Role of Bone Scan and MRI in Designing of Customized Prosthesis for Limb Salvage Surgery of Long Bone Tumors: 4 Years of Single Institution Analysis

Indian J Surg Oncol. 2022 Jun;13(2):364-371. doi: 10.1007/s13193-021-01475-6. Epub 2021 Nov 10.

Abstract

The purpose of this study is to evaluate the role of bone scan (BS) and MRI measurement data in designing Custom Made Prosthesis (CMP) in Limb Salvage Surgery (LSS) in orthopedic oncology patients. The study was done on 126 patients, which include 88 males and 38 females. Pre-operative planning including determination of the osteotomy plane and dimension of the prosthesis was performed based on Tc99m MDP bone scan and MR images comparing with the histopathology examination (HPE) values. Descriptive statistics using appropriate measures of central tendency and dispersion were employed to describe the data. Karl-Pearson correlation coefficient was used to establish the association between continuous covariates. Paired t-test was utilized to test the differences in paired values for statistical significance. Bone scan and HPE values are positively correlated; p value is 0.913 (p < 0.001). However, mean difference between the HPE and bone scan is statistically significant (p < 0.001). MRI scan and HPE values are positively correlated 0.920 (p < 0.001) and mean difference is also statistically not significant (0.920; p < 0.001). If we apply ± 20% window, 94/126 patients (75%) bone scan measurements and 94/112 patients (84%) MRI measurements are matching with the HPE measurements. We conclude that bone scan measurements were found to be more or less equal to MR imaging for determining the tumor extent for the fit of the prosthesis and excellent functional results.

Keywords: Bone scan; CMP; HPE; LSS; MRI.