Utilizing 3D head and neck specimen scanning for intraoperative margin discussions: Proof of concept of our novel approach

Abstract

Background The current standard of documenting and communicating frozen section margin results is inefficient. We present a novel method of generating 3D digital models of gross tumor specimens to more clearly visualize histopathological margin results. Methods Fifty‐five head and neck specimens were scanned and virtually “inked” using 3D software. These 3D specimen maps were displayed in the operating room to provide the surgeon with a real‐time specimen‐to‐defect relationship by which further resections could be guided. Results Margin results were reported within an average of 34 min using the proposed workflow. The scanner rendered accurate models of specimens that exceeded 3.0 × 3.0 × 3.0 cm. Critical specimen features to consider were size, color, textural complexity, and the presence of discernible anatomic landmarks. Conclusions Optical 3D scanning technology can improve the quality of head and neck margin documentation and the efficiency with which results are communicated between the pathologist and surgeon.

Virtual Resection Specimen Interaction Using Augmented Reality Holograms to Guide Margin Communication and Flap Sizing

“…We used semitransparent ink in Blender (Blender Foundation) to annotate and color‐code anatomical orientations on the model surfaces to imitate what could become a specialized pathology staining protocol (Figure 1C) (Supplemental Video 1, available online). Such annotations are similar to previous 3D scan studies in head‐neck surgery 4 …”

“…Such annotations are similar to previous 3D scan studies in head-neck surgery. 4 The surgeon then donned the see-through AR headset HoloLens 2 and started the Microsoft Mesh application (Microsoft), a collaborative 3D workspace. Here, users can view and manipulate these 3D models while still being able to see their real-world surroundings.…”

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

“…8 Subsequent studies by Saturno et al and Sharif et al outlined similar 3D specimen scanning techniques, enhanced by the ability to virtually annotate the generated models with computerassisted design (CAD) software. 2,9 They also demonstrated the feasibility of incorporating scanning into the frozen section workflow.…”

“…We recently reported our work in intraoperative 3D imaging of resection specimens, which produces very accurate renderings. 2 These renderings serve as a visual aid in communicating the results of cancer margin mapping over a Zoom platform. This enhanced pathologist/surgeon real-time communication increases the surgeon's workflow efficiency.…”

“…Koivuholma et al first reported successful creation of a digital 3D model of resected tongue tissue involved by squamous cell carcinoma (SCC) using a tabletop scanner 8 . Subsequent studies by Saturno et al and Sharif et al outlined similar 3D specimen scanning techniques, enhanced by the ability to virtually annotate the generated models with computer‐assisted design (CAD) software 2,9 . They also demonstrated the feasibility of incorporating scanning into the frozen section workflow.…”