Quantitative Ablation Confirmation Methods in Percutaneous Thermal Ablation of Malignant Liver Tumors: Technical Insights, Clinical Evidence, and Future Outlook

Authors

Iwan Paolucci
Jessica Albuquerque Marques Silva
Yuan-Mao Lin
Alexander Shieh
Anna Maria Ierardi
Gianpaolo Caraffiello
Carlo Gazzera
Kyle A Jones
Paolo Fonio
Reto Bale
Kristy K Brock
Marco Calandri
Bruno C Odisio

Publication Date

5-1-2025

Journal

Radiology Imaging Center

DOI

10.1148/rycan.240293

PMID

40314585

PMCID

PMC12130695

PubMedCentral® Posted Date

5-2-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Percutaneous image-guided thermal ablation is an established local curative-intent treatment technique for the treatment of primary and secondary malignant liver tumors. Whereas margin assessment after surgical resection can be accomplished with microscopic examination of the resected specimen, margin assessment after percutaneous thermal ablation relies on cross-sectional imaging. The critical measure of technical success is the minimal ablative margin (MAM), defined as the minimum distance between the tumor and the edge of the ablation zone. Traditionally, the MAM has been assessed qualitatively using anatomic landmarks, which has suboptimal accuracy and reproducibility and is prone to operator bias. Consequently, specialized software-based methods have been developed to standardize and automate MAM quantification. In this review, the authors discuss the technical components of such methods, including image acquisition, segmentation, registration, and MAM computation, define the sources of measurement error, describe available software solutions in terms of image processing techniques and modes of integration, and outline the current clinical evidence, which strongly supports the use of such dedicated software. Finally, the authors discuss current logistical and financial barriers to widespread use of ablation confirmation methods as well as potential solutions.

Keywords

Humans, Liver Neoplasms, Ablation Techniques, Surgery, Computer-Assisted, Catheter Ablation, Margins of Excision, Tomography, X-Ray Computed, Software, Reproducibility of Results, Ablation Techniques, CT, Image Postprocessing, Liver

Published Open-Access

yes

Recommended Citation

Paolucci, Iwan; Albuquerque Marques Silva, Jessica; Lin, Yuan-Mao; et al., "Quantitative Ablation Confirmation Methods in Percutaneous Thermal Ablation of Malignant Liver Tumors: Technical Insights, Clinical Evidence, and Future Outlook" (2025). Faculty, Staff and Student Publications. 4265.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4265