MRI Evaluation of Resection Margins in Bone Tumour Surgery
Simon Vandergugten,
Sidi Yaya Traore,
Olivier Cartiaux,
Frédéric Lecouvet,
Christine Galant,
Pierre-Louis Docquier
Affiliations
Simon Vandergugten
Computer Assisted and Robotic Surgery (CARS), Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, avenue Mounier 53, 1200 Brussels, Belgium
Sidi Yaya Traore
Computer Assisted and Robotic Surgery (CARS), Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, avenue Mounier 53, 1200 Brussels, Belgium
Olivier Cartiaux
Computer Assisted and Robotic Surgery (CARS), Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, avenue Mounier 53, 1200 Brussels, Belgium
Département de Pathologie, Cliniques Universitaires Saint-Luc, 10 avenue Hippocrate, 1200 Brussels, Belgium
Pierre-Louis Docquier
Computer Assisted and Robotic Surgery (CARS), Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, avenue Mounier 53, 1200 Brussels, Belgium
In 12 patients operated on for bone sarcoma resection, a postoperative magnetic resonance imaging of the resection specimens was obtained in order to assess the surgical margins. Margins were classified according to MRI in R0, R1, and R2 by three independent observers: a radiologist and two orthopaedic surgeons. Final margin evaluation (R0, R1, and R2) was assessed by a confirmed pathologist. Agreement for margin evaluation between the pathologist and the radiologist was perfect (κ=1). Agreement between the pathologist and an experienced orthopaedic surgeon was very good while it was fair between the pathologist and a junior orthopaedic surgeon. MRI should be considered as a tool to give quick information about the adequacy of margins and to help the pathologist to focus on doubtful areas and to spare time in specimen analysis. But it may not replace the pathological evaluation that gives additional information about tumor necrosis. This study shows that MRI extemporaneous analysis of a resection specimen may be efficient in bone tumor oncologic surgery, if made by an experienced radiologist with perfect agreement with the pathologist.
