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3D Specimen Scanning and Mapping in Musculoskeletal Oncology: A Feasibility Study

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Abstract

Background

Surgical resection is the primary treatment for bone and soft tissue tumors. Negative margin status is a key factor in prognosis. Given the three-dimensional (3D) anatomic complexity of musculoskeletal tumor specimens, communication of margin results between surgeons and pathologists is challenging. We sought to perform ex vivo 3D scanning of musculoskeletal oncology specimens to enhance communication between surgeons and pathologists.

Methods

Immediately after surgical resection, 3D scanning of the fresh specimen is performed prior to frozen section analysis. During pathologic grossing, whether frozen or permanent, margin sampling sites are annotated on the virtual 3D model using computer-aided design (CAD) software.

Results

3D scanning was performed in seven cases (six soft tissue, one bone), with specimen mapping on six cases. Intraoperative 3D scanning and mapping was performed in one case in which the location of margin sampling was shown virtually in real-time to the operating surgeon to help achieve a negative margin. In six cases, the 3D model was used to communicate final permanent section analysis. Soft tissue, cartilage, and bone (including lytic lesions within bone) showed acceptable resolution.

Conclusions

Virtual 3D scanning and specimen mapping is feasible and may allow for enhanced documentation and communication. This protocol provides useful information for anatomically complex musculoskeletal tumor specimens. Future studies will evaluate the effect of the protocol on positive margin rates, likelihood that a re-resection contains additional malignancy, and exploration of targeted adjuvant radiation protocols using a patient-specific 3D specimen map.

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Acknowledgment

JMC is supported by the National Institute of General Medical Sciences (NIGMS) of the National Institutes of Health under award number T32GM007347. The content in this report is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding

This work was supported by a Vanderbilt Clinical Oncology Research Career Development Program (K12 NCI 2K12CA090625-22A1) and an ACS Institutional Research Grant (#IRG-19-139-60).

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Authors and Affiliations

  1. School of Medicine, Vanderbilt University, Nashville, TN, USA

    Juan M. Colazo BS & Kayvon Sharif MD

  2. Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Kavita Prasad BA, Alexis Miller BS, Marina Aweeda BS, Carly Fassler BS & Michael C. Topf MD

  3. Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA

    Reena Singh MD

  4. Division of Musculoskeletal Oncology, Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Herbert S. Schwartz MD, Joshua M. Lawrenz MD & Ginger E. Holt MD

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  1. Juan M. Colazo BS
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Corresponding author

Correspondence to Michael C. Topf MD.

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Disclosures

Kayvon Sharif: USPTO application number: 63/351,292. Patent application title: Three-Dimensional Models of Surgical Margins. Juan M. Colazo, Kavita Prasad, Alexis Miller, Marina Aweeda, Carly Fassler, Reena Singh, Herbert S. Schwartz, Joshua M. Lawrenz, Ginger E. Holt, and Michael C. Topf have no conflicts of interest to declare in relation to this work.

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Colazo, J.M., Prasad, K., Miller, A. et al. 3D Specimen Scanning and Mapping in Musculoskeletal Oncology: A Feasibility Study. Ann Surg Oncol 31, 2051–2060 (2024). https://doi.org/10.1245/s10434-023-14757-w

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