European Radiology最新文献

{"title":"Breaking new ground in COPD imaging: 3D-PREFUL MRI versus traditional techniques.","authors":"Gaël Dournes, Ilyes Benlala","doi":"10.1007/s00330-024-10994-z","DOIUrl":"10.1007/s00330-024-10994-z","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"940-942"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESR Essentials: basic physics of MR safety-practice recommendations by the European Society for Magnetic Resonance in Medicine and Biology.","authors":"Love Engström Nordin, Karin Åberg, Johan Kihlberg, Titti Owman, Boel Hansson, Isabella M Björkman-Burtscher, Cecilia Petersen, Peter Lundberg","doi":"10.1007/s00330-024-10999-8","DOIUrl":"10.1007/s00330-024-10999-8","url":null,"abstract":"<p><strong>Objectives: </strong>The use of magnetic resonance imaging (MRI) is safe from a long-term perspective since there are no known cumulative risks for patients or personnel. However, the technique comes with several acute risks associated with the powerful electromagnetic fields that are necessary to produce medical images. These risks include, among other things, a projectile hazard, loud noise, and the risk of heating. Safe use of MRI requires knowledge about the different hazards related to MRI and organizational structured work including the implementation of routines describing a safe workflow from the referral of a patient to the signed report. In this article, the risks associated with MRI are described along with suggestions for how each risk can be minimized or eliminated.</p><p><strong>Conclusion: </strong>The aim of this article is to provide support for the development of, and compliance with, MRI safety routines, and to work with the technique in a safe way. The scope of this treatise does not cover specific details of implant safety, however, the physical principles described can be applied to the risk assessment of implants.</p><p><strong>Key points: </strong>Establish whether any MR contraindications apply to the patient. Evaluate means to deal with identified risks for both patients and personnel. It is imperative to always perform and document a risk-benefit assessment.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"572-579"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bystanders or stakeholders: patient perspectives on the adoption of AI in radiology.","authors":"Salvatore Claudio Fanni, Emanuele Neri","doi":"10.1007/s00330-024-11135-2","DOIUrl":"10.1007/s00330-024-11135-2","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"767-768"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based automatic ASPECTS calculation can improve diagnosis efficiency in patients with acute ischemic stroke: a multicenter study.","authors":"Jianyong Wei, Kai Shang, Xiaoer Wei, Yueqi Zhu, Yang Yuan, Mengfei Wang, Chengyu Ding, Lisong Dai, Zheng Sun, Xinsheng Mao, Fan Yu, Chunhong Hu, Duanduan Chen, Jie Lu, Yuehua Li","doi":"10.1007/s00330-024-10960-9","DOIUrl":"10.1007/s00330-024-10960-9","url":null,"abstract":"<p><strong>Objectives: </strong>The Alberta Stroke Program Early CT Score (ASPECTS), a systematic method for assessing ischemic changes in acute ischemic stroke using non-contrast computed tomography (NCCT), is often interpreted relying on expert experience and can vary between readers. This study aimed to develop a clinically applicable automatic ASPECTS system employing deep learning (DL).</p><p><strong>Methods: </strong>This study enrolled 1987 NCCT scans that were retrospectively collected from four centers between January 2017 and October 2021. A DL-based system for automated ASPECTS assessment was trained on a development cohort (N = 1767) and validated on an independent test cohort (N = 220). The consensus of experienced physicians was regarded as a reference standard. The validity and reliability of the proposed system were assessed against physicians' readings. A real-world prospective application study with 13,399 patients was used for system validation in clinical contexts.