Helene Weigl1, Sonja Janssen2, Nikolaos Vassos3, Peter Hohenberger4, Anna Simeonova-Chergou5, Frederik Wenz6, Holger Haubenreisser2, Jens Jakob7. 1. Department of Surgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany. 2. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany. 3. Department of Surgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany; Division of Surgical Oncology & Thoracic Surgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany. 4. Division of Surgical Oncology & Thoracic Surgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany. 5. Department of Radiotherapy and Oncology, University Medical Center Mannheim, Mannheim, Germany. 6. University Medical Center Freiburg, Freiburg, Germany. 7. Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Göttingen, Germany. Electronic address: jens.jakob@med.uni-goettingen.de.
Abstract
BACKGROUND: Local recurrence (LR) of retroperitoneal soft tissue sarcoma (RPS) is a common and life-threatening event. The evaluation of the exact anatomical patterns of local recurrence might help to improve local treatment in RPS. METHODS: Of our local database we extracted ten patients with LR of RPS with axial MRI and/or CT datasets of the primary tumor (PT) and the LR. Using the Osirix DICOM viewer Version v.3.9.4 64-bit (Pixmeo, Geneva, Switzerland) we performed a three-step fusion algorithm consisting of: a) 3-point co-registration of the axial datasets depicting the PT and the LR using three abdominal landmarks b) re-orientation of the datasets and c) image fusion. We evaluated the feasibility of this technique with regard to categorizing the localization of LR as within or distant from the PT. RESULTS: Fusion imaging was feasible in seven out of ten patients. In the other three patients anatomical shifting of organs after surgery led to a relevant mismatch of anatomical landmarks and impeded interpretation of the fused images. In five of seven patients with successful fusion imaging, local recurrences were located within the anatomical borders of the primary tumor, in two out of seven patients local recurrences were distant to the primary. CONCLUSIONS: Fusion imaging of primary tumors and local recurrences is feasible in most patients with RPS. Most local recurrences occurred within the anatomical localization of the primary tumor. For further investigations validation of the technique in larger patient cohorts is required.
BACKGROUND: Local recurrence (LR) of retroperitoneal soft tissue sarcoma (RPS) is a common and life-threatening event. The evaluation of the exact anatomical patterns of local recurrence might help to improve local treatment in RPS. METHODS: Of our local database we extracted ten patients with LR of RPS with axial MRI and/or CT datasets of the primary tumor (PT) and the LR. Using the Osirix DICOM viewer Version v.3.9.4 64-bit (Pixmeo, Geneva, Switzerland) we performed a three-step fusion algorithm consisting of: a) 3-point co-registration of the axial datasets depicting the PT and the LR using three abdominal landmarks b) re-orientation of the datasets and c) image fusion. We evaluated the feasibility of this technique with regard to categorizing the localization of LR as within or distant from the PT. RESULTS: Fusion imaging was feasible in seven out of ten patients. In the other three patients anatomical shifting of organs after surgery led to a relevant mismatch of anatomical landmarks and impeded interpretation of the fused images. In five of seven patients with successful fusion imaging, local recurrences were located within the anatomical borders of the primary tumor, in two out of seven patients local recurrences were distant to the primary. CONCLUSIONS: Fusion imaging of primary tumors and local recurrences is feasible in most patients with RPS. Most local recurrences occurred within the anatomical localization of the primary tumor. For further investigations validation of the technique in larger patient cohorts is required.
Authors: Madelaine Hettler; Julia Kitz; Ali Seif Amir Hosseini; Manuel Guhlich; Babak Panahi; Jennifer Ernst; Lena-Christin Conradi; Michael Ghadimi; Philipp Ströbel; Jens Jakob Journal: Cancers (Basel) Date: 2022-09-05 Impact factor: 6.575