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Article summary:

1. A biomechanical deformable image registration (DIR) method was used to quantify minimal ablative margin (MAM) of colorectal liver metastases (CLM) treated with CT-guided microwave or radiofrequency ablation.

2. An MAM of 0 mm was depicted in 14.6% of CLMs, from greater than 0 to less than 5 mm in 40.4%, and greater than or equal to 5 mm in 45.1%.

3. An MAM of 0 mm was independently associated with local disease progression, while no local disease progression was observed for an MAM greater than or equal to 5 mm.

Article analysis:

The article is generally reliable and trustworthy, as it is based on a single-institution retrospective study that included 124 consecutive patients with CLM treated with CT-guided microwave or radiofrequency ablation from October 2015 to March 2020. The authors also used a biomechanical DIR method with AI-based autosegmentation of liver, tumors, and ablation zones on CT images for MAM quantification retrospectively, which provides a more accurate assessment of the minimal ablative margin compared to manual segmentation methods. Furthermore, the results were evaluated using the multivariable Fine-Gray subdistribution hazard model and a 3D ray-tracing method for spatial localization of local disease progression sites within the tissue at risk for tumor progression (<5mm).

However, there are some potential biases that should be noted when interpreting the results of this study. First, since this is a retrospective study, there may be selection bias due to the fact that only patients who had undergone CT-guided microwave or radiofrequency ablation were included in the study sample. Second, since this is a single institution study, there may be institutional bias due to differences in patient characteristics between institutions that could affect the results. Finally, since this is an observational study rather than a randomized controlled trial, it is possible that other factors not accounted for by the authors could have influenced the results.