Ex vivo 3D scanning and specimen mapping in anatomic pathology

Perez, Alexander N.; Sharif, Kayvon F.; Guelfi, Erica; Li, Sophie; Miller, Alexis; Prasad, Kavita; Sinard, Robert J.; Lewis, James S.; Topf, Michael C.

doi:10.1016/j.jpi.2022.100186

Cited by 16 publications

(11 citation statements)

References 15 publications

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“…Previous studies have investigated the incorporation of 3D specimen scans into multimodal pathology reports that can effectively illustrate areas of tissue sectioning and record the status of final margins. 10 Novel studies have examined the use of augmented reality technology to manually align virtual head and neck resection specimens into their corresponding resection beds. Prasad et al examined 20 head and neck specimen holograms and recorded a mean relocation error of 4 mm when specimen holograms were manually placed back into the defect by the surgeon.…”

Section: Discussionmentioning

confidence: 99%

“…It is a novel means of multidisciplinary communication and precise documentation of harvested supplemental margins not otherwise possible using conventional 2D photography. Previous studies have investigated the incorporation of 3D specimen scans into multimodal pathology reports that can effectively illustrate areas of tissue sectioning and record the status of final margins 10 . Novel studies have examined the use of augmented reality technology to manually align virtual head and neck resection specimens into their corresponding resection beds.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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“…We envision the pathology report of the future will include screenshots of 3D specimen maps or a video file that can be manipulated in real time by the provider. 7 In addition, the scans were used to facilitate discussion during multidisciplinary head and neck tumor board, as final margin status is a key factor in determining a patient's adjuvant treatment course. 8,9 The 3D specimen maps can be used to guide surgical re-resection.…”

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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“…Recent studies have highlighted the value of 3D scanning with annotation of margin sampling site for enhanced communication between surgeons and pathologists. 19,20 Another combined 3D scanning with augmented reality to accurately guide re-resection. 21 Finally, intraoperative adjuncts, such as fluorescence 22 and ultrasound, 23 can further improve margin analysis and excision.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings demonstrate a need for further innovation and novel techniques to help guide margin relocation. Recent studies have highlighted the value of 3D scanning with annotation of margin sampling site for enhanced communication between surgeons and pathologists 19,20 . Another combined 3D scanning with augmented reality to accurately guide re‐resection 21 .…”

Section: Discussionmentioning

confidence: 99%

How Often is Cancer Present in Oral Cavity Re‐resections After Initial Positive Margins?

et al. 2023

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ObjectiveTo evaluate the rate at which carcinoma is present in the re‐resection specimen following initial positive margins during head and neck cancer surgery and its impact on oncologic outcomes.Study DesignRetrospective chart review.MethodsA single institution retrospective chart review of patients that underwent curative‐intent surgery for oral cavity cancer was performed. Final pathology reports were reviewed to identify patients with initial positive margins who underwent re‐resection during the same operation. Initial positive margin was defined as severe dysplasia, carcinoma in situ (CIS), or carcinoma. Cox proportional hazards and Kaplan–Meier analyses were used to assess for associations with survival outcomes.ResultsAmong 1873 total patients, 190 patients (10.1%) had initial positive margins and underwent re‐resection during the same surgery. Additional carcinoma, CIS, or severe dysplasia was found in 29% of re‐resections, and 31% of patients with initial positive margins had final positive margins. Half of the patients with a final positive margin had a positive margin at an anatomic site different than the initial positive margin that was re‐resected. The median follow‐up was 636 days (range 230–1537). Re‐resection with cancer and final positive margin status was associated with worse overall survival (OS; p = 0.044 and p = 0.05, respectively). However, only age, T4 disease, and surgery for recurrent oral cavity cancer were independently associated with OS (p < 0.001, p = 0.005, and p = 0.001, respectively).ConclusionsFewer than a third of oral cavity re‐resections contain further malignancy, which may suggest that surgeons have difficulty relocating the site of initial positive margin. Final positive margins are often at anatomic sites different than the initial positive margin.Level of Evidence4 Laryngoscope, 2023

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Ex vivo 3D scanning and specimen mapping in anatomic pathology

Cited by 16 publications

References 15 publications

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

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

Virtual 3D Specimen Mapping in Head & Neck Oncologic Surgery

How Often is Cancer Present in Oral Cavity Re‐resections After Initial Positive Margins?

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