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Bone Tumors and Orthopedics

(P 85) MAKING NEGATIVE MARGIN MUSCULOSKELETAL TUMOR SURGERY A VIRTUAL REALITY USING 3D SPECIMEN SCANNING

    Author(s)

  • Riley S. Gilbertson, BA (he/him/his)

    Medical Student
    School of Medicine, Vanderbilt University, Nashville, TN, USA
    nashville, Tennessee, United States

    • Co-Author(s)

  • SK

    Sakshi Krishna, BS

    Vanderbilt University School of Medicine
    Nashville, Tennessee, United States

  • Whitney Jin, BA

    Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center
    Nashville, Tennessee, United States

  • SS

    Sindhura Sridhar, BS

    Vanderbilt University Medical Center
    Austin, Texas, United States

  • SC

    Stephen Chenard, MSc

    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

  • BS

    Ben Sonkin, n/a

    Penn State University
    Nashville, Tennessee, United States

  • JC

    Juan Colazo, MD

    School of Medicine, Vanderbilt University, Nashville, TN, USA
    Saint Louis, Missouri, United States

  • JH

    Jennifer L. Halpern, MD

    Assistant Professor
    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

  • Herbert S. Schwartz, MD

    Professor of Orthopaedic Surgery
    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

  • Reena Singh, MD

    Section Chief of Bone, Soft Tissue, and Skin Pathology
    Vanderbilt University Medical Center
    Nashville, Tennessee, United States

  • MT

    Michael Topf, MD

    Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center
    Nashville, Tennessee, United States

  • Joshua M. Lawrenz, MD

    Assistant Professor of Orthopaedic Surgery
    Division of Musculoskeletal Oncology, Department of Orthopaedic Surgery, Vanderbilt University Medical Center
    Nashville, Tennessee, United States

Objective: Surgical resection is the primary treatment for bone and soft tissue sarcoma. Negative margin status is associated with improved local control. Given the large volume and 3D anatomic complexity of many musculoskeletal tumors, communication of margin results between surgeons and pathologists can lack specificity based in a two-dimensional report. We sought to perform a feasibility study of ex vivo 3D scanning of bone and soft tissue tumor specimens to enhance communication between surgeons and pathologists.

Methods: Immediately after surgical resection, 3D scanning of the gross specimen was performed using the Einscan SP 3D scanner. During standard-of-care gross specimen processing, frozen and final margin sampling sites are annotated on the virtual 3D model. Then, using the 3D modeling software Blender, final margin distance to viable tumor was heat mapped onto 3D models for improved visualization.

Results: 3D scanning was performed in 19 cases (Table 1). This novel method of 3D margin mapping was found to be a feasible and reliable technique for communicating detailed information about margin status across a wide range of histopathological diagnoses and tumor locations. As gross sectioning disrupts the original specimen’s structure, a scanned 3D virtual specimen can be kept indefinitely and used for communication and margin localization.

Conclusion: Virtual 3D scanning specimen mapping is feasible and allows for enhanced documentation and communication. This technology provides useful insight into anatomically complex musculoskeletal tumor specimens. Future studies should validate the utility of this method to assist in planning additional resections and adjuvant therapies.

Demographic and Surgical Characteristics of Included Patients
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