Ultrasound fusion imaging for improving diagnostic and therapeutic strategies of focal liver lesions: A preliminary study

Abstract Purpose To assess the effect of ultrasound (US) fusion imaging on the clinical diagnostic and therapeutic strategies of focal liver lesions, which are difficult to detect or diagnose by conventional US. Methods From November 2019 to June 2022, 71 patients with invisible or undiagnosed focal liver lesions who underwent fusion imaging combining US with CT or MR were included in this retrospective study. The reasons for US fusion imaging were as follows: (1) lesions that were undetectable or inconspicuous on B‐mode US; (2) post‐ablation lesions that could not be assessed accurately by B‐mode US; (3) to evaluate whether the lesions detected by B‐mode US that were consistent with those presented on MRI/CT images. Results Of the 71 cases, 43 cases were single lesions, and 28 cases were multiple lesions. Among the 46 cases which were invisible on conventional US, the display rate of lesions using US‐CT/MRI fusion imaging was 30.8%, and that combined with CEUS was 76.9%. US‐guided biopsy was performed in 30 patients after the detection and localization determined by fusion imaging, with a positive rate of 73.3%. Six patients with recurrence after ablation therapy were all detected and located accurately after fusion imaging, and 4 of them successfully underwent ablation therapy again. Conclusion Fusion imaging contributes to the understanding of the anatomical relationship between lesion location and blood vessels. Additionally, fusion imaging can improve the diagnostic confidence, be helpful to guide interventional operations, and hence be conducive to clinical therapeutic strategies.