Radical shift in the communication paradigm in head and neck frozen section analysis: Intraoperative three‐dimensional specimen scanning

Brandwein-Weber, Margaret; Urken, Mark L.; Topf, Michael C.; Lewis, James S.; Kang, Stephen Y.; Curry, Joseph; Chai, Raymond L.; Khan, Mohammed; Modica, Ippolito; Chung, Dan; Rosenthal, Eben L.

doi:10.1002/hed.27247

Cited by 5 publications

(6 citation statements)

References 12 publications

(26 reference statements)

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“…Brandwein and colleagues describe the difficult-to-decipher nature of operative and pathology reports, suggesting 3D images as a valuable adjunct to traditional methods, especially when coordinating cancer care at multiple hospitals. 16 Fig. 7.…”

Section: Discussionmentioning

confidence: 99%

Virtual 3D Specimen Mapping in Head & Neck Oncologic Surgery

Miller,

Prasad,

Sharif

et al. 2023

The Laryngoscope

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ObjectivesVirtual 3D specimen mapping of oncologic surgical specimens provides a visual record of the specimen and margin sampling sites which can be utilized in a variety of cancer care settings. Our objective was to perform a retrospective review of head and neck surgical oncology cases where the specimen was mapped post‐operatively and to evaluate the utility of these 3D specimen maps amongst the multidisciplinary cancer care team.MethodsA retrospective review of our 3D specimen model biorepository was performed. Surgical specimens were 3D scanned and then graphically annotated (or “mapped”) during routine pathologic processing. The resulting 3D specimen maps were distributed to the multidisciplinary oncologic care team. Final margin status and any use of the 3D specimen maps were recorded.ResultsA total of 28 cases were included. Virtual 3D specimen maps were utilized by the cancer care team in 8 cases (29%), including 2 positive margin cases, 2 close margin cases, and 4 indeterminate margin cases. 3D specimen maps were used to visualize positive margin sites for pathologist‐surgeon communication as a visual reference during tumor board discussions and to inform radiation treatment planning.ConclusionPost‐operative virtual 3D specimen mapping of oncologic specimens creates a permanent visual record of the specimen and the margins sampled and may serve as a beneficial tool for communication amongst the multidisciplinary cancer care team.Level of EvidenceLevel 4 Laryngoscope, 2023

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Section: Discussionmentioning

confidence: 99%

Virtual 3D Specimen Mapping in Head & Neck Oncologic Surgery

Miller,

Prasad,

Sharif

et al. 2023

The Laryngoscope

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“…[3][4][5][6] Specimen-based margin assessment allows pathologists to more comprehensively analyze at-risk surfaces, determine margin distance, and worst pattern of invasion (WPOI). 7 While specimen-based margins are superior to tumor defect-based margins, it is still necessary to refer to the surgical defect when anatomically orienting specimens, discussing margin results, and harvesting supplemental margins. Typically, the surgeon and pathologist must convene in-person to discuss specimen orientation and margin results.…”

Section: Introductionmentioning

confidence: 99%

“…While surgeons and pathologists may use hand-drawn 2D sketches as visual aids to assist communication, it is still ultimately difficult to accurately, and thoroughly delineate the complex spatial relationship between specimen and defect. 7 Virtual 3D representation of both specimen and defect can be extremely helpful for guiding orientation and interpretation during the frozen section process. Multiple recent studies have discussed the utility of optical 3D scanning to generate high-resolution digital representations of head and neck tumor specimens.…”

Section: Introductionmentioning

confidence: 99%

“…An increasing amount of literature has demonstrated that specimen‐based margin assessment is associated with a lower incidence of final positive margins and local recurrence 3–6 . Specimen‐based margin assessment allows pathologists to more comprehensively analyze at‐risk surfaces, determine margin distance, and worst pattern of invasion (WPOI) 7 . While specimen‐based margins are superior to tumor defect‐based margins, it is still necessary to refer to the surgical defect when anatomically orienting specimens, discussing margin results, and harvesting supplemental margins.…”

Section: Introductionmentioning

confidence: 99%

“…The pathologist must then orient the specimen based on the surgeon's description, which is susceptible to misinterpretation and omission of significant details. While surgeons and pathologists may use hand‐drawn 2D sketches as visual aids to assist communication, it is still ultimately difficult to accurately, and thoroughly delineate the complex spatial relationship between specimen and defect 7 …”

Section: Introductionmentioning

confidence: 99%

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Intraoperative three‐dimensional scanning of head and neck surgical defects: Enhanced communication and documentation of harvested supplemental margins

Yun,

Su,

Kapustin

et al. 2023

Head & Neck

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BackgroundWe have demonstrated the effectiveness of 3D resection specimen scanning for communicating margin results. We now address the corresponding surgical defect by debuting 3D defect models, which allow for accurate annotations of harvested supplemental margins.MethodsSurgical defects were rendered into 3D models, which were annotated to document the precise location of harvested supplemental margins. 3D defect scans were also compared with routine 2D photography and were analyzed for quality, clarity, and the time required to complete the scan.ResultsForty defects were scanned from procedures including segmental mandibulectomy, maxillectomy, and laryngopharyngectomy. Average duration of defect scan was 6 min, 45 s. In six of ten 2D photographs, the surgeon was unable to precisely annotate the extent of at least one supplemental margin.Conclusion3D defect scanning offers advantages in that this technique enables documentation of the precise location and breadth of supplemental margins harvested to address margins at‐risk.

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