Table 3.
Summary of the characteristics of the studies evaluating intraoperative margin assessment.
| Author | Study design | Number of patients | Primary diagnosis (number of patients) | Relapse (%) | Technology | Distinguishing factors | Detection mode |
|---|---|---|---|---|---|---|---|
| L.Cannavò et al.[32] | Retrospective Cohort | 46 | Primary malignant bone tumours | No | MRI + CT | Bone and soft-tissue margins | Non-invasive |
| Anderson et al. [16] | Retrospective Cohort | 142 | Primary bone sarcomas | No | Cryosection + Microscopical analysis | Bone marrow margins | Invasive |
| Bajpai et al. [21] | Prospective Cohort | 31 | Osteosarcoma | No | Dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) | VEGF and Angiogenesis | Non-invasive |
| Aszodi et al. [33] | Prospective Cohort | 13 | Primary bone sarcomas | No | Cryosection + Microscopical analysis | Histological examination of malignancy | Invasive |
| Fayad et al. [22] | Retrospective Cohort | 13 | Skeletal sarcomas | No | Multivoxel proton magnetic resonance spectroscopic imaging (MRSI) | Markers of malignancy, such as elevated levels of metabolites (choline) that reflect high cell turnover | Non-invasive |
| Bosma et al. [30] | Case control | 70 | Pelvic or Sacral sarcomas | No | CT fluoroscopy / intraop. CT | Bone and soft-tissue surgical margins (Enneking system) | Non-invasive |
| Boufettal et al. [35] | Case series | 5 | Osteoid osteoma | No | Isotopic tracking probe using HMDP-99mTc probe | 99mTc-HMDP tracer fixation on the bone lesion | Minimally invasive |
| Cates et al. [24] | Retrospective cohort | 186 | High-grade osteosarcomas | Yes (20%) | Musculoskeletal Tumor Society (MSTS) + American Joint Committee on Cancer (AJCC) R system + margin distance method |
Pathology reports and operative notes | Margin assessment schemes |
| Seong Cho et al. [23] | Retrospective cohort | 6 | High-grade osteosarcoma, chondrosarcoma, and adamantinoma | No | MR images to navigation-assisted bone tumor surgery | Bone and soft-tissue margins | Non-invasive |
| Evrard et al. [31] | Case-Control | 28 | Primary pelvic bone sarcomas | No | MRI + CT + Patient-specific instruments (PSIs) | Bony margins and soft-tissue margins | Non-invasive |
| Fujiwara et al. [28] | Case control | 50 | Chondrosarcoma | Yes (48%) | Oncology-specific navigation surgery (fused with pre-op CT and MR images) | Bone and soft-tissue margins | Non-invasive |
| Hodel et al. [29] | Retrospective Cohort | 68 | Chondrosarcoma | Yes (17.6%) | CT | Histological grading | Non-invasive |
| Kseniya S. Shin et al. [34] | Specimen study | 16 | Skull base tumours | N/A | Stimulated Raman scattering (SRS) imaging technique with a new pseudo-H&E recolouring methodology | Histological examination | Non-invasive |
| Malek et al. [25] | Case control | 32 | Osteosarcoma | N/A | Diffusion-weighted (DW) imaging and proton magnetic resonance (MR) spectroscopy | MR Spectroscopy- choline containing compounds. DWI- Restriction of water molecules mobility | Non-invasive |
| Meyer et al. [14] | Retrospective Cohort | 113 | High grade osteosarcoma |
Yes ((8.2% (7/85)) |
Frozen section with/without pre-operative MRI | Marrow margins | Non-invasive Pre-operative MRI + Invasive (frozen section) |
| Sakamoto et al. [26] | Specimen study | 5 | Primary bone sarcomas | N/A | Intra-operative specimen MRI |
Marrow margins | Mixed |
| Wong et al. [27] | Retrospective Cohort | 8 | High grade osteosarcoma, parosteal osteosarcoma, Low grade chondrosarcoma | No | MRI + CT + 3D software aided visualization for navigation |
Transition of marrow signal from abnormal to normal in T1-weighted MR images. | Non-invasive |