Allograft imaging in orthopaedic oncology - A tertiary sarcoma centre experience allograft imaging

Musculoskeletal tumour imaging utilises a multimodality approach to obtain valuable diagnostic information about the bone tumour and plan appropriate management strategies for their resection. Conventional radiography has been the workhorse for bone tumours evaluation. However, with rapid evolution and advancements in cross-sectional imaging modalities such as CT, MRI, and PET CT, additional insights on tumour imaging have been made possible, for accurate staging and optimal surgical planning. Recent innovations in image fusion further enhance the precision of tumoral assessment. Additionally, imaging has also proven crucial in guiding treatment planning, evaluating surgical resectability, and optimising the selection and placement of allografts. They also play a role during intra-operative guidance and post-operative assessment. The advancements in 3D printing technology have changed the challenging domain of musculoskeletal oncology by paving the way for computer-generated customised tools like Patient Specific Cutting Guides (PSCG) for primary bone tumour resections. This breakthrough has improved surgical precision and patient outcomes. This article highlights and discusses how imaging enhances the accuracy and effectiveness of allograft assessment and explores the application of 3D CT reconstruction in evaluating allografts, guiding surgical resections, and complex musculoskeletal reconstructions while achieving consistent tumour-free margins for limb salvage surgery.