</p><p><strong>Results: </strong>The DL-based system achieved an area under the receiver operating characteristic curve (AUC) of 84.97% and an intraclass correlation coefficient (ICC) of 0.84 for overall-level analysis on the test cohort. The system's diagnostic sensitivity was 94.61% for patients with dichotomized ASPECTS at a threshold of ≥ 6, with substantial agreement (ICC = 0.65) with expert ratings. Combining the system with physicians improved AUC from 67.43 to 89.76%, reducing diagnosis time from 130.6 ± 66.3 s to 33.3 ± 8.3 s (p < 0.001). During the application in clinical contexts, 94.0% (12,591) of scans successfully processed by the system were utilized by clinicians, and 96% of physicians acknowledged significant improvement in work efficiency.</p><p><strong>Conclusion: </strong>The proposed DL-based system could accurately and rapidly determine ASPECTS, which might facilitate clinical workflow for early intervention.</p><p><strong>Clinical relevance statement: </strong>The deep learning-based automated ASPECTS evaluation system can accurately and rapidly determine ASPECTS for early intervention in clinical workflows, reducing processing time for physicians by 74.8%, but still requires validation by physicians when in clinical applications.</p><p><strong>Key points: </strong>The deep learning-based system for ASPECTS quantification has been shown to be non-inferior to expert-rated ASPECTS. This system improved the consistency of ASPECTS evaluation and reduced processing time to 33.3 seconds per scan. 94.0% of scans successfully processed by the system were utilized by clinicians during the prospective clinical application.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"627-639"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of microvascular flow imaging for radiofrequency ablation in recurrent thyroid cancer: comparison with power Doppler imaging.","authors":"Pae Sun Suh, Jung Hwan Baek, Jae Ho Lee, Sae Rom Chung, Young Jun Choi, Ki-Wook Chung, Tae Yong Kim, Jeong Hyun Lee","doi":"10.1007/s00330-024-10977-0","DOIUrl":"10.1007/s00330-024-10977-0","url":null,"abstract":"<p><strong>Objectives: </strong>To compare microvascular flow imaging (MVFI) and power Doppler ultrasonography imaging (PDUS) for detecting intratumoral vascularity in recurrent thyroid cancer both before and after radiofrequency ablation (RFA).</p><p><strong>Methods: </strong>This retrospective study included 80 patients (age, 57 ± 12 years; 54 women) with 110 recurrent tumors who underwent RFA between January 2021 and June 2023. A total of 151 PDUS and MVFI image sets were analyzed (85 pre-RFA, 66 post-RFA). Two readers assessed vascularity on the images using a four-point scale with a 2-week interval between PDUS and MVFI to estimate inter-reader agreement. Intra-reader agreement was determined by reinterpreting images in reverse order (MVFI-PDUS) after a 1-month gap. Additionally, diagnostic performance for identifying viable tumors after RFA was assessed in 44 lesions using thyroid-protocol CT as a reference standard.</p><p><strong>Results: </strong>MVFI demonstrated higher vascular grades than PDUS, both before (reader 1: 3.04 ± 1.15 vs. 1.93 ± 1.07, p < 0.001; reader 2: 3.20 ± 0.96 vs. 2.12 ± 1.07, p < 0.001) and after RFA (reader 1: 2.44 ± 1.28 vs. 1.67 ± 1.06, p < 0.001; reader 2: 2.62 ± 1.23 vs. 1.83 ± 0.99, p < 0.001). Inter-reader agreement was substantial (κ = 0.743) and intra-reader agreement was almost perfect (κ = 0.840). MVFI showed higher sensitivity (81.5%-88.9%) and accuracy (84.1%-86.4%) than PDUS (sensitivity: 51.9%, p < 0.01; accuracy: 63.6-70.5%, p < 0.04), without sacrificing specificity.</p><p><strong>Conclusion: </strong>MVFI was superior to PDUS for assessing intratumoral vascularity and showed good inter- and intra-reader agreement, highlighting its clinical value for assessing pre-RFA vascularity and accurately identifying post-RFA viable tumors in recurrent thyroid cancer.</p><p><strong>Clinical relevance statement: </strong>Microvascular flow imaging (MVFI) is superior to power-Doppler US for assessing intratumoral vascularity; therefore, MVFI can be a valuable tool for assessing vascularity before radiofrequency ablation (RFA) and for identifying viable tumors after RFA in patients with recurrent thyroid cancer.