Image fusion-guided liver ablation: an effective tool for ultrasound invisible lesions

Benjamín Horwitz-Zanolli, Departamento de Imágenes, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
Nicolás Radic-González, Departamento de Imágenes, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
Antonio Vallejos-Cabezas, Departamento de Imágenes, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
Patricio Vargas-Hudson, Departamento de Imágenes, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
Roberto Muñoz-Estrada, Departamento de Imágenes, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
Paula Araneda-Castiglioni, Departamento de Imágenes, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
Diego Constenla-Vásquez, Departamento de Imágenes, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile

Introduction: Ultrasound (US)-guided percutaneous ablation is an effective alternative for the treatment of liver tumors. However, its utility decreases in small or iso-echoic lesions. Image fusion allows localization of these lesions, increasing treatment options and reducing complication rates. Objective: To describe our center’s experience with image fusion-guided liver tumor ablation and to assess its clinical utility and reproducibility. Material and methods: We conducted a retrospective study of image fusion-guided liver ablations performed between 2017 and 2023 at our center. A descriptive analysis was performed, including variables such as age, sex, tumor size and histology, US visibility, technical success, local recurrence, and complications. Results: A total of 134 ablations were performed in 62 patients. Hepatocellular carcinoma accounted for 81% of cases, followed by metastases. Lesions were visible by conventional US in 43% of cases and in 100% with image fusion. The technical success rate was 90% after the first session and 94% after a second. Local recurrence was 12%. No major complications were reported. Conclusion: Image fusion-guided liver ablation is a safe, effective, and useful technique, particularly for the treatment of small lesions.

Keywords: r neoplasm. Image fusion. Ablation techniques. Interventional ultrasonography.