{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:07:41Z","timestamp":1788847661597,"version":"build-2803163510"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>During CT-guided thermal ablation of lung tumors, guidelines define the intraprocedural endpoint as a circumferential margin of increased attenuation extending 5\u201310\u2005mm beyond the tumor. This criterion does not require the strict radiologic texture of ground-glass opacity. The timely appearance of this margin is the main real-time marker of an adequate treatment volume, and its absence is conventionally read as underablation, prompting additional energy delivery. We report a metastatic solid nodule in the left lower lobe treated with microwave ablation (45 W, 8\u2005min total) via a single antenna, without repositioning. No such margin formed after three ablation cycles or after needle withdrawal, on a scan obtained 21\u2005min after the first cycle and beyond the recommended 5- to 10-minute window; the only intraprocedural change was slight, non-circumferential enlargement of the solid-attenuation area. A well-defined margin with dense consolidation appeared only at 30.5\u2005h; by 32 days, most consolidation had resorbed, forming a cavity. Despite adequate energy delivery, the guideline-defined margin in this solid nodule remained unconfirmed well beyond the standard observation window, and its absence should not be treated as an automatic indication for further ablation.<\/jats:p>","DOI":"10.3389\/fmed.2026.1972087","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:34:53Z","timestamp":1788845693000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Delayed appearance of the ablation margin after CT-guided microwave ablation of a solid pulmonary nodule"],"prefix":"10.3389","volume":"13","author":[{"given":"Hao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiology, Dianjiang People\u2019s Hospital of Chongqing","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Hao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dianjiang People\u2019s Hospital of Chongqing","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-En","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dianjiang People\u2019s Hospital of Chongqing","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Dianjiang People\u2019s Hospital of Chongqing","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1007\/s00270-025-03984-1","article-title":"Radiofrequency ablation versus thoracoscopic sublobar resection for the treatment of pulmonary ground glass nodules: a retrospective observational study","volume":"48","author":"Zhao","year":"2025","journal-title":"Cardiovasc Intervent Radiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s00270-012-0340-1","article-title":"Cardiovascular and interventional radiological society of Europe (CIRSE). standards of practice: guidelines for thermal ablation of primary and secondary lung tumors","volume":"35","author":"Pereira","year":"2012","journal-title":"Cardiovasc Intervent Radiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1242.e1","DOI":"10.1016\/j.jvir.2021.04.027","article-title":"Society of interventional radiology quality improvement standards on percutaneous ablation of non-small cell lung cancer and metastatic disease to the lungs","volume":"32","author":"Genshaft","year":"2021","journal-title":"J Vasc Interv Radiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1111\/1759-7714.15333","article-title":"2024 Multidisciplinary consensus on image-guided lung tumor ablation from the Taiwan academy of tumor ablation","volume":"15","author":"Chang","year":"2024","journal-title":"Thorac Cancer"},{"key":"B5","doi-asserted-by":"publisher","first-page":"64","DOI":"10.21037\/cco.2019.12.09","article-title":"Advances in percutaneous lung tumor therapy: 2019 update","volume":"8","author":"Kodama","year":"2019","journal-title":"Chin Clin Oncol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e232558","DOI":"10.1148\/radiol.232558","article-title":"Fleischner society: glossary of terms for thoracic imaging","volume":"310","author":"Bankier","year":"2024","journal-title":"Radiology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"471","DOI":"10.2214\/AJR.21.27099","article-title":"Update on image-guided thermal lung ablation: society guidelines, therapeutic alternatives, and postablation imaging findings","volume":"219","author":"Murphy","year":"2022","journal-title":"AJR Am J Roentgenol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1007\/s11604-012-0054-y","article-title":"Loss of cellular viability in areas of ground-glass opacity on computed tomography images immediately after pulmonary radiofrequency ablation in rabbits","volume":"30","author":"Kuroki","year":"2012","journal-title":"Jpn J Radiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.4103\/jcrt.jcrt_837_23","article-title":"Lung microwave ablation: post-procedure imaging features and evolution of pulmonary ground-glass nodule-like lung cancer","volume":"19","author":"Xue","year":"2023","journal-title":"J Cancer Res Ther"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1016\/j.jvir.2014.08.027","article-title":"Image-guided tumor ablation: standardization of terminology and reporting criteria\u2013a 10-year update","volume":"25","author":"Ahmed","year":"2014","journal-title":"J Vasc Interv Radiol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.4103\/jcrt.jcrt_880_22","article-title":"Clinical practice guidelines on image-guided thermal ablation of primary and metastatic lung tumors (2022 edition).","volume":"18","author":"Ye","year":"2022","journal-title":"J Cancer Res Ther"},{"key":"B12","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s13244-021-00997-5","article-title":"Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art","volume":"12","author":"P\u00e1ez-Carpio","year":"2021","journal-title":"Insights Imaging"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1299","DOI":"10.2214\/AJR.04.0968","article-title":"Radiofrequency ablation in a porcine lung model: correlation between CT and histopathologic findings","volume":"185","author":"Yamamoto","year":"2005","journal-title":"AJR Am J Roentgenol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1016\/j.jvir.2024.07.028","article-title":"Patient-Specific prediction of immediate phase lung microwave ablation zone size","volume":"35","author":"Kim","year":"2024","journal-title":"J Vasc Interv Radiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"617","DOI":"10.3390\/tomography8020051","article-title":"CT After lung microwave ablation: normal findings and evolution patterns of treated lesions","volume":"8","author":"Vespro","year":"2022","journal-title":"Tomography"},{"key":"B16","doi-asserted-by":"publisher","first-page":"3738","DOI":"10.3390\/cancers15143738","article-title":"Histology-Validated dielectric characterisation of lung carcinoma tissue for microwave thermal ablation applications","volume":"15","author":"Farina","year":"2023","journal-title":"Cancers (Basel)"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1972087\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:34:54Z","timestamp":1788845694000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1972087\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,8]]},"references-count":16,"alternative-id":["10.3389\/fmed.2026.1972087"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1972087","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,8]]},"article-number":"1972087"}}