</p><p><strong>Key points: </strong>The value of microvascular flow imaging (MVFI) for evaluating intratumoral vascularity is unexplored. MVFI demonstrated higher vascular grades than power Doppler US before and after ablation. Microvascular flow imaging showed higher sensitivity and accuracy than power Doppler US without sacrificing specificity.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"597-607"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucose metabolic rate from four-dimensional [¹⁸F]FDG PET/CT to differentiate sarcoid lesions from malignant lesions.","authors":"Akihiro Inoue, Michinobu Nagao, Koichiro Kaneko, Atsushi Yamamoto, Yurie Shirai, Ohno Toshihiro, Akiko Sakai, Risa Imakado, Shuji Sakai","doi":"10.1007/s00330-024-11022-w","DOIUrl":"10.1007/s00330-024-11022-w","url":null,"abstract":"<p><strong>Objectives: </strong>On ¹⁸F-Fludeoxyglucose (FDG) PET/CT, active sarcoid lesions are often difficult to differentiate from malignant lesions. We investigated the potential of the glucose metabolic rate (MR_glc, mg/min/100 mL), a new quantification of glucose metabolic kinetics derived from direct reconstruction based on linear Patlak analysis, to distinguish between sarcoidosis and malignant lesions.</p><p><strong>Materials and methods: </strong>A total of 100 patients with cardiac sarcoidosis (CS) and 67 patients with cancer who underwent four-dimensional FDG PET/CT were enrolled. The lesions with a standardized uptake value (SUV) ≥ 2.7 on the standard scan were included as active lesions in the analysis. SUV and MR_glc were derived using data acquired between 30 min and 50 min on four-dimensional FDG PET/CT. The mean value in the volume of interest (size 1.5 cm³) was measured. The diagnostic performance of sarcoidosis using MR_glc and SUV was evaluated using receiver-operating-characteristic (ROC) analysis.</p><p><strong>Results: </strong>A total of 90 sarcoidosis lesions from 44 CS patients (18 males, 63.4 ± 12.2 years) and 87 malignant lesions from 57 cancer-bearing patients (32 males, 65 ± 14 years) were analyzed. SUV and MR_glc for sarcoid lesions were significantly lower than those for malignant lesions (SUV, 4.98 ± 2.00 vs 6.21 ± 2.14; MR_glc, 2.52 ± 1.39 vs 3.68 ± 1.61; p < 0.01). ROC analysis indicated that the ability to discriminate sarcoid patients from those with malignancy yielded areas under the curves of 0.703 and 0.754, with sensitivities of 64% and 77% and specificities of 75% and 72% for SUV 5.025 and MR_glc 2.855, respectively.</p><p><strong>Conclusion: </strong>MR_glc was significantly lower in sarcoid lesions than malignant lesions, and improved sarcoid lesions identification over SUV alone.</p><p><strong>Clinical relevance statement: </strong>MR_glc improves sarcoid lymph node identification over SUV alone and is expected to shorten the examination time by eliminating delayed scans.</p><p><strong>Key points: </strong>Active sarcoid lesions are sometimes associated with FDG accumulation and should be differentiated from malignant lesions. SUV and metabolic rate of glucose (MRglc) strongly positively correlated, and MRglc could differentiate sarcoid and malignant lesions. MRglc allows for accurate evaluation and staging of malignant lesions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1012-1021"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dilated lenticulostriate artery on whole-brain vessel wall imaging differentiates pathogenesis and predicts clinical outcomes in single subcortical infarction.","authors":"Jin Li, Junxia Niu, Weimin Zheng, Yueyan Bian, Fang Wu, Xiuqin Jia, Zhaoyang Fan, Xihai Zhao, Qi Yang","doi":"10.1007/s00330-024-10971-6","DOIUrl":"10.1007/s00330-024-10971-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the dilation of lenticulostriate artery (LSA) identified by whole-brain vessel wall imaging (WB-VWI) in differentiating the etiologic subtypes of single subcortical infarction (SSI) and to determine whether the appearance of dilated LSA was associated with 90-day clinical outcomes in parental atherosclerotic disease (PAD)-related SSI.