TY - JOUR
T1 - International multisociety Delphi consensus for liver tumour thermal ablation
T2 - margin assessment
AU - Paolucci, Iwan
AU - Overduin, Christiaan G.
AU - Johnston, Edward W.
AU - Laimer, Gregor
AU - Ahmed, Muneeb
AU - Arellano, Ronald S.
AU - Beerman, Marie
AU - Beyer, Lukas P.
AU - Breen, David J.
AU - Burgmans, Mark C.
AU - Calandri, Marco
AU - Chern, Ming Chih
AU - Crocetti, Laura
AU - van Dam, Ronald M.
AU - Denys, Alban
AU - Edwin, Bjørn
AU - Filippiadis, Dimitrios
AU - Fong, Yuman
AU - Fotiadis, Nicos
AU - Freedman, Jacob
AU - Fretland, Åsmund A.
AU - Gimenez, Mariano
AU - Garcia, Rodrigo G.
AU - Grasso, Rosario F.
AU - Helmberger, Thomas K.
AU - Hendriks, Pim
AU - Iezzi, Roberto
AU - Jenniskens, Sjoerd F.M.
AU - Kupferthaler, Alexander
AU - Lachenmayer, Anja
AU - Lee, Fred T.
AU - Lee, Jeong M.
AU - van der Lei, Susan
AU - van der Leij, Christiaan
AU - Liang, Ping
AU - Lin, Charles C.W.
AU - Luerken, Lukas
AU - Maglione, Manuel
AU - Mahnken, Andreas
AU - McWilliams, Justin P.
AU - Menezes, Marcos
AU - Narayanan, Govindarajan
AU - Orsi, Franco
AU - Pereira, Philippe L.
AU - Pua, Uei
AU - Puijk, Robbert S.
AU - Rhim, Hyunchul
AU - Rilling, William S.
AU - Ruiter, Simeon J.S.
AU - Ryan, Anthony G.
AU - Et al.
N1 - Funding Information:
We thank Ursula Juerschik and Martin Knoflach, Medical University Innsbruck, for their support in organising the hybrid meeting in Innsbruck. We thank Erica Goodoff, Senior Scientific Editor in the Research Medical Library at The University of Texas MD Anderson Cancer Center, for editing this article. We thank Kelly Kage, Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, for providing illustrations. These guidelines are formally endorsed by the Cardiovascular and Interventional Radiological Society of Europe, the European Society of Surgical Oncology, and the Society of Interventional Oncology. During the preparation of this manuscript, generative AI was used solely for paraphrasing and language editing to improve readability. All outputs were reviewed and edited by the authors, who take full responsibility for the content of the manuscript.
Publisher Copyright:
© 2026 Elsevier Ltd.
PY - 2026/5/1
Y1 - 2026/5/1
N2 - This multisociety, multidisciplinary consensus—formally endorsed by the European Society of Surgical Oncology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology—was developed to standardise the assessment of ablation margins in liver tumour thermal ablation. A modified Delphi process, consisting of two online surveys and a hybrid (online and in-person meeting in Innsbruk) consensus meeting of 72 experts from North America, South America, Europe, and Asia. Formal consensus was reached for 150 (75%) of 199 statements. Strong agreement was observed between interventional and surgical oncologists, with only 12 (6%) of 199 statements showing significantly different ratings. Participants agreed that ablation margins should be assessed and documented for every treated tumour. Margins should be assessed quantitatively in three dimensions, with contrast-enhanced CT or MRI, preferably intraprocedurally with ablation confirmation software. Ablation margins should be categorised as A0 (tumour completely covered with sufficient margin), A1 (tumour completely covered but insufficient margin), or A2 (portion of tumour remains unablated). This effort is, to our knowledge, the first international consensus initiative to define best-practice recommendations for margin assessment in liver tumour thermal ablation to standardise practices, aiming to improve and promote uniform outcomes.
AB - This multisociety, multidisciplinary consensus—formally endorsed by the European Society of Surgical Oncology, the Cardiovascular and Interventional Radiological Society of Europe, and the Society of Interventional Oncology—was developed to standardise the assessment of ablation margins in liver tumour thermal ablation. A modified Delphi process, consisting of two online surveys and a hybrid (online and in-person meeting in Innsbruk) consensus meeting of 72 experts from North America, South America, Europe, and Asia. Formal consensus was reached for 150 (75%) of 199 statements. Strong agreement was observed between interventional and surgical oncologists, with only 12 (6%) of 199 statements showing significantly different ratings. Participants agreed that ablation margins should be assessed and documented for every treated tumour. Margins should be assessed quantitatively in three dimensions, with contrast-enhanced CT or MRI, preferably intraprocedurally with ablation confirmation software. Ablation margins should be categorised as A0 (tumour completely covered with sufficient margin), A1 (tumour completely covered but insufficient margin), or A2 (portion of tumour remains unablated). This effort is, to our knowledge, the first international consensus initiative to define best-practice recommendations for margin assessment in liver tumour thermal ablation to standardise practices, aiming to improve and promote uniform outcomes.
U2 - 10.1016/S1470-2045(26)00143-9
DO - 10.1016/S1470-2045(26)00143-9
M3 - (Systematic) Review article
SN - 1470-2045
VL - 27
SP - e248-e258
JO - The Lancet Oncology
JF - The Lancet Oncology
IS - 5
ER -