International multisociety Delphi consensus for liver tumour thermal ablation: margin assessment

Area of Science:

• Oncology
• Medical Imaging
• Interventional Radiology

Background:

• Liver tumor thermal ablation requires standardized margin assessment.
• Current practices lack uniformity, potentially impacting patient outcomes.

Purpose of the Study:

• To establish international consensus on best practices for assessing ablation margins in liver tumor thermal ablation.
• To standardize margin assessment to improve and promote uniform outcomes.

Main Methods:

• Modified Delphi process involving 72 experts from multiple continents.
• Two online surveys and a hybrid consensus meeting.
• Formal consensus reached on 150 of 199 statements.

Main Results:

• Agreement that ablation margins must be assessed and documented for all treated liver tumors.
• Recommendation for quantitative, 3D margin assessment using contrast-enhanced CT or MRI, preferably intraprocedurally.
• Defined margin categories: A0 (sufficient margin), A1 (insufficient margin), A2 (residual tumor).

Conclusions:

• This is the first international consensus initiative for liver tumor thermal ablation margin assessment.
• Standardized assessment aims to improve clinical practice and patient outcomes.
• Strong agreement between interventional and surgical oncologists on key recommendations.