Image-guided ablation has emerged as a potentially curative treatment for colorectal cancer liver metastases (CRLM), yet substantial heterogeneity persists in patient selection, technical execution, and perioperative management. To establish standardized, evidence-based guidance, a multidisciplinary panel of 68 experts including image-guided interventionalists, surgeons, and oncologists conducted a systematic review of literature from 2000 to 2025 and developed consensus recommendations through a modified two-round Delphi process. Evidence was graded using the Oxford Centre for Evidence-Based Medicine framework, achieving at least conditional consensus (≥75% agreement) for all statements. Finally, twenty consensus recommendations were established addressing patient selection, imaging evaluation, image-guided techniques, ablation strategies, complication management, surveillance protocols, and combination therapies. This expert consensus provides a comprehensive framework for optimizing image-guided ablation as an integral component of multidisciplinary, personalized CRLM management.
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Cui et al. (2026) studied this question.
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