</p><p><strong>Methods: </strong>Patients with acute SSI were prospectively enrolled and categorized into PAD-related SSI and cerebral small-vessel disease (CSVD)-related SSI groups. The imaging features of LSA morphology (branches, length, dilation, and tortuosity), plaques (burden, remodeling index, enhancement degree, and hyperintense plaque), and CSVD (white matter hyperintensity, lacunes, cerebral microbleed, and enlarged perivascular space) were evaluated. The logistic regression was performed to determine the association of dilated LSA with PAD-related SSI and 90-day clinical outcomes.</p><p><strong>Results: </strong>In total, 131 patients (mean age, 52.2 ± 13.2 years; 99 men) were included. The multivariate logistic regression analysis revealed that the presence of dilated LSAs (odds ratio (OR), 7.40; 95% confidence interval (CI): 1.88-29.17; p = 0.004)) was significantly associated with PAD-related SSI. Moreover, after adjusting for confounding factors, the association of poor outcomes with the total length of LSAs (OR, 0.94; 95% CI: 0.90-0.99; p = 0.011), dilated LSAs (OR, 0.001; 95% CI: 0.0001-0.08; p = 0.002), and plaque burden (OR, 1.35; 95% CI: 1.11-1.63; p = 0.002) remained statistically significant.</p><p><strong>Conclusion: </strong>The dilation of LSA visualized on WB-VWI could differentiate various subtypes of SSI within LSA territory and was a prognostic imaging marker for 90-day clinical outcomes for PAD-related SSI.</p><p><strong>Clinical relevance statement: </strong>Evaluation of LSA morphology based on WB-VWI can differentiate the pathogenesis and predict clinical outcomes in SSI, providing crucial insights into the etiologic mechanisms, risk stratification, and tailored therapies for these patients.</p><p><strong>Key points: </strong>The prognosis of SSIs within lenticulostriate territory depend on the etiology of the disease. LSA dilation on WB-VWI was associated with parental atherosclerosis and better 90-day outcomes. Accurately identifying the etiology of SSIs in lenticulostriate territory assists in treatment decision-making.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"929-939"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke and AI diagnostics: a matter of time?","authors":"Kevin J Chung","doi":"10.1007/s00330-024-10962-7","DOIUrl":"10.1007/s00330-024-10962-7","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"624-626"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of a single-phase portal venous CT protocol using bolus tracking technique and lean body weight-based contrast media dose.","authors":"Riccardo Valletta, Matteo Bonatti, Vincenzo Vingiani, Valentina Corato, Bernardo Proner, Fabio Lombardo, Giacomo Avesani, Patrizia Pertner, Giulia A Zamboni","doi":"10.1007/s00330-024-11009-7","DOIUrl":"10.1007/s00330-024-11009-7","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of the use of lean body weight (LBW)-based contrast material (CM) dose and bolus tracking technique on portal venous phase abdominal CT image quality.</p><p><strong>Materials and methods: </strong>IRB-approved prospective study; informed consent was acquired. In the period July-November 2023, we randomly selected 105 oncologic patients scheduled for a portal venous phase abdominal CT to undergo our experimental protocol (i.e., 0.7 gI/Kg of LBW CM administration and bolus tracking on the liver). Included patients had performed a \"standard\" portal venous phase abdominal CT (i.e., 0.6 gI/Kg of total body weight (TBW) contrast material administration and 70 s fixed delay) on the same scanner within the previous 12 months. One reader evaluated CT images measuring liver, portal vein, kidney cortex, and spleen attenuation; values were normalized to paraspinal muscles.</p><p><strong>Results: </strong>Median administered contrast dose (350 mgI/mL CM) was 99 mL (IQR: 81-115 mL) using the experimental protocol and 110 mL (IQR: 100-120 mL) using the standard one (p < 0.0001). Median acquisition delay using the experimental protocol was 65\" (IQR 59-73\"). Median normalized hepatic enhancement was significantly higher using the experimental protocol (1.97, IQR: 1.83-2.47 vs. 1.86, IQR: 1.58-2.11; p < 0.0001). Median normalized portal vein enhancement was significantly higher using the experimental protocol (3.43, IQR: 2.73-4.04 vs. 2.91, IQR: 2.58-3.41; p < 0.0001). No statistically significant differences were found in the kidneys' cortex and aorta normalized enhancement (p > 0.05).