Identification of A0 minimum ablative margins for colorectal liver metastases: multicentre, retrospective study using deformable CT registration and artificial intelligence-based autosegmentation
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Le résumé fourni par la source
BACKGROUND: Several 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. METHODS: This 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%. RESULTS: A 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. CONCLUSION: A 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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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Identification of A0 minimum ablative margins for colorectal liver metastases: multicentre, retrospective study using deformable CT registration and artificial intelligence-based autosegmentation
- Date Crossref
- 30/08/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The University of Texas MD Anderson Cancer Center Department of Interventional Radiology pays non établi dans la noticeÉtablissement de santé
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Innsbruck Medical University pays non établi dans la noticeUniversité ou école supérieure
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Universität Innsbruck pays non établi dans la noticeUniversité ou école supérieure
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University of Turin Department of Surgical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo Department of Radiology pays non établi dans la noticeÉtablissement de santé
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Azienda Ospedaliera Citta' della Salute e della Scienza di Torino pays non établi dans la noticeÉtablissement de santé
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Medical University of Innsbruck Department of Radiology pays non établi dans la noticeUniversité ou école supérieure
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Department of Diagnostic Imaging and Interventional Radiology pays non établi dans la noticeInstitution
Department of Interventional Radiology — The University of Texas MD Anderson Cancer Center, Innsbruck Medical University et Universität Innsbruck, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.