Image Fusion for Computer-assisted Bone Tumor Surgery

• Published in: Clinical orthopaedics and related research 2008-10, Vol.466 (10), p.2533-2541
• Main Authors: Wong, Kwok Chuen, Kumta, Shekhar Madhuker, Antonio, Gregory Ernest, Tse, Lung Fung
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Bone Neoplasms - pathology; Bone Neoplasms - surgery; Child; Conservative Orthopedics; Diseases of the osteoarticular system; Feasibility Studies; Female; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multimedia; Multimedia Article; Orthopedic Procedures - methods; Orthopedics; Preoperative Care; Reproducibility of Results; Sports Medicine; Surgery; Surgery, Computer-Assisted; Surgical Orthopedics; Tomography, X-Ray Computed; Treatment Outcome; Tumors of striated muscle and skeleton
• ISSN: 0009-921X; 1528-1132
• DOI: 10.1007/s11999-008-0374-5

The fusion of computed tomography and magnetic resonance images is a software-dependent processing technique that enables one to integrate and analyze preoperative images for planning complex musculoskeletal tumor resections. By integrating various imaging modalities into one imaging data set we may facilitate preoperative image analysis and planning of navigation computer-assisted bone tumor resection and reconstruction. We performed image fusion for computer-assisted tumor surgery in 13 consecutive patients, seven males and six females, with a mean age of 35.8 years (range, 6–80 years). Visual verification of fused images was accurate in all patients. The mean time for image fusion was 30.6 minutes (range, 8–80 minutes). After intraoperative registration, all tumor resections were performed as planned preoperatively under navigation image guidance. Resections achieved after navigation resection planning were validated by postoperative CT or resected specimens in seven patients. Histologic examination of all resected specimens showed tumor-free margins in patients with bone sarcoma. The fusion of computed tomography and magnetic resonance imaging has the potential to enhance computer-assisted bone tumor surgery. The fusion image, when combined with surgical navigation, helps surgeons reproduce a preoperative plan reliably and may offer substantial clinical benefits. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.