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MRI-Based Assessment of Safe Margins in Tumor Surgery
Laura Bellanova1, Thomas Schubert1, Olivier Cartiaux1
1Computer Assisted and Robotic Surgery (CARS), Institut de Recherche Expérimentale et Clinique (IREC), Université catholique de Louvain Tour Pasteur +4, Avenue Mounier, 53, 1200 Brussels, Belgium.
Abstract:
Introduction. In surgical oncology, histological analysis of excised tumor specimen is the conventional method to assess the safety of the resection margins. We tested the feasibility of using MRI to assess the resection margins of freshly explanted tumor specimens in rats. Materials and Methods. Fourteen specimen of sarcoma were resected in rats and analysed both with MRI and histologically. Slicing of the specimen was identical for the two methods and corresponding slices were paired. 498 margins were measured in length and classified using the UICC classification (R0, R1, and R2). Results. The mean difference between the 498 margins measured both with histology and MRI was 0.3 mm (SD 1.0 mm). The agreement interval of the two measurement methods was [-1.7 mm; 2.2 mm]. In terms of the UICC classification, a strict correlation was observed between MRI- and histology-based classifications (κ = 0.84, P < 0.05). Discussion. This experimental study showed the feasibility to use MRI images of excised tumor specimen to assess the resection margins with the same degree of accuracy as the conventional histopathological analysis. When completed, MRI acquisition of resected tumors may alert the surgeon in case of inadequate margin and help advantageously the histopathological analysis.
Insights
Magnetic Resonance Imaging (MRI) can accurately assess tumor resection margins in excised specimens, matching traditional histopathology. This feasibility study in rats shows MRI
Area of Science:
- Surgical Oncology
- Medical Imaging
- Experimental Pathology
Background:
- Histological analysis of excised tumor specimens is the standard for assessing surgical resection margin safety.
- Accurate margin assessment is critical to prevent cancer recurrence.
Purpose of the Study:
- To evaluate the feasibility of using Magnetic Resonance Imaging (MRI) to assess resection margins in freshly explanted rat tumor specimens.
- To compare MRI-based margin assessment with conventional histopathological analysis.
Main Methods:
- Fourteen rat sarcoma specimens were resected and analyzed using both MRI and histology.
- Specimen slicing was standardized, and corresponding slices were paired for analysis.
- 498 margins were measured and classified using the Union for International Cancer Control (UICC) criteria (R0, R1, R2).
Main Results:
- The mean difference in margin measurement between MRI and histology was 0.3 mm (SD 1.0 mm).
- The agreement interval between the two methods was [-1.7 mm; 2.2 mm].
- A strong correlation (κ = 0.84, P < 0.05) was found between MRI and histology for UICC margin classification.
Conclusions:
- MRI is a feasible tool for assessing resection margins in excised tumor specimens.
- MRI demonstrates comparable accuracy to histopathological analysis for margin assessment.
- Integrating MRI into surgical workflow may enhance intraoperative decision-making and guide histopathological analysis.
