Computer-enhanced preoperative planning of soft tissue sarcoma surgery

When dealing with soft-tissue sarcomas of the extremities and aiming to perform limb-sparing surgery, it is mandatory to define the extent of the tumor and the connections with the surrounding tissues and anatomic structures. We started with MR images of 256×256 pixels (each pixel represented by 12 bits), at the same slice location in a given patient. A new single image representation of all three images is then generated by color compositing these into a 24-bit RGB framebuffer on a HP 900/735 workstation. PD was mapped to green, T1 to blue and T2 to red. This environment allows the creation of a spatial manipulation system in a 3D object space as well as the interactive navigation of the operator through the same space. The surgeon can thus easily discriminate tissues by their color characteristics. The color statistics of the image can be used to interactively segment out different tissues for removal and/or closer inspection. All this, in our experience, has greatly facilitated the simulation of soft-tissue sarcoma resections In our opinion, this computer-based technique, aiming to enhance the preoperative-planning´s accuracy in the surgical management of soft-tissue sarcoma of the extremities, aids in performing a radical conservative eradication of the malignancy.