Imaging, precise tools, in-procedure ablation zone visibility and confirmation of success with adequate margins could propel thermal ablation to achieve outcomes on par with surgery

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Constantinos Sofocleous (New York, USA) sits down with Interventional News to discuss how image-guided thermal ablation, when it is deployed with an intent to cure small colorectal liver metastases, can be fine-tuned so that its outcomes match those achieved by open surgery.

There are several minimum requirements for ablation to be curative, and Sofocleous outlines these as: adequate imaging to see the target tumour well; tools that allow for optimal placement of the electrode; intraprocedural ability to see the ablation zone and the ability to confirm tumour eradication with adequate margins at the end of the procedure.

Sofocleous also discusses the ACCLAIM trial, of which he is the principal investigator with particular reference to the ablation margins (5mm, and ideally 10mm), stating that when margins are adequately ablated, local tumour control is similar, if not better, than wedge resection for small colorectal liver metastases.

The Society of Interventional Oncology aims to use the trial’s findings to raise the bar and demonstrate that with minimum requirements and standards, ablation can be moved to being a standard of care across different global health care systems.


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