Abstract
Background
We describe a method for the direct application of MR images to navigation-assisted bone tumor surgery as an alternative to CT–MRI fusion.
Method
Six patients with an orthopedic malignancy were employed for this method during navigation-assisted tumor resection. Tumor types included osteosarcoma (4), high-grade chondrosarcoma (1), and adamantinoma (1). Mean patient age was 25.3 years (range 18–52 years). Mean duration of follow-up was 25.8 months (range 18–32 months). Resorbable pin placement and rapid 3-dimensional spoiled gradient echo sequences made the direct application of MR images to computer-assisted bone tumor surgery without CT–MR image fusion possible. A paired-point registration technique was employed for patient-image registration in all patients.
Results
It took 20 min on average to set up the navigation (range 15–25 min). The mean registration error was 0.98 mm (range 0.4–1.7 mm). On histologic examination, distances from tumors to resection margins were in accord with preoperative plans. No patient had a local recurrence or distant metastasis at the last follow-up.
Conclusion
Direct patient-to-MRI registration is a very useful method for bone tumor surgery, permitting the application of MR images to intraoperative visualization without any additional costs or exposure of the patient to radiation from the preoperative CT scan.
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Acknowledgments
This study was supported by a Korea Healthcare Technology R&D Project grant from the Ministry for Health, Welfare and Family Affairs, Republic of Korea (A084177). No benefits of any form have been or will be received from a commercial party directly or indirectly relating to the subject of this article.
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Cho, H.S., Park, IH., Jeon, IH. et al. Direct application of MR images to computer-assisted bone tumor surgery. J Orthop Sci 16, 190–195 (2011). https://doi.org/10.1007/s00776-011-0035-5
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DOI: https://doi.org/10.1007/s00776-011-0035-5