{"doi":"10.1007/s00330-024-10956-5","title":"Multicenter and inter-software evaluation of ablative margins after thermal ablation of colorectal liver metastases","abstract":"<jats:title>Abstract</jats:title>\n          <jats:sec>\n            <jats:title>Purpose</jats:title>\n            <jats:p>To assess the association between minimal ablative margin (MAM) and local tumor progression (LTP) following CT-guided thermal ablation of colorectal liver metastases (CRLM) in a multicenter cohort and across two confirmation software.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods</jats:title>\n            <jats:p>This multicenter retrospective study included patients who underwent CT-guided radiofrequency or microwave ablation for CRLM between 2009 and 2021 in three institutions. Three-dimensional (3D) MAM was retrospectively assessed using dedicated ablation confirmation software by automatic non-rigid (Ablation-fit) or semi-automatic rigid co-registration (SAFIR) of intraprocedural pre- and post-ablation contrast-enhanced CT scans by two independent reader teams blinded to patient outcomes. LTP was assessed on a per-tumor basis. Factors associated with LTP-free survival were assessed using multivariable Cox regression analysis.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Results</jats:title>\n            <jats:p>Overall, 113 patients (mean age: 67 ± 10 years; 78 men) who underwent thermal ablation for 189 CRLM (mean diameter: 1.9 ± 1.1 cm) met the inclusion criteria. 173/189 (92%) CRLM could be successfully analyzed using both software. Over a median follow-up of 31 months (IQR: 22–47), 21 of 173 CRLM (12.1%) developed LTP. On multivariable analysis, 3D MAM was independently associated with LTP in both software (Ablation-fit: HR 0.47, 95% CI: 0.36–0.61, <jats:italic>p</jats:italic> &lt; 0.001; SAFIR: HR 0.42, 95% CI: 0.32–0.55, <jats:italic>p</jats:italic> &lt; 0.001). No LTP was observed in CRLM ablated with MAM ≥ 4 mm (Ablation-fit) and ≥ 5 mm (SAFIR). The per-tumor median absolute difference in MAM quantification between both software was 2 mm (IQR: 1–3).</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion</jats:title>\n            <jats:p>MAM was independently associated with LTP after thermal ablation of CRLM across multicenter data and two confirmation software. Ablations achieving a MAM ≥ 5 mm were associated with local control in both software.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Clinical relevance statement</jats:title>\n            <jats:p>MAMs from intraprocedural contrast-enhanced CT were independently associated with LTP after thermal ablation of CRLM across multicenter data and two confirmation software, with a margin ≥ 5 mm associated with local control in both software.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Key Points</jats:title>\n            <jats:p>\n              <jats:list list-type=\"bullet\">\n                <jats:list-item>\n                  <jats:p>\n                    <jats:italic>Sufficient ablative margins are critical for local control following thermal ablation of CRLM</jats:italic>.</jats:p>\n                </jats:list-item>\n                <jats:list-item>\n                  <jats:p>\n                    <jats:italic>Intraprocedural CT-derived MAM was the only independent factor associated with LTP across two confirmation software.</jats:italic>\n                  </jats:p>\n                </jats:list-item>\n                <jats:list-item>\n                  <jats:p>\n                    <jats:italic>No LTP was observed in CRLM ablated with a MAM ≥</jats:italic> <jats:italic>5</jats:italic> <jats:italic>mm</jats:italic>.</jats:p>\n                </jats:list-item>\n              </jats:list>\n            </jats:p>\n          </jats:sec>","journal":"European Radiology","year":2024,"id":609460,"datarank":0.515098080672772,"base_score":3.4339872044851463,"endowment":3.4339872044851463,"self_citation_contribution":0.515098080672772,"citation_network_contribution":0.0,"self_endowment_contribution":0.515098080672772,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":30,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1566483,"name":"Koen H. M. Verdonschot","orcid":null,"position":1,"is_corresponding":false},{"id":1566485,"name":"Lina Kopf","orcid":null,"position":2,"is_corresponding":false},{"id":1566487,"name":"Susan van der Lei","orcid":null,"position":3,"is_corresponding":false},{"id":1566489,"name":"Yannick Scharll","orcid":null,"position":4,"is_corresponding":false},{"id":1566490,"name":"Gerjon Hannink","orcid":null,"position":5,"is_corresponding":false},{"id":1566491,"name":"Sjoerd F. M. Jenniskens","orcid":null,"position":6,"is_corresponding":false},{"id":1543909,"name":"Martijn R. Meijerink","orcid":null,"position":7,"is_corresponding":false},{"id":339946,"name":"Reto Bale","orcid":"0000-0003-0021-5792","position":8,"is_corresponding":false},{"id":339959,"name":"Christiaan G. Overduin","orcid":"0000-0002-4589-4357","position":9,"is_corresponding":false},{"id":1214591,"name":"Gregor Laimer","orcid":"0000-0002-6116-4901","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Multicenter and inter-software evaluation of ablative margins after thermal ablation of colorectal liver metastases","abstract":"<jats:title>Abstract</jats:title>\n          <jats:sec>\n            <jats:title>Purpose</jats:title>\n            <jats:p>To assess the association between minimal ablative margin (MAM) and local tumor progression (LTP) following CT-guided thermal ablation of colorectal liver metastases (CRLM) in a multicenter cohort and across two confirmation software.