Evaluating 3D MR Ablation Margins in Hepatocellular Carcinoma after Thermal Ablation Using Open-Source Software

Motivation: Accurate assessment of ablation margins is crucial in hepatocellular carcinoma (HCC) patients following thermal ablation. Goal(s): To evaluate the feasibility of open-source software for quantifying MR 3D ablation margins and identifying independent risk factors for local recurrence. Approach: Analysis of 73 HCCs treated with thermal ablation was conducted using 3D Slicer. Univariate and multivariate Cox model was built to assess factors associated with local recurrence. Results: The 3D minimal ablative margin (MAM) and proximity to large vessels were significant predictors of local recurrence, with multivariate Cox model's AUC values of 0.85, 0.78, and 0.82 at 1, 2, and 3 years, respectively. Impact: Open-source software can quantify 3D ablation margins at MR images, offering a practical tool in assessing HCC thermal ablation efficacy.