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

Abstract

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. 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. 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. 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. 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.