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With the technical development of ultrasonography (US), electromagnetic tracking-based fusion imaging of real-time US and computed tomography/magnetic resonance (CT/MR) images has been used for percutaneous hepatic intervention such as biopsy and radiofrequency ablation (RFA). Because of the fusion imaging technique, the fused CT or MR images show the same plane and move synchronously while performing real-time US. With this information, fusion imaging can enhance lesion detectability and reduce

Fusion imaging-guided percutaneous RFA is effective in the management of HCC that has poor ultrasound conspicuity.

The overall detection rate for small (<or= 3 cm) HCC on targeted sonography was 78.5%. Small size and subphrenic location of the tumor were two independent predictors of sonographic invisibility.

RFA as a first-line stand-alone bridge therapy to LT achieves excellent long-term overall and tumor-specific survivals, with a low dropout rate from tumor progression despite long wait list times and a sustained low tumor recurrence rate upon post-LT follow-up of up to 10 years. (Hepatology 2017;65:1979-1990).

Fusion imaging is effective for percutaneous biopsy of focal hepatic lesions with poor sonographic conspicuity.

In living donor candidates, both CTA and MRA can provide a complete evaluation of the hepatic vascular anatomy.

An increased intraabdominal fat echo on sonography is highly specific for the presence of RLQ inflammatory disease.

The most common cause of mistargeting was confusion with cirrhotic nodules, followed by poor conspicuity of the hepatocellular carcinoma, a poor sonic window, a poor electrode path, and inaccurate electrode placement. The use of artificial ascites and the presence of more than 3 mistargeting causes were factors affecting the feasibility of a second radio frequency ablation session.