Applications of Technical Fusion in Uroradiology

Abstract

Technical fusion is defined as the ultrasound-guided navigation through a previously generated 3 D imaging dataset such as a computed tomography (CT) or magnetic resonance imaging (MRI). This technique allows for moving the fused CT/MRI datasets synchroneously with the real-time ultrasound in the same plane. Established and furthermore not yet described applications, the technical principles and the limitations of this promising technique will be introduced.

Key points:

• improves detection rates of lesions on ultrasound

• more reliable size controls at different time points

• may be an alternative to in bore biopsies

• can be used for focal therapy

Citation Format:

• Aigner F, De Zordo T, Pallwein-Prettner L et al. Applications of Technical Fusion in Uroradiology. Fortschr Röntgenstr 2015; 187: 331 – 337

Zusammenfassung

Unter technischer Fusion versteht man das ultraschallgeführte Navigieren durch einen zuvor generierten 3D-Bildatensatz wie beispielsweise einer Computertomografie (CT) oder Kernspintomografie (MRT). Diese Technik erlaubt es, die in das Ultraschallgerät eingespielten CT/MRT-Datensätze simultan mit dem durchgeführten Echtzeitultraschall zu bewegen, nachdem selbe Schichtpositionen anhand bestimmter anatomischer „Landmarken“ registriert wurden. In der vorliegenden Arbeit werden etablierte, aber auch noch nicht beschriebene Einsatzmöglichkeiten, die Technik und die Limitationen dieser interessanten Methode auf dem Gebiete der Uroradiologie beschrieben.

Key words

fusion imaging - targeted biopsy - ultrasound - prostate cancer - renal lesion - contrast enhanced ultrasound

