Quantifying Functional Liver Volume Loss after CT-guided Percutaneous Thermal Ablation: A COVER-ALL Trial Post Hoc Analysis
Abstract
Purpose To quantify functional liver volume (FLV) loss relative to minimal ablative margins (MAMs) achieved during percutaneous thermal ablation (TA) of liver tumors in COVER-ALL randomized controlled trial (RCT) participants. Materials and Methods In the COVER-ALL single-center RCT (June 2020 through October 2023), software-based ablation confirmation (AC) (experimental) and visual margin (control) assessment were compared among participants with histology-agnostic liver tumors. In this post hoc analysis, the authors compared CT-derived volumes, MAMs, and changes in laboratory-based hepatic function using Wilcoxon rank sum and Spearman correlation tests. Results Among 100 participants (mean age ± SD, 57.8 years ± 13.2; 61 male; experimental group, n = 74, 98 tumors ablated, median diameter = 1.5 cm; control group, n = 26, 41 tumors ablated, median diameter = 1.3 cm), the experimental and control group baseline median FLVs (1707 cm3 [IQR, 1467-1964 cm3] vs 1722 cm3 [IQR, 1338-1916 cm3]; P = .84) were comparable. The median MAM was larger in the experimental versus the control group (6 mm [IQR, 4.5-7.9 mm] vs 1 mm [IQR, 0-4 mm]; P P = .03). The median postablation FLV was comparable between the experimental and control groups (1643 cm3 [IQR, 1403-1886 cm3] and 1696 cm3 [IQR, 1315-1843 cm3]; P = .87). We observed no association between percentage FLV loss and changes in serum albumin (ρ = -0.153, P = .16) or total bilirubin concentrations (ρ = -0.128, P = .25). Conclusion…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 100 participants or records.
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