biopsies for focal hepatic lesions invisible on fusion imaging of real-time ultrasonography (US) with computed tomography/magnetic resonance images, and evaluate its impact on clinical decision making. The Institutional Review Board approved this retrospective study. Between June 2013 and January 2015, 711 US-guided percutaneous biopsies were performed for focal hepatic lesions. Biopsies were performed using CEUS for guidance if lesions were invisible on fusion imaging. We retrospectively evaluated the number of target lesions initially invisible on fusion imaging that became visible after applying CEUS, using a 4-point scale. Technical success rates of biopsies were evaluated based on histopathological results. In addition, the occurrence of changes in clinical decision making was assessed. Among 711 patients, 16 patients (2.3%) were included in the study. The median size of target lesions was 1.1 cm (range, 0.5-1.9 cm) in pre-procedural imaging. After CEUS, 15 of 16 (93.8%) focal hepatic lesions were visualized. The conspicuity score was significantly increased after adding CEUS, as compared to that on fusion imaging (p < 0.001). The technical success rate of biopsy was 87.6% (14/16). After biopsy, there were changes in clinical decision making for 11 of 16 patients (68.8%). The addition of CEUS could improve the conspicuity of focal hepatic lesions invisible on fusion imaging. This dual guidance using CEUS and fusion imaging may affect patient management via changes in clinical decision-making.