ArticleInternational journal of surgery (London, England)2026
A predictive model for optimal CT-guided thermal ablation margins in liver malignancies ≤3 cm: a retrospective cohort study.
Article in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Ionic characteristics and osmolarity of cooling fluid in hepatic laser ablation: a 7T MRI-based comparison in ex vivo bovine liver.Lasers in medical science · 2026Article
- Intra-procedural CT control versus ultrasound only in ultrasound-guided thermal ablation of colorectal liver metastases: a single-centre cohort study.Surgical endoscopy · 2026Article
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11 authors.
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Abstract
BACKGROUND AND
aimsStandardized quantitative criteria are lacking for the recommended circumferential thermal ablative margin in liver malignancies ≤3 cm. This study aimed to identify predictors of technical success in thermal ablation and develop a predictive model defining optimal ablation margins.
methodsThis retrospective study analyzed 979 patients undergoing computed tomography-guided radiofrequency or microwave ablation for liver malignancies ≤3 cm. Using a radiotherapy treatment planning system, preoperative tumor dimensions [maximum tumor area, preoperative maximum tumor area (PreMTA); tumor volume, preoperative tumor volume (PreTV)] and postoperative ablation characteristics [maximum ablation area, postoperative maximum ablation area (Post-MAA); ablation volume, postoperative ablation volume (PostAV)] were volumetrically quantified. Volume ratio (PostAV/PreTV) and area ratio (PostMAA/PreMTA) were calculated. Univariate and multivariate logistic regression identified predictors of residual tumor. A nomogram was developed and validated using Harrell's C-index, calibration curves, and receiver operating characteristic analysis. Size- and location-specific margin recommendations were derived mathematically.
resultsResidual tumor occurred in 91 patients (9.3%). Multivariate analysis identified adjacent large vessel [odd ratio (OR) = 1.97; P = 0.015], larger PreMTA (OR = 1.44; P = 0.014), and lower volume ratio (OR = 0.77; P = 0.009) as independent predictors. For non-perivascular tumors, optimal volume ratios were 4.3, 6.0, and 8.8 (corresponding ΔR = 0.3 cm, 0.8 cm, 1.6 cm) for diameters 1.0 cm, 2.0 cm, and 3.0 cm, respectively. A web-based calculator was implemented (https://fbzl.org/monitor/ablation_model.html).
conclusionsThis study establishes and validates a computational model defining tumor size- and vessel proximity-specific optimal ablation margins for liver malignancies ≤3 cm. The web-accessible model provides evidence-based individualized ablation targets that optimize oncological efficacy while preserving parenchyma, replacing conventional fixed margins.
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