Intraoperative control of resection margins in advanced head and neck cancer using a 3D-navigation system based on PET/CT image fusion

Feichtinger, Matthias; Pau, Mauro; Zemann, Wolfgang; Aigner, Reingard; Kärcher, Hans

doi:10.1016/j.jcms.2010.02.004

Cited by 69 publications

(41 citation statements)

References 18 publications

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“…The prognosis for cases with recurrence is very poor (23,24). To determine the resection range for the primary lesion in such cases, further improvements are required in the imaging evaluation of jaw bone infiltration, tumor invasion pattern and infiltration into the surrounding soft tissues in consideration of the direction of tumor advancement (25).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative frozen section histological analysis of resection samples is useful for the control of primary lesions in patients with oral squamous cell carcinoma

Miyawaki

Hara

Ishida

et al. 2014

Molecular and Clinical Oncology

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Abstract. To ensure reliable surgical margins, intraoperative frozen section histological analysis (FS) has been performed since October, 2005 as follows: i) the orientation at the anatomical position and extent of the tumor are shared between oral pathologists and oral surgeons using imaging evaluations and pathological pictures and the planned site of sampling for intraoperative FS is confirmed; ii) a tumor team is organized and the team marks the tumor area and sets the resection range to correct the setting errors of the resection range among operators; iii) vital Lugol staining is applied to the lesion prior to tumor resection, the surgical margin is set based on the non-stained region and the extent of the tumor is macroscopically confirmed in the maximum cross-sectional surface of the resected specimen; and iv) FS is performed using samples from resected specimens to confirm the mucoepithelium and safety margin of the deep stump. The aim of this study was to evaluate the usefulness of our FS method. The treatment outcomes of oral squamous cell carcinoma were retrospectively investigated in patients treated prior to (Group 1) and after (Group 2) the introduction of our FS method. The recurrence rate of the primary lesions was high (17.3%) in Group 1, but decreased significantly in Group 2 (6.9%). Regarding clinicopathological factors, the condition of the surgical margins was associated with recurrence of the primary lesion in Group 1, but not in Group 2. In conclusion, our FS method appears to be useful for resecting tumors with reliable safety margins.

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Section: Discussionmentioning

confidence: 99%

Intraoperative frozen section histological analysis of resection samples is useful for the control of primary lesions in patients with oral squamous cell carcinoma

Miyawaki

Hara

Ishida

et al. 2014

Molecular and Clinical Oncology

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“…If positive, they can be a guide to additional resection, but when negative, they add no information about the distance from the tumor of the margin. 19 Computer-assisted oncologic surgery increases reliability by facilitating correct safety margins and protecting vital structures. In addition, it increases the precision of radiotherapy planning, and it facilitates the reconstruction process.…”

Section: Discussionmentioning

confidence: 99%

“…17,18 However, even with this combined imaging modality, the intraoperative evaluation of the distance between the resection margins and the tumor margin remains a challenge in oncologic surgery. 19 To demonstrate the procedure, a 51-year-old woman with a primary T4a squamous cell carcinoma (SCC) of the maxillary sinus and nasal cavity with invasion of the pterygoid fossa was operated on via computer-assisted surgery (Fig. 3A).…”

Section: Intraoperative Imageycontrolled Tumor Resectionmentioning

confidence: 99%

Advances and Innovations in Computer-Assisted Head and Neck Oncologic Surgery

Rana¹,

Essig²,

Eckardt³

et al. 2012

Journal of Craniofacial Surgery

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Over the past years, computer-assisted surgery has gained more importance in craniomaxillofacial surgery, especially in primary and secondary treatment of head and neck malignancies. The basis for oncologic treatment of the head and neck region requires detailed planning using computed tomography, cone-beam computed tomography, or magnetic resonance imaging in combination with computer-assisted, infrared-based navigation system. These techniques allow a preplanned image-guided path to the tumor region for taking biopsies, resection, or reconstruction. The aim of this work was to show the advances and technical benefits for tumor surgery in a daily clinical routine from the view of the craniomaxillofacial surgeon. The target of our working group was to develop and clinically evaluate a novel three-dimensional planning and navigation software solution for treatment of craniofacial tumors. This work was carried out on 5 categories for oncologic surgical procedures in which computer-assisted surgery was applied from 2005 to 2011: preplanned trajectorial-guided tumor biopsy, intraoperative image-controlled tumor resection, tumor mapping, reconstruction after tumor surgery (true to original), and oral rehabilitation (backward planning). Successful preoperative planning, import of image data suitable for navigation, and intraoperative precise infrared-based navigation were obtained for all 5 categories without any complications. Image-guided navigation technique for head and neck oncologic surