CNR – IBF Istituto di Biofisica

Autori: Haitham Shoman, Jawad Al-Kassmy, Maryam Ejaz, Justin Matta, Sandi Alakhras, Kalin Kahla, Mario D’Acunto
Rivista: Journal of Bone Oncology
DOI: 10.1016/j.jbo.2023.100469
Abstract:
Osteosarcoma is the most common malignant tumour of the bone. Complete surgical excision is critical to achieve optimal outcomes and lower recurrence rates. However, accurate assessment of tumour margins remains a challenge and multiple technologies are employed for this purpose. The aim of this study is to highlight current and emerging technologies and their efficacy in detecting clear bone margins intraoperatively, through a systematic review of the literature.
The following databases were searched using the OVID platform: Medline, Embase, Global Health and Google Scholar. Studies were screened using predetermined eligibility criteria. Data was extracted based on study and patient characteristics, modes of detection, and commercial availability, followed by quality assessment.
A total of 17 studies were included. The primary diagnosis varied, with osteosarcoma being reported by 9 studies. Three studies reported relapse, ranging between 17.6%−48%. Twelve studies reported non-invasive imaging as the mode of detection used, while 4 studies reported the use of frozen section. MRI and CT were found to have an accuracy of up to 93 %. Raman spectroscopy was reported to have an accuracy, sensitivity, and specificity of 69%, 58.8% and 83.3% respectively. CT had a sensitivity and specificity up to 83% and 100%, respectively.

Keywords: Osteosarcoma, Intra-operative, Margin assessment, relapse