Evrard Robin, Schubert Thomas, Paul Laurent, Docquier Pierre-Louis
Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab (NMSK), Université catholique de Louvain, Avenue Mounier 53, B-1200 Brussels, Belgium.
Service d'orthopédie et de traumatologie de l'appareil locomoteur, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, B-1200 Brussels, Belgium.
J Bone Oncol. 2022 May 13;34:100434. doi: 10.1016/j.jbo.2022.100434. eCollection 2022 Jun.
Patient Specific Instruments (PSI) is currently a proven technique for bone tumor resection. In a previous publication, we analyzed the quality of margin resection of pelvic sarcoma resections with the use of PSI (by pathologic evaluation of the margins). In this new study, we compare preoperative resection planning and actual resection margins by MRI analysis of the resection specimens.
Between 2011 and 2020, 31 patients underwent bone tumor resection with the use of PSI. Preoperatively, the margins were planned with a software and PSI were made according to these margins. Postoperatively, the surgical resection specimens were analyzed with MRI. Resection margins were measured with the same software used in the preoperative planning.
All margins were safe (free of tumor). The differences between preoperative planned margins and the obtained ones were within the range -5 to +5 mm. The correlation between planned margin and the obtained one was excellent (R = 0.841; p < 0.0001).
This study demonstrates the accuracy of PSI. In our series, all resection margins were safe. A minimal 5 mm-margin has to be planned but a larger sample is needed to give recommendations.
定制型器械(PSI)目前是一种经证实的骨肿瘤切除技术。在之前的一篇出版物中,我们通过病理评估切缘分析了使用PSI进行骨盆肉瘤切除的切缘质量。在这项新研究中,我们通过对切除标本的MRI分析来比较术前切除计划和实际切除切缘。
2011年至2020年期间,31例患者使用PSI进行了骨肿瘤切除。术前,使用软件规划切缘并根据这些切缘制作PSI。术后,对手术切除标本进行MRI分析。使用术前规划中使用的相同软件测量切除切缘。
所有切缘均安全(无肿瘤)。术前规划切缘与实际获得切缘之间的差异在-5至+5毫米范围内。规划切缘与实际获得切缘之间的相关性极佳(R = 0.841;p < 0.0001)。
本研究证明了PSI的准确性。在我们的系列研究中,所有切除切缘均安全。必须规划至少5毫米的切缘,但需要更大的样本量才能给出建议。