Optical coherence tomography for surgical margin assessment of soft-tissue sarcomas of the extremities and trunk
Abstract
IntroductionIncomplete resection of superficial trunk and extremity soft-tissue sarcomas can impact the risk of local recurrence and overall prognosis for patients after surgical resection. Multiple methods have been described for intraoperative surgical margin assessment of soft-tissue sarcomas, including optical coherence tomography (OCT) evaluation of surgical margins. The accuracy of OCT imaging for evaluating the surgical margins of soft-tissue sarcoma has not been reported. The first aim of this study was to determine the OCT imaging features of different tissue types at the surgical margins when compared to histopathology to allow for image interpretation training for observers. The second aim was to determine the diagnostic accuracy of OCT for identification of incomplete margin status for soft-tissue sarcomas of the superficial trunk or extremities. MethodsThe surgical margins of 20 soft-tissue sarcoma specimens were imaged using OCT following surgical resection. The OCT images from the first five tumors were used to identify features of different tissue types compared to histopathology and create a training presentation. The OCT images from all tumors were then used to create a training set and test set. Seven observers underwent a training session using a training presentation and interpreted a training and test set. Images were graded on a numeric scale from 1 (no tumor present) to 4 (tumor present). The results of the test set were used to evaluate the sensitivity, specificity, accuracy, and inter- and intraobserver variability. ResultsThe overall sensitivity and specificity for detection of tumor on the surgical margin were 83.5% [95% confidence interval (CI): 74.6% -89.7%] and 76.8% (95% CI: 68.2% -83.6%), respectively. The overall correct classification rate of the surgical margin was 162/203 (79.8%; 95% CI: 73.8% -84.7%). DiscussionFurther research is needed in an intraoperative setting with a larger patient population to evaluate the use of OCT to evaluate the surgical margins for soft-tissue sarcomas.
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BibTeX
@article{johnson2026optical,
title = {{Optical coherence tomography for surgical margin assessment of soft-tissue sarcomas of the extremities and trunk}},
author = {Carley Johnson and John Alexander and Joel Mayerson and Thomas Scharschmidt and Valerie Grignol and Raphael Pollock and O. Hans Iwenofu and Gabrielle S. Fontes and Jocosa Yasenchack and Jorge Santana Mignucci and Laura E. Selmic},
journal = {Frontiers in Oncology},
year = {2026},
month = nov,
doi = {10.3389/fonc.2026.1911225},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1911225},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Optical coherence tomography for surgical margin assessment of soft-tissue sarcomas of the extremities and trunk
AU - Carley Johnson
AU - John Alexander
AU - Joel Mayerson
AU - Thomas Scharschmidt
AU - Valerie Grignol
AU - Raphael Pollock
AU - O. Hans Iwenofu
AU - Gabrielle S. Fontes
AU - Jocosa Yasenchack
AU - Jorge Santana Mignucci
AU - Laura E. Selmic
PY - 2026
DA - 2026/11/05
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1911225
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1911225
AB - IntroductionIncomplete resection of superficial trunk and extremity soft-tissue sarcomas can impact the risk of local recurrence and overall prognosis for patients after surgical resection. Multiple methods have been described for intraoperative surgical margin assessment of soft-tissue sarcomas, including optical coherence tomography (OCT) evaluation of surgical margins. The accuracy of OCT imaging for evaluating the surgical margins of soft-tissue sarcoma has not been reported. The first aim of this study was to determine the OCT imaging features of different tissue types at the surgical margins when compared to histopathology to allow for image interpretation training for observers. The second aim was to determine the diagnostic accuracy of OCT for identification of incomplete margin status for soft-tissue sarcomas of the superficial trunk or extremities. MethodsThe surgical margins of 20 soft-tissue sarcoma specimens were imaged using OCT following surgical resection. The OCT images from the first five tumors were used to identify features of different tissue types compared to histopathology and create a training presentation. The OCT images from all tumors were then used to create a training set and test set. Seven observers underwent a training session using a training presentation and interpreted a training and test set. Images were graded on a numeric scale from 1 (no tumor present) to 4 (tumor present). The results of the test set were used to evaluate the sensitivity, specificity, accuracy, and inter- and intraobserver variability. ResultsThe overall sensitivity and specificity for detection of tumor on the surgical margin were 83.5% [95% confidence interval (CI): 74.6% -89.7%] and 76.8% (95% CI: 68.2% -83.6%), respectively. The overall correct classification rate of the surgical margin was 162/203 (79.8%; 95% CI: 73.8% -84.7%). DiscussionFurther research is needed in an intraoperative setting with a larger patient population to evaluate the use of OCT to evaluate the surgical margins for soft-tissue sarcomas.
SN - 2234-943X
ER -