• Literatur

• 1 Nakano S, Yoshida M, Fujii K et al. Fusion of MRI and sonography image for breast cancer evaluation using real-time virtual sonography with magnetic navigation: first experience. Jpn J Clin Oncol 2009; 39: 552-559
• 2 Nakano S, Ando T, Tetsuka R et al. Reproducible surveillance breast ultrasound using an image fusion technique in a short-interval follow-up for BI-RADS 3 lesions: a pilot study. Ultrasound Med Biol 2014; 40: 1049-1057
• 3 Wysock JS, Rosenkrantz AB, Huang WC et al. A Prospective, Blinded Comparison of Magnetic Resonance (MR) Imaging-Ultrasound Fusion and Visual Estimation in the Performance of MR-targeted Prostate Biopsy: The PROFUS Trial. Eur Urol 2013; pii: S0302-2838(13)01186-X [Epub ahead of print]
• 4 Gómez Veiga F, Ponce Reixa J, Barbagelata López A et al. Current role of PSA and other markers in the diagnosis of prostate cancer. Arch Esp Urol 2006; 59: 1069-1082
• 5 Norberg M, Egevad L, Holmberg L et al. The sextant protocol for ultrasound-guided core biopsies of the prostate underestimates the presence of cancer. Urology 1997; 50: 562-566
• 6 Johnson LM, Turkbey B, Figg WD et al. Multiparametric MRI in prostate cancer management. Nat Rev Clin Oncol 2014; 11: 346-353
• 7 Boesen L, Noergaard N, Chabanova E et al. Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy. Scand J Urol 2014; 12: 1-10
• 8 Polanec SH, Helbich TH, Margreiter M et al. Magnetic resonance imaging-guided prostate biopsy: institutional analysis and systematic review. Fortschr Röntgenstr 2014; 186: 501-507
• 9 Brock M, Roghmann F, Sonntag C et al. Fusion of Magnetic Resonance Imaging and Real-Time Elastography to Visualize Prostate Cancer: A Prospective Analysis using Whole Mount Sections after Radical Prostatectomy. Ultraschall in Med 2014; [Epub ahead of print]
• 10 Durmus T, Stephan C, Grigoryev M et al. Detection of prostate cancer by real-time MR/ultrasound fusion-guided biopsy: 3T MRI and state of the art sonography. Fortschr Röntgenstr 2013; 185: 428-433
• 11 Robertson NL, Emberton M, Moore CM. MRI-targeted prostate biopsy: a review of technique and results. Nat Rev Urol 2013; 10: 589-597
• 12 Volkin D, Turkbey B, Hoang AN et al. Multiparametric MRI and Subsequent MR/Ultrasound Fusion-Guided Biopsy Increase the Detection of Anteriorly Located Prostate Cancers. BJU Int 2014; [Epub ahead of print]
• 13 Da Rosa MR, Milot L, Sugar L et al. A prospective comparison of MRI-US fused targeted biopsy versus systemic ultrasound-guided biopsy for detecting clinically significant prostate cancer in patients on active surveillance. J Magn Reson Imaging 2014; [Epub ahead of print]
• 14 Helck A, D'Anastasi M, Notohamiprodjo M et al. Multimodality imaging using ultrasound image fusion in renal lesions. Clin Hemorheol Microcirc 2012; 50: 79-89
• 15 Del Viscovo L, Ginolfi F, Rotondo A et al. Errors of magnetic resonance in the diagnosis of small renal tumors. Radiol Med 1993; 86: 847-850
• 16 Clevert DA, Minaifar N, Weckbach S et al. Multislice computed tomography versus contrast-enhanced ultrasound in evaluation of complex cystic renal masses using the Bosniak classification system. Clin Hemorheol Microcirc 2008; 39: 171-178
• 17 Piscaglia F, Nolsøe C, Dietrich CF et al. The EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall in Med 2012; 33: 33-59
• 18 Tamai H, Takiguchi Y, Oka M et al. Contrast-enhanced ultrasonography in the diagnosis of solid renal tumors. J Ultrasound Med 2005; 24: 1635-1640
• 19 Correas JM, Claudon M, Tranquart F et al. The kidney: imaging with microbubble contrast agents. Ultrasound Q 2006; 22: 53-66
• 20 Mazziotti S, Zimbaro F, Pandolfo A et al. Usefulness of contrast-enhanced ultrasonography in the diagnosis of renal pseudotumors. Abdom Imaging 2010; 35: 241-245
• 21 Quaia E, Bertolotto M, Cioffi V et al. Comparison of contrast-enhanced sonography with unenhanced sonography and contrast-enhanced CT in the diagnosis of malignancy in complex cystic renal masses. Am J Roentgenol 2008; 191: 1239-1249
• 22 Park BK, Kim B, Kim SH et al. Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US. Eur J Radiol 2007; 61: 310-314
• 23 Ascenti G, Mazziotti S, Zimbaro G et al. Complex cystic renal masses: characterization with contrast-enhanced US. Radiology 2007; 243: 158-165
• 24 Mauri G, Cova L, De Beni S et al. Real-Time US-CT/MRI Image Fusion for Guidance of Thermal Ablation of Liver Tumors Undetectable with US: Results in 295 Cases. Cardiovasc Intervent Radiol 2014; [Epub ahead of print]
• 25 Xu ZF, Xie XY, Kuang M et al. Percutaneous radiofrequency ablation of malignant liver tumors with ultrasound and CT fusion imaging guidance. J Clin Ultrasound 2014; 42: 321-330
• 26 Ukimura O, Mitterberger M, Okihara K et al. Real-time virtual ultrasonographic radiofrequency ablation of renal cell carcinoma. BJU Int 2008; 101: 707-711
• 27 Amalou H, Wood BJ. Multimodality Fusion with MRI, CT, and Ultrasound Contrast for Ablation of Renal Cell Carcinoma. Case Rep Urol 2012; 2012 : DOI 10.1155/2012/390912
• 28 Schilling D, Kurosch M, Mager R et al. Fusion imaging in urology: combination of MRI and TRUS for detection of prostate cancer. Urologe A 2013; 52: 481-489
• 29 Junker D, De Zordo T, Quentin M et al. Real-time elastography of the prostate. Biomed Res Int 2014; 2014 , DOI: 10.1155/2014/180804
• 30 Logan JK, Rais-Bahrami S, Turkbey B et al. Current status of magnetic resonance imaging (MRI) and ultrasonography fusion software platforms for guidance of prostate biopsies. BJU Int 2013; [Epub ahead of print]
• 31 Pokorny M, Van de Ven W, Barentsz J et al. Reply to Yaalini Shanmugabavan, Stephanie Guillaumier and Hashim U. Ahmed's Letter to the Editor re: Morgan R. Pokorny, Maarten de Rooij, Earl Duncan, et al. Prospective Study of Diagnostic Accuracy Comparing Prostate Cancer Detection by Transrectal Ultrasound-Guided Biopsy Versus Magnetic Resonance (MR) Imaging with Subsequent MR-guided Biopsy in Men Without Previous Prostate Biopsies. Eur Urol 2014; Article in Press
• 32 Ukimura O, Desai MM, Palmer S et al. 3-Dimensional elastic registration system of prostate biopsy location by real-time 3-dimensional transrectal ultrasound guidance with magnetic resonance/transrectal ultrasound image fusion. J Urol 2012; 187: 1080-1086