Objective To investigate the utility of fusion imaging of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CT)/magnetic resonance imaging (MRI) before radiofrequency ablation (RFA) for liver cancers.Materials and Methods Forty-five patients with 70 consecutive liver lesions were included between March 2013 and October 2015.Planning US for percutaneous RFA was performed using conventional US first and then using US-CECT/CEMRI and CEUS-CECT/CEMRI fusion imaging during the same session.The number of the lesions initially not visible on conventional US whereas could be visualized and ablated after applying the fusion imaging technique was evaluated.The reasons for lesion blurring and the self-confidence level of the operators before RFA were analyzed.RFA was performed according to the results of the fusion imaging.The complete response rate and the complications were calculated.Results On conventional US,25 of the 70 lesions were clearly visualized,24 were obscure and 21 were totally invisible.Of them, 49 lesions could be detected and located through US-CECT/CEMRI fusion imaging and CEUS-CECT/ CEMRI fusion imaging aided in detecting additional 18 lesions.The detection rate for the lesions was 95.7%(67/70) with fusion imaging whereas 35.7% (25/70) with conventional US (P <0.001).Lesion maximum diameter ≤2cm, isoechogenicity, depth ≥ 5cm, closing to the surface of liver or greater vessel and associated with chronic hepatic disease were the main reasons for lesion blurring on conventional US.The self-confidence level of operators increased significantly after the fusion imaging technique was applied (P<0.001).The complete response (CR) rate for RFA was 97.0% (64/66) in accordance to the CECT/CEMRI results one month later.No procedure-related deaths and major complications occurred after the RFA procedure.Conclusion Fusion imaging, particularly the fusion of CEUS and CT/MRI,improves the detection of inconspicuous lesions on conventional US and facilitated the subsequent percutaneous RFA.