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods</jats:title>\n            <jats:p>This multicenter retrospective study included patients who underwent CT-guided radiofrequency or microwave ablation for CRLM between 2009 and 2021 in three institutions. Three-dimensional (3D) MAM was retrospectively assessed using dedicated ablation confirmation software by automatic non-rigid (Ablation-fit) or semi-automatic rigid co-registration (SAFIR) of intraprocedural pre- and post-ablation contrast-enhanced CT scans by two independent reader teams blinded to patient outcomes. LTP was assessed on a per-tumor basis. Factors associated with LTP-free survival were assessed using multivariable Cox regression analysis.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Results</jats:title>\n            <jats:p>Overall, 113 patients (mean age: 67 ± 10 years; 78 men) who underwent thermal ablation for 189 CRLM (mean diameter: 1.9 ± 1.1 cm) met the inclusion criteria. 173/189 (92%) CRLM could be successfully analyzed using both software. Over a median follow-up of 31 months (IQR: 22–47), 21 of 173 CRLM (12.1%) developed LTP. On multivariable analysis, 3D MAM was independently associated with LTP in both software (Ablation-fit: HR 0.47, 95% CI: 0.36–0.61, <jats:italic>p</jats:italic> &lt; 0.001; SAFIR: HR 0.42, 95% CI: 0.32–0.55, <jats:italic>p</jats:italic> &lt; 0.001). No LTP was observed in CRLM ablated with MAM ≥ 4 mm (Ablation-fit) and ≥ 5 mm (SAFIR). The per-tumor median absolute difference in MAM quantification between both software was 2 mm (IQR: 1–3).</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion</jats:title>\n            <jats:p>MAM was independently associated with LTP after thermal ablation of CRLM across multicenter data and two confirmation software. Ablations achieving a MAM ≥ 5 mm were associated with local control in both software.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Clinical relevance statement</jats:title>\n            <jats:p>MAMs from intraprocedural contrast-enhanced CT were independently associated with LTP after thermal ablation of CRLM across multicenter data and two confirmation software, with a margin ≥ 5 mm associated with local control in both software.</jats:p>\n          </jats:sec>\n          <jats:sec>\n            <jats:title>Key Points</jats:title>\n            <jats:p>\n              <jats:list list-type=\"bullet\">\n                <jats:list-item>\n                  <jats:p>\n                    <jats:italic>Sufficient ablative margins are critical for local control following thermal ablation of CRLM</jats:italic>.</jats:p>\n                </jats:list-item>\n                <jats:list-item>\n                  <jats:p>\n                    <jats:italic>Intraprocedural CT-derived MAM was the only independent factor associated with LTP across two confirmation software.</jats:italic>\n                  </jats:p>\n                </jats:list-item>\n                <jats:list-item>\n                  <jats:p>\n                    <jats:italic>No LTP was observed in CRLM ablated with a MAM ≥</jats:italic> <jats:italic>5</jats:italic> <jats:italic>mm</jats:italic>.</jats:p>\n                </jats:list-item>\n              </jats:list>\n            </jats:p>\n          </jats:sec>","is_dataset_classified":null,"base_score":3.4339872044851463,"endowment":3.4339872044851463,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39093415","pmcid":null,"openalex_id":"https://openalex.org/W4401250775","authors":[],"funders":[],"total_grants":0,"fwci":7.3682,"citation_percentile":0.9822027,"influential_citations":0,"citation_trend":[{"year":2024,"count":1},{"year":2025,"count":12},{"year":2026,"count":17}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://link.springer.com/content/pdf/10.1007/s00330-024-10956-5.pdf","host_type":"journal"},{"url":"https://link.springer.com/content/pdf/10.1007/s00330-024-10956-5.pdf","host_type":"publisher"},{"url":"https://link.springer.com/article/10.1007/s00330-024-10956-5/fulltext.html","host_type":"publisher"},{"url":"https://doi.org/10.1007/s00330-024-10956-5","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39093415","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11782453","host_type":"repository"},{"url":"https://hdl.handle.net/2066/316991","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11782453/pdf/330_2024_Article_10956.pdf","host_type":"repository"},{"url":"https://repository.ubn.ru.nl//bitstream/handle/2066/316991/316991.pdf","host_type":"repository"}],"fields_of_study":["Hepatocellular Carcinoma Treatment and Prognosis","Management of metastatic bone disease","Cholangiocarcinoma and Gallbladder Cancer Studies"],"mesh_terms":["Margins of Excision","Radiofrequency Ablation","Aged","Contrast Media","Female","Humans","Liver Neoplasms","Male","Microwaves","Middle Aged","Retrospective Studies","Software","Tomography, X-Ray Computed","Colorectal Neoplasms","Radiography, Interventional","Treatment Outcome","Surgery, Computer-Assisted"],"keywords":["Medicine","Ablation","Ablative case","Multicenter study","Retrospective cohort study","Interventional radiology","Radiofrequency ablation","Radiology","Nuclear medicine","Microwave ablation","Proportional hazards model","Neuroradiology","Thermal ablation","Surgery","Internal medicine","Radiation therapy","Neurology","Randomized controlled trial"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-31T08:05:04.326875Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}