Accuracy of magnetic resonance imaging in planning the osseous resection margins of bony tumours in the proximal femur: based on coronal T1-weighted versus STIR images

Ahmad, Sarfraz; Stevenson, Jonathan; Mangham, Charles A.; Cribb, G.L.; Cool, Paul

doi:10.1007/s00256-014-1979-2

Cited by 19 publications

(7 citation statements)

References 29 publications

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“…The coronal T 1 weighted image is reported to be excellent for evaluating bone marrow spread in the long-axis of osteosarcoma and Ewing sarcoma tumors. 6,7 For the current specimen MRI, the T 1 weighted image was useful to evaluate tumor extension in the bone marrow. The specimen MRI can be used to confirm the planned surgical margin.…”

Section: Discussionmentioning

confidence: 99%

MRI examination of resected malignant bone tumor can be an option for assessment of the osseous surgical margin

Sakamoto

Okamoto

Ikeguchi

et al. 2019

The British Journal of Radiology

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Objective: Confirming the surgical osseous margin of a resected malignant bone tumor macroscopically before reconstruction with a prosthesis is ideal. However, making the cut-surface of the femur specimen during surgery is difficult because of the hard bone tissue. In order to resolve this problem, the possibility of intraoperative MRI was considered. Methods: MRI was performed at the surgical unit for five malignant femoral bone tumors that included two osteosarcomas and one undifferentiated high-grade sarcoma, and two metastatic tumors immediately after the tumor resection. The specimens were prepared in plastic containers with saline. Results: The osseous surgical margins were confirmed to be those planned pre-operatively in all cases without metal-induced artifacts. The T1 weighted image (WI) was useful for evaluation of the osseous surgical margin, whereas the T2WI was useful for confirmation of extraosseous soft-tissue. Conclusion: The MRI was performed post-operatively as a preliminary evaluation of the technique. However, a limited sequence (i.e. coronal T1WI) with short examination time could be performed during surgery for the sole purpose of assessing the osseous margin. Advances in knowledge: MRI examination of a resected malignant bone tumor specimen has not been reported, and can be an option for assessment of the osseous surgical margin.

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Section: Discussionmentioning

confidence: 99%

MRI examination of resected malignant bone tumor can be an option for assessment of the osseous surgical margin

Sakamoto

Okamoto

Ikeguchi

et al. 2019

The British Journal of Radiology

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“…At present, the validity of MRI in the measurement of intramedullary range of bone tumor has been verified in many reports. [ 2 3 ] Studies conducted by O’Flanagan et al . [ 1 ] and Onikul et al .…”

Section: Discussionmentioning

confidence: 99%

“…Unenhanced T1-weighted magnetic resonance imaging (T1WI MRI) is an important preoperative examination used to visualize the intramedullary extent of malignant long bone tumors. Early reports stated that MRI, especially T1WI MRI in patients with primary bone tumors, were reliable;[ 1 2 3 4 ] however, the reported case numbers were small, and most studies were focused on osteosarcoma. We evaluated the validity of T1WI in determining the extent of intramedullary tumor in patients with primary malignant tumors, including osteosarcoma and some other primary malignant tumors in long bones, in a large number of patients.…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging for the Assessment of Long Bone Tumors

Jin

Deng

Liu

et al. 2017

Chinese Medical Journal

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Background:Wide resection margins of osseous tumors are associated with a low incidence of local recurrence, making accurate measurement of the intraosseous extent of primary malignant long bone tumors is crucial. We compared the intraosseous tumor extent assessed by magnetic resonance imaging (MRI) with the gross specimen to evaluate the accuracy of MRI.Methods:A total of 255 patients with primary malignant tumors in the long bones were included. Using MRI, we defined the length of tumor as the distance from the articular surface to the boundary between abnormal and normal marrow signal. The extent of the abnormal intraosseous signal was measured on unenhanced T1-weighted (T1WI) magnetic resonance images after chemotherapy. All gross surgical specimens were sectioned, and tumor extent was measured. Wilcoxon signed-rank test was used to test the differences between MRI and gross specimen findings. Spearman's correlation analysis was used to test the correlation between groups.Results:Median tumor length by gross specimen (112 mm; range, 45–300 mm) was longer than that by MRI (108 mm; range, 45–304 mm; Z = −6.916, P < 0.001). Of 255 images, tumor length was accurately represented on 27 T1WI magnetic resonance images, overestimated on 79 images, and underestimated on 149 images. The median difference between imaging and gross specimen measurements was 2.0 mm (range: 1.0–15.0 mm) for the 79 cases where tumor length was overestimated, and 5.0 mm (range: 1.0–18.0 mm) for the 149 cases where tumor length was underestimated. The Spearman correlation demonstrated a high correlation of tumor length on gross specimen with the tumor length on MRI (R = 0.99, P < 0.01).Conclusions:We conclude that preoperative MRI could be a useful method in determining intramedullary malignant bone tumor boundaries and may serve as an accepted assessment method of long bone tumors before limb-sparing surgery.

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“…Resection levels are assessed on T1-weighted sequences as short TI inversion recovery (STIR) sequences overestimate intra-osseous extent by highlighting peri-tumoural oedema. 19 MRI is frequently helpful to assess tumour response to adjuvant radiation or chemotherapy when re-staging tumours immediately prior to resection. The development of non-enhancing regions of a tumour may indicate a positive response to radiation or chemotherapy, and peri-tumoural oedema frequently reduces.…”

Section: Surgical Planningmentioning

confidence: 99%

Radiological investigations in orthopaedic oncology

Malik

Hall

Stevenson

et al. 2017

Orthopaedics and Trauma

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Accuracy of magnetic resonance imaging in planning the osseous resection margins of bony tumours in the proximal femur: based on coronal T1-weighted versus STIR images

Abstract: This study has shown T1-weighted MRI sequences to be unbiased compared with STIR sequences at determining intra-osseous tumour extent. STIR overestimates the length of bone tumours. T1 is therefore preferred for pre-operative planning for the resection of bone tumours.

Cited by 19 publications

References 29 publications

MRI examination of resected malignant bone tumor can be an option for assessment of the osseous surgical margin

MRI examination of resected malignant bone tumor can be an option for assessment of the osseous surgical margin

Magnetic Resonance Imaging for the Assessment of Long Bone Tumors

Radiological investigations in orthopaedic oncology

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