</p><p><strong>Conclusion: </strong>The combination of LBW-based CM dose administration and bolus tracking allows a significant CM dose reduction and a significant liver and portal vein enhancement increase.</p><p><strong>Clinical relevance statement: </strong>Lean body weight-based contrast material (CM) dose administration and bolus tracking technique in portal venous phase CT scans overcome differences in body composition and hemodynamics, improving reproducibility. It allows a significant CM dose reduction with increased liver and portal vein enhancement.</p><p><strong>Key points: </strong>Lean body weight (LBW)-based contrast material (CM) dosing could be superior to total body weight dosing. Portal venous phase CT with a liver bolus tracking technique improved liver and spleen enhancement with a reduced contrast dose. The combination of LBW-based CM dosing and liver bolus tracking technique enables more \"customized\" CT examinations.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1067-1075"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter and inter-software evaluation of ablative margins after thermal ablation of colorectal liver metastases.","authors":"Gregor Laimer, Koen H M Verdonschot, Lina Kopf, Susan van der Lei, Yannick Scharll, Gerjon Hannink, Sjoerd F M Jenniskens, Martijn R Meijerink, Reto Bale, Christiaan G Overduin","doi":"10.1007/s00330-024-10956-5","DOIUrl":"10.1007/s00330-024-10956-5","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the association between minimal ablative margin (MAM) and local tumor progression (LTP) following CT-guided thermal ablation of colorectal liver metastases (CRLM) in a multicenter cohort and across two confirmation software.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study included patients who underwent CT-guided radiofrequency or microwave ablation for CRLM between 2009 and 2021 in three institutions. Three-dimensional (3D) MAM was retrospectively assessed using dedicated ablation confirmation software by automatic non-rigid (Ablation-fit) or semi-automatic rigid co-registration (SAFIR) of intraprocedural pre- and post-ablation contrast-enhanced CT scans by two independent reader teams blinded to patient outcomes. LTP was assessed on a per-tumor basis. Factors associated with LTP-free survival were assessed using multivariable Cox regression analysis.</p><p><strong>Results: </strong>Overall, 113 patients (mean age: 67 ± 10 years; 78 men) who underwent thermal ablation for 189 CRLM (mean diameter: 1.9 ± 1.1 cm) met the inclusion criteria. 173/189 (92%) CRLM could be successfully analyzed using both software. Over a median follow-up of 31 months (IQR: 22-47), 21 of 173 CRLM (12.1%) developed LTP. On multivariable analysis, 3D MAM was independently associated with LTP in both software (Ablation-fit: HR 0.47, 95% CI: 0.36-0.61, p < 0.001; SAFIR: HR 0.42, 95% CI: 0.32-0.55, p < 0.001). No LTP was observed in CRLM ablated with MAM ≥ 4 mm (Ablation-fit) and ≥ 5 mm (SAFIR). The per-tumor median absolute difference in MAM quantification between both software was 2 mm (IQR: 1-3).</p><p><strong>Conclusion: </strong>MAM was independently associated with LTP after thermal ablation of CRLM across multicenter data and two confirmation software. Ablations achieving a MAM ≥ 5 mm were associated with local control in both software.</p><p><strong>Clinical relevance statement: </strong>MAMs from intraprocedural contrast-enhanced CT were independently associated with LTP after thermal ablation of CRLM across multicenter data and two confirmation software, with a margin ≥ 5 mm associated with local control in both software.</p><p><strong>Key points: </strong>Sufficient ablative margins are critical for local control following thermal ablation of CRLM. Intraprocedural CT-derived MAM was the only independent factor associated with LTP across two confirmation software. No LTP was observed in CRLM ablated with a MAM ≥ 5 mm.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"1046-1056"},"PeriodicalIF":4.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}