CT-monitored minimal ablative margin control in single-session microwave ablation of liver tumors: an effective strategy for local tumor control

• DOI: 10.1007/s00330-022-08723-5
• Publication Date: 2022-04-07T10:21:36Z
• Authors: Ijin Joo; Kenneth W. Morrow; Steven S. Raman; Justin P. McWilliams; James W. Sayre; David S. Lu
• Keywords: Microwave ablation; Ablative case; Interventional radiology; Neuroradiology; Tumor progression; Ablation zone; Liver tumor

To investigate the usefulness of minimal ablative margin (MAM) control by intra-procedural contrast-enhanced CT (CECT) in microwave ablation (MWA) liver tumors.A total 334 consecutive tumors (240 hepatocellular carcinomas [HCCs] and 94 colorectal metastases [CRLMs]) 172 patients treated with percutaneous MWA were retrospectively included. MAM each tumor was assessed after expected completion using CECT, allowing within-session additional to any potentially insufficient margin. On immediate post-MWA MRI, complete coverage final status determined. The cumulative local progression (LTP) rate estimated Kaplan-Meier method. identify predictors LTP, Cox regression analysis a shared frailty model performed.Intra-procedural CECT findings prompted 18.9% (63/334) tumors. Final sufficient determined MRI be achieved 99.4% (332/334) 77.5% (259/334), their 6-month, 1-year, 2-year LTP rates 3.2%, 7.5%, 12.9%; 1.0%, 2.1%, 6.9%, respectively. Insufficient on perivascular location, size (cm) independent risk factors for (hazard ratio = 14.4, 6.0, 1.1, p < 0.001, 0.003, 0.011, respectively), while subcapsular location histology (HCC vs CRLM) not.In tumors, monitoring facilitates identification suboptimal margins guides intra-session maximize margin-sufficient ablations, latter being highly predictive marker excellent long-term control.• In can margin, leading single treatment session. • Achieving finally through results control.