ArticleThe British journal of surgery2024
Identification of A0 minimum ablative margins for colorectal liver metastases: multicentre, retrospective study using deformable CT registration and artificial intelligence-based autosegmentation.
Article in The British journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Quantifying Functional Liver Volume Loss after CT-guided Percutaneous Thermal Ablation: A COVER-ALL Trial Post Hoc Analysis.Radiology. Imaging cancer · 2026Trial
- Software-based versus visual assessment of the minimal ablative margin in patients with liver tumours undergoing percutaneous thermal ablation (COVER-ALL): a randomised phase 2 trial.The lancet. Gastroenterology & hepatology · 2025Trial
- Results from the Pan-European CIEMAR study: Local Tumour Control After Microwave Ablation of Colorectal Liver Metastases and Exploratory Associations with Ablation Margins and Confirmation Software.Cardiovascular and interventional radiology · 2026Article
- [Interventional therapeutic strategies for metastatic liver cancer].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Review
- AI-driven ablative margin assessment after HCC radiofrequency ablation: a case-control feasibility study.European radiology experimental · 2026Article
- BioDeformUNet: A Deep Learning Model for Biomechanically Informed Liver Image Registration.medRxiv : the preprint server for health sciences · 2026Article
- Thermal Ablation for Colorectal Liver Metastases: Current Evidence and Future Horizons.Diagnostics (Basel, Switzerland) · 2026Review
- Can a Free Open-Source Software Platform Serve as Minimal Ablation Confirmation Assessment Software in Real-Life Practice?Cardiovascular and interventional radiology · 2026Article
- Ablation Confirmation Software in Thermal Ablation of Liver Tumours: A Scoping Review of Contemporary Applications and Clinical Usability.Cardiovascular and interventional radiology · 2026Review
- Is There a Role for Hepatobiliary Scintigraphy in Thermal Ablation of Hepatocellular Carcinoma?Cancers · 2026Article
- A predictive model for optimal CT-guided thermal ablation margins in liver malignancies ≤3 cm: a retrospective cohort study.International journal of surgery (London, England) · 2026Article
- The effects of measurement errors on minimum ablative margins after thermal ablation of liver tumors: a simulation study.CVIR oncology · 2026Article
- Association between Three-dimensional Margin Assessment and Local Tumor Control in Percutaneous Lung Cryoablation of Colorectal Metastases.Radiology. Imaging cancer · 2026Article
- Radiofrequency ablation for colorectal liver metastases: an evolving alternative or complement to resection?Hepatobiliary surgery and nutrition · 2025Article
- The influence of AI on surgical and ablative treatments for colorectal liver metastases: a review of the current literature.Insights into imaging · 2025Review
- In Situ Vaccination by Tumor Ablation: Principles and Prospects for Systemic Antitumor Immunity.Vaccines · 2025Review
- Article
- Interventional Oncology for Colorectal Liver Metastases: From Local Cure to Salvage Therapy.Biomedicines · 2025Review
- Visual Inspection of Thermal Ablation for Liver Tumors: Another One Bites the Dust.Cardiovascular and interventional radiology · 2025Article
- CT-guided Thermal Ablation of Liver Tumors Using Intraprocedural CT-CT Fusion for Applicator Position and Ablation Completeness Assessment: a Single-Center Comparative Analysis.Cardiovascular and interventional radiology · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
17 authors.
Funding
Abstract
backgroundSeveral ablation confirmation software methods for minimum ablative margin assessment have recently been developed to improve local outcomes for patients undergoing thermal ablation of colorectal liver metastases. Previous assessments were limited to single institutions mostly at the place of development. The aim of this study was to validate the previously identified 5 mm minimum ablative margin (A0) using autosegmentation and biomechanical deformable image registration in a multi-institutional setting.
methodsThis was a multicentre, retrospective study including patients with colorectal liver metastases undergoing CT- or ultrasound-guided microwave or radiofrequency ablation during 2009-2022, reporting 3-year local disease progression (residual unablated tumour or local tumour progression) rates by minimum ablative margin across all institutions and identifying an intraprocedural contrast-enhanced CT-based minimum ablative margin associated with a 3-year local disease progression rate of less than 1%.
resultsA total of 400 ablated colorectal liver metastases (median diameter of 1.5 cm) in 243 patients (145 men; median age of 62 [interquartile range 54-70] years) were evaluated, with a median follow-up of 26 (interquartile range 17-40) months. A total of 119 (48.9%) patients with 186 (46.5%) colorectal liver metastases were from international institutions B, C, and D that were not involved in the software development. Three-year local disease progression rates for 0 mm, >0 and <5 mm, and 5 mm or larger minimum ablative margins were 79%, 15%, and 0% respectively for institution A (where the software was developed) and 34%, 19%, and 2% respectively for institutions B, C, and D combined. Local disease progression risk decreased to less than 1% with an intraprocedurally confirmed minimum ablative margin greater than 4.6 mm.
conclusionA minimum ablative margin of 5 mm or larger demonstrates optimal local oncological outcomes. It is proposed that an intraprocedural minimum ablative margin of 5 mm or larger, confirmed using biomechanical deformable image registration, serves as the A0 for colorectal liver metastasis thermal ablation.
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