Fusion Imaging Techniques in Liver Tumor Ablation

Fusion imaging integrates pre-procedural cross-sectional datasets—such as contrast-enhanced computed tomography and magnetic resonance imaging—with real-time ultrasonography to guide percutaneous liver tumour ablation. By co-registering these modalities, operators achieve precise device placement even for lesions that are small, deep-seated or poorly visible on conventional ultrasound. Recent developments include three-dimensional ultrasound fusion, contrast-enhanced ultrasound overlay and the use of cone-beam CT within angiographic suites to confirm target coverage during thermal ablation. These innovations permit immediate intra-procedural assessment of ablative margins and enable prompt supplementary treatment where necessary, reducing local tumour progression. As a result, fusion imaging has expanded the indications for radiofrequency and microwave ablation, improved safety in high-risk locations, and facilitated standardisation of protocols across institutions, thereby enhancing global outcomes in hepatocellular carcinoma management.

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Fusion Imaging Techniques in Liver Tumor Ablation publication trend

The graph below shows the total number of articles in fusion imaging techniques in liver tumor ablation across all publications each year (not limited to Nature Index journals).

Technical terms

Fusion imaging: The co-registration and simultaneous display of datasets from two or more imaging modalities to enhance anatomical localisation and procedural guidance.

Contrast-enhanced ultrasound (CEUS): The use of intravenous microbubble agents to improve ultrasound visualisation of vascular structures and lesion margins.

Cone-beam CT (CBCT): A volumetric imaging technique performed within an angiographic suite that provides intra-procedural cross-sectional images for registration with other modalities.

Radiofrequency ablation (RFA): A thermal treatment that uses alternating current to generate ionic friction and coagulative necrosis within tumours.

Microwave ablation (MWA): A form of thermal therapy that employs electromagnetic waves to agitate water molecules and induce cell death in target tissues.

Ablative margin (AM): The rim of normal tissue surrounding the tumour that has been successfully treated, typically measured to ensure at least 5 mm of coverage.

Image registration: The computational alignment of images from different times or modalities to the same coordinate system for accurate overlay and navigation.

References

1. Role of Fusion Imaging in Image-Guided Thermal Ablations. Diagnostics (2021).
2. Ultrasound and cone beam CT fusion for liver ablation: technical note. International Journal of Hyperthermia (2018).
3. Three-dimensional contrast-enhanced ultrasound fusion imaging predicts local tumor progression by evaluating ablative margin of radiofrequency ablation for hepatocellular carcinoma: a preliminary report. International Journal of Hyperthermia (2018).
4. Percutaneous Microwave Ablation of Hepatocellular Carcinoma with “Double Fusion” Technique: Technical Note and Single-Center Preliminary Experience. Diagnostics (2023).
5. Contrast-enhanced ultrasonography–CT/MRI fusion guidance for percutaneous ablation of inconspicuous, small liver tumors: improving feasibility and therapeutic outcome. Cancer Imaging (2024).
6. Efficacy of fusion imaging for immediate post‐ablation assessment of malignant liver neoplasms: A systematic review. Cancer Medicine (2023).