Identification of high-risk areas for local tumor progression following microwave ablation of colorectal cancer liver metastases using three-dimensional MRI imaging
10.3760/cma.j.cn131148-20250303-00114
- VernacularTitle:基于三维磁共振图像识别结直肠癌肝转移微波消融后高危进展区
- Author:
Lu LI
1
;
Jianming LI
;
Hefei LI
;
Wenqi CHEN
;
Jie HU
;
Zhen WANG
;
Xueqin TIAN
;
Jie YU
;
Ping LIANG
Author Information
1. 中国人民解放军总医院第五医学中心介入超声科，北京 100039
- Publication Type:Journal Article
- Keywords:
Microwave ablation;
Colorectal cancer liver metastases;
Local tumor progression;
Spatial distribution characteristics
- From:
Chinese Journal of Ultrasonography
2025;34(5):431-438
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the spatial distribution patterns of local tumor progression（LTP）after microwave ablation（MWA）for colorectal liver metastases（CRLMs）and identify high-risk progression zones.Methods:A total of 471 CRLM lesions from 246 patients treated with MWA at the Chinese PLA General Hospital between September 2009 and March 2022 were retrospectively analyzed. Three-dimensional visualized MRI image fusion technology was employed to evaluate the spatial relationship between ablation margins（AM）and LTP. The liver was partitioned into nine specific anatomical regions. Machine learning（Boruta algorithm）was used to assess the importance of these regions on LTP risk. Multivariate analysis of LTP was performed at the tumor level and at the patient level using the Cox mixed effects model and the Cox regression model，respectively.Results:LTP occurred in 115 lesions，with an LTP rate of 40.0%（80/200）in ablated lesions which were located in the high-risk progression area，and 12.9%（35/271）in low-risk progression area. Multivariate analysis identified AM < 5 mm，tumor size ≥3 cm and location in high-risk zones as independent risk factors for LTP. Notably，LTP in high-risk zones predominantly clustered around the ablation needle tip.Conclusions:Post-MWA LTP in CRLMs exhibits distinct spatial clustering，particularly at the needle tip within high-risk progression zones. These findings provide critical insights for optimizing ablation strategies and improving clinical outcomes.
