The Future of Liver Tumour Thermal Ablation: New Delphi Consensus Published in The Lancet Oncology

‼️ Redefining liver tumour ablation: new international consensus ‼️

Two recent international multisociety Delphi consensus papers published in The Lancet Oncology are setting the direction for the future of liver tumour thermal ablation.

👉 “International multisociety Delphi consensus for liver tumour thermal ablation: margin assessment” (https://lnkd.in/gqXcKfMr) highlighted the need for:

•  Standardised methodology and outcome reporting for ablation margin assessment

• Intraprocedural pre- and post-ablation contrast-enhanced CT imaging, acquired in the same respiratory phase to improve registration accuracy

• Quantitative, three-dimensional intraprocedural margin assessment for every treated tumour

• The use of ablation confirmation software based on non-rigid registration with verification of registration accuracy by physicians

• Documentation of technical success and achieved ablation margins in patient records

• A minimum A0 margin threshold of at least 5 mm supported by most experts for both colorectal liver metastases and hepatocellular carcinoma

The consensus also defined the key desirable characteristics for ablation confirmation software, including quantitative and visual evaluation of sufficient and insufficient margins or tumour coverage, which are functionalities already integrated into Ablation-fit.

👉 “International multisociety Delphi consensus for liver tumour thermal ablation: procedural and practice standards” (https://lnkd.in/ggHV-YHD) reinforced that:

•  Ablation margins are the strongest predictor of outcomes in thermal ablation

• In the era of ablation confirmation software, achieving sufficient margins is more important than tumour size or tumour type

• Standardised planning, execution, and intraprocedural control are essential

• Technical approach, image guidance, and applicator strategy are central to procedural safety and adequate margins, with minimally invasive percutaneous approaches prioritised whenever possible

• Intraprocedural CT should be incorporated whenever feasible during ultrasound-guided ablations

• CT guidance should be used for tumours requiring multiple overlapping ablation zones

In this evolving scenario, technologies supporting precision guidance like Endosight and quantitative treatment assessment like Ablation-fit are becoming increasingly relevant. Our products fully align with the direction outlined by these international expert consensus recommendations.