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Updated: Aug 5, 2026
Enhanced Communication of Tumor Margins Using 3D Scanning and Mapping
Published on: December 15, 2023
Three-Dimensional Margin Assessment Predicts Local Tumor Progression After Stereotactic Microwave Ablation of Small
Michael P Brönnimann1, Philippe Lauber2, Matthew L Hung3
1Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Rosenbühlgasse 27, 3010 Bern, Switzerland; Division of Interventional Radiology, Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
Purpose:
To evaluate the impact of the minimal ablation margin (MAM) on local tumor progression (LTP) after stereotactic microwave ablation (MWA) of small hepatocellular carcinoma (HCC) using three-dimensional quantitative ablation margin assessment (3D-QAM).
Materials And Methods:
This retrospective single-center study included 175 lesions in 115 patients with HCC ≤ 3 cm treated with stereotactic MWA. The MAM was assessed using 3D-QAM analysis. Associations with LTP were evaluated using multivariable logistic regression. Model performance was assessed by receiver operating characteristic (ROC) analysis and internally validated using bootstrap resampling. Sensitivity analyses included generalized estimating equations (GEE) to account for clustering of lesions within patients. Additional analyses adjusted for re-ablation and included time-to-event analyses.
Results:
LTP occurred in 36 of 175 lesions (20.6%). Lesions with LTP had significantly smaller margins compared with those without progression (2.9 vs. 4.7 mm, p < 0.001). The MAM was a strong independent protective factor (odds ratio 0.68 per millimeter increase, p < 0.001). Right-sided lesion location was associated with increased risk (odds ratio 2.75, p = 0.045), whereas multifocality was not significant. ROC analysis showed moderate discrimination (area under the curve 0.70). Internal validation demonstrated stable model performance with an optimism-corrected AUC of 0.73 and good calibration (slope 0.93). Results remained consistent in sensitivity analyses using GEE. Time-to-event analyses confirmed the MAM-LTPFS association.
Conclusion:
The MAM is a key determinant of LTP after stereotactic MWA of small HCC. Margin-based risk prediction is robust and supports the clinical use of three-dimensional margin assessment to optimize local tumor control.
