ArticleEuropean radiology2022
Are all local tumour progressions of HCC related to thermal ablation? A study of the causes and classification of local tumour progression.
Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Neutrophil extracellular traps drive local tumor progression and metastasis following thermal ablation in liver cancer via TLR9-mediated inflammatory feedback and immunosuppression.Journal for immunotherapy of cancer · 2026Article
- Microwave Ablation Versus Thyroid Lobectomy for Solitary cT1aN0M0 Papillary Thyroid Carcinoma: A Prospective Multicenter Cohort Study.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026Article
- Radiofrequency ablation for recurrent hepatocellular carcinoma: 10-year outcomes of local tumor progression vs intrahepatic distant recurrence.Insights into imaging · 2025Article
- [Establishment of a database for liver cancer ablation and its clinical research value].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Article
- Microwave Ablation Versus Surgical Resection for Small (≤3 cm) Hepatocellular Carcinoma in Older Patients: A Propensity Score Matching Analysis.Korean journal of radiology · 2025Article
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8 authors.
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Abstract
objectivesLocal tumour progression (LTP) is believed to be a negative consequence of imperfect thermal ablation, but we wondered if all LTP is truly due to imperfect ablation.
methodsThis study included 185 LTPs occurring within 1 cm of the ablation zone (AZ) after clinical curative thermal ablation for ≤ 5 cm hepatocellular carcinoma between 2010 and 2019. The AZ was divided into 8 quadrants by coronal, sagittal, and horizontal planes. Two methods, visual assessment through pre- and post-MRI (VA) and tumour mapping for 3D visualisation pre- and post-MRI fusion (MF), were used to assess which AZ quadrant included the shortest ablation margin (AM) by three doctors. LTP subclassification was based on whether LTP contacted the AZ margin (contacted LTP and dissociated-type LTP) and occurrence at different time points (12, 18, and 24 months).
resultsFleiss's Kappa of VA and MF was 0.769 and 0.886, respectively. Cohen's Kappa coefficient between VA and MF was 0.830. For all LTPs, 98/185 (53.0%) occurred in the shortest AM quadrant, which showed a significant central tendency (p < 0.001). However, only 8/51 (15.7%) dissociated - type LTPs and 6/39 (15.4%) LTPs after 24 months occurred in the shortest AM quadrant, which showed no evenly distributed difference (p = 0.360 and 0.303).
conclusionsMF is an accurate and convenient method to assess the shortest AM quadrant. LTP is a central tendency in the shortest AM quadrant, but dissociated-type and LTPs after 24 months are not, and these LTP types could be considered nonablation-related LTPs. KEY POINTS: • LTPs are not evenly distributed around the AZ. More than half of LTPs occur in the shortest AM quadrant. • Subgroup analysis showed that the occurrence of contacted-type LTPs (tumour margin has direct contact with the AZ) within 24 months after ablation indeed had a high proportion in the shortest AM quadrant, and they could be called ablation-related LTPs. • However, the dissociated-type LTPs (tumour margin adjacent to but not in contact with the AZ) or LTPs occurring beyond 24 months after ablation were evenly distributed around the AZ, and they could be called nonablation-related LTPs.
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