sefulness of Magnetic Resonance Imaging/Ultrasound Fusion Imaging and Intraoperative Magnetic Resonance Imaging for Malignant Soft Tissue Tumor: A Case Report

Yoshioka K1*, Furuta T1 , Kubo T1 , Sakuda T1 , Saito T2 , Arihiro K3 and Adachi N1

Department of Orthopedic Surgery, Hiroshima University, Graduate School of Biomedical & Health Sciences, Hiroshima, Japan 2 Department of Neurosurgery, Tokyo Women?s Medical University, Tokyo, Japan 3 Department of Pathology, Hiroshima University, Graduate School of Biomedical & Health Sciences, Hiroshima, Japan

^*Correspondance to: Koki Yoshioka 

 PDF  Full Text DOI: 10.25107/2474-1647.2961

Abstract

Purpose: Achieving a balance between wide resection and function preservation is important when treating malignant soft tissue tumors; thus, tumor invasiveness must be determined precisely. This determination is typically evaluated by palpation with reference to Magnetic Resonance Imaging (MRI) and computed tomography images. However, this procedure cannot be performed in real time. Therefore, we paid attention to the combination of MRI/Ultrasound Fusion Imaging (M/UFI) and intraoperative MRI (iMRI) to evaluate tumor invasiveness precisely. Methods: A 46-year-old woman presented with dermatofibrosarcoma protuberans on her left ankle. To facilitate initial alignment in M/UFI, we injected a titanium marker into the tumor and performed iMRI under anesthesia preoperatively. iMRI images were uploaded on an ultrasound device, and the initial alignment in M/UFI was performed based on the marker. We marked tumor margin evaluated on palpation with reference to Magnetic Resonance Imaging (MRI) as ? and tumor margin evaluated on M/UFI as ?. Tumor resection was performed at a width of 2.5 cm and height of 3 cm from ?. Results: After tumor resection, tumor slices were obtained and evaluated macroscopically. ? depicted precise tumor margin more accurately than ?. Conclusion: M/UFI combined with iMRI enabled visual evaluation of tumor margin in reference to the latest MRI images, and it may help prevention of recurrence and limited operation.

Keywords

Magnetic resonance imaging/ultrasound fusion imaging; Intraoperative magnetic resonance imaging; Malignant soft tissue tumor; Tumor margin

Cite the article

Yoshioka K, Furuta T, Kubo T, Sakuda T, Saito T, Arihiro K, et al. Usefulness of Magnetic Resonance Imaging/ Ultrasound Fusion Imaging and Intraoperative Magnetic Resonance Imaging for Malignant Soft Tissue Tumor: A Case Report. Clin Surg. 2020; 5: 2961..