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Perspectives in Medicine (2012) 1, 8081

Bartels E, Bartels S, Poppert H (Editors):

New Trends in Neurosonology and Cerebral Hemodynamics an Update.
Perspectives in Medicine (2012) 1, 8081

journal homepage: www.elsevier.com/locate/permed

Ultrasound fusion imaging

Jeffrey Stoll

Siemens Ultrasound, Mountain View, CA, USA

KEYWORDS Summary Condent interpretation of image data is critical for the success of complex cases.
By enabling the simultaneous live navigation of reference series, such as CT, MRI and PET, side-
by-side with live ultrasound, fusion imaging enables the physician to directly correlate anatomy
between modalities. This display facilitates interpretation of ultrasound and communication of
2012 Elsevier GmbH. Open access under CC BY-NC-ND license.

Ultrasound fusion is an emerging technique in the eld of visualizing the same anatomy from the same view angle.
abdominal imaging with translation possibilities to neuro- Ultrasound is also useful for guiding biopsies for denitive
radiology. This technique involves the co-registered display diagnosis. Once again, clear correlation with CT or MRI is
of live ultrasound with a reference series from another required to condently target a specic lesion. Fusion imag-
modality, such as CT, MRI or PET [1,2]. As the ultrasound ing also has potential as a training tool, similarly allowing
exam is performed the fusion system continuously generates trainees to better understand ultrasound in the context of
reformatted planes from the reference series matching the CT or MRI.
oblique imaging planes of the ultrasound transducer. The Fusion imaging makes use of a tracking system to
reformatted planes are displayed either as an overlay or localize ultrasound transducers and other devices rela-
side-by-side with the live ultrasound (Figs. 1 and 2). This tive to the patient. Optical and electromagnetic systems
display enhances interpretation of ultrasound by enabling a are available, the latter being most commonly used. Var-
direct comparison with the reference images from the same ious software tools are also used to bring the reference
view angle. series into alignment with the tracking system for fusion
The combined use of different modalities for denitive display [36]. Research into these tools has been ongo-
diagnosis is common. Ultrasound, for instance, is useful to ing for approximately 20 years. Clinical implementation
assess indeterminate lesions identied in CT or MRI. A con- of fusion imaging has suffered, however, due to the time
dent diagnosis can be made if a clear correlation can be required to achieve adequate alignment using traditional
made between ultrasound and the preceding series. How- methods. Recent advancements in automatic image analysis
ever, if a physician is not condent that ultrasound has may potentially reduce this time greatly.
found the correct lesion, the case may be further referred to Tracking sensors are also incorporated into some inter-
another modality with increased time, cost and potentially ventional devices such as introducers and ablation needles,
mixed results. Fusion imaging enables greater condence enabling the display of needle location as an overlay on
in establishing a clear correlation between modalities by live ultrasound images (Fig. 2). This display can be use-
ful for overcoming difculties in visualizing needles during
ultrasound-guided procedures [7]. Such devices may allow
procedures to be completed more quickly and with fewer
E-mail addresses: jeffrey.stoll@siemens.com,
placement attempts, particularly for more complex cases
jeff.stoll@gmail.com (Fig. 3).

2211-968X 2012 Elsevier GmbH. Open access under CC BY-NC-ND license.

Ultrasound fusion imaging 81

Figure 1 Ultrasound (right) fused with a contrast CT of the Figure 3 Needle spatial tracking data overlaid graphically on
liver (left). The ultrasound image is taken from an oblique plane live ultrasound images. The colors indicate parts of the needle
showing the hepatic vasculature. The same vasculature is visu- behind and in front of the ultrasound image. The display enables
alized in the same anatomical plane from the CT. the physician to orient the needle with respect to the image.


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