Virtual navigator real-time ultrasound fusion imaging with positron emission tomography for liver interventions

Real-Time US-18FDG-PET/CT Image Fusion for Guidance of Thermal Ablation of 18FDG-PET-Positive Liver Metastases: The Added Value of Contrast Enhancement

PURPOSE

To assess the feasibility of US-¹⁸FDG-PET/CT fusion-guided microwave ablation of liver metastases either poorly visible or totally undetectable with US, CEUS and CT, but visualized by PET imaging.

MATERIALS AND METHODS

Twenty-three patients with 58 liver metastases underwent microwave ablation guided by image fusion system that combines US with ¹⁸FDG-PET/CT images. In 28/58 tumors, ¹⁸FDG-PET/CT with contrast medium (PET/CECT) was used. The registration technical feasibility, registration time, rates of correct targeting, technical success at 24 h, final result at 1 year and complications were analyzed and compared between the PET/CT and PET/CECT groups.

RESULTS

Registration was successfully performed in all cases with a mean time of 7.8 + 1.7 min (mean + standard deviation), (4.6 + 1.5 min for PET/CECT group versus 10.9 + 1.8 min for PET/CT group, P < 0.01). In total, 46/58 (79.3%) tumors were correctly targeted, while 3/28 (10.7%) and 9/30 (30%) were incorrectly targeted in PET/CT and PET/CECT group, respectively (P < 0.05). Complete ablation was obtained at 24 h in 70.0% of cases (n = 40 tumors), 23/28 (82.1%) in the PET/CECT group and 17/30 (56.7%) in the PET/CT group (P < 0.037). Fourteen tumors underwent local retreatment (11 ablations, 2 with resection and 1 with stereotactic body radiation therapy), while 4 tumors could not be retreated because of distant disease progression and underwent systemic therapy. Finally, 54/58 (93.1%) tumors were completely treated at 1 year. One major complication occurred, a gastrointestinal hemorrhage which required surgical repair.

CONCLUSIONS

Percutaneous ablation of ¹⁸FDG-PET-positive liver metastases using fusion imaging of real-time US and pre-acquired ¹⁸FDG-PET/CT images is feasible, safe and effective. Contrast-enhanced PET/CT improves overall ablation accuracy and shortens procedural duration time.

Sensor Fusion and Smart Sensor in Sports and Biomedical Applications

The following work presents an overview of smart sensors and sensor fusion targeted at biomedical applications and sports areas. In this work, the integration of these areas is demonstrated, promoting a reflection about techniques and applications to collect, quantify and qualify some physical variables associated with the human body. These techniques are presented in various biomedical and sports applications, which cover areas related to diagnostics, rehabilitation, physical monitoring, and the development of performance in athletes, among others. Although some applications are described in only one of two fields of study (biomedicine and sports), it is very likely that the same application fits in both, with small peculiarities or adaptations. To illustrate the contemporaneity of applications, an analysis of specialized papers published in the last six years has been made. In this context, the main characteristic of this review is to present the largest quantity of relevant examples of sensor fusion and smart sensors focusing on their utilization and proposals, without deeply addressing one specific system or technique, to the detriment of the others.

Magnetic Resonance Imaging-Ultrasound Fusion-Guided Prostate Biopsy: Review of Technology, Techniques, and Outcomes

Transrectal ultrasound (TRUS)-guided (12-14 core) systematic biopsy of the prostate is the recommended standard for patients with suspicion of prostate cancer (PCa). Advances in imaging have led to the application of magnetic resonance imaging (MRI) for the detection of PCa with subsequent development of software-based co-registration allowing for the integration of MRI with real-time TRUS during prostate biopsy. A number of fusion-guided methods and platforms are now commercially available with common elements in image and analysis and planning. Implementation of fusion-guided prostate biopsy has now been proven to improve the detection of clinically significant PCa in appropriately selected patients.