3D Specimen Scanning and Mapping in Musculoskeletal Oncology: A Feasibility Study

Background Surgical resection is the primary treatment for bone and soft tissue tumors. Negative margin status is a key factor in prognosis. Given the three-dimensional (3D) anatomic complexity of musculoskeletal tumor specimens, communication of margin results between surgeons and pathologists is c...

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Bibliographic Details
Published in:Annals of surgical oncology 2024-03, Vol.31 (3), p.2051-2060
Main Authors: Colazo, Juan M., Prasad, Kavita, Miller, Alexis, Sharif, Kayvon, Aweeda, Marina, Fassler, Carly, Singh, Reena, Schwartz, Herbert S., Lawrenz, Joshua M., Holt, Ginger E., Topf, Michael C.
Format: Article
Language:English
Subjects:
Bone tumors
Communication
Feasibility studies
Malignancy
Mapping
Medicine
Medicine & Public Health
Oncology
Sampling
Sarcoma
Scanning
Surgeons
Surgery
Surgical Oncology
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Summary:Background Surgical resection is the primary treatment for bone and soft tissue tumors. Negative margin status is a key factor in prognosis. Given the three-dimensional (3D) anatomic complexity of musculoskeletal tumor specimens, communication of margin results between surgeons and pathologists is challenging. We sought to perform ex vivo 3D scanning of musculoskeletal oncology specimens to enhance communication between surgeons and pathologists. Methods Immediately after surgical resection, 3D scanning of the fresh specimen is performed prior to frozen section analysis. During pathologic grossing, whether frozen or permanent, margin sampling sites are annotated on the virtual 3D model using computer-aided design (CAD) software. Results 3D scanning was performed in seven cases (six soft tissue, one bone), with specimen mapping on six cases. Intraoperative 3D scanning and mapping was performed in one case in which the location of margin sampling was shown virtually in real-time to the operating surgeon to help achieve a negative margin. In six cases, the 3D model was used to communicate final permanent section analysis. Soft tissue, cartilage, and bone (including lytic lesions within bone) showed acceptable resolution. Conclusions Virtual 3D scanning and specimen mapping is feasible and may allow for enhanced documentation and communication. This protocol provides useful information for anatomically complex musculoskeletal tumor specimens. Future studies will evaluate the effect of the protocol on positive margin rates, likelihood that a re-resection contains additional malignancy, and exploration of targeted adjuvant radiation protocols using a patient-specific 3D specimen map.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-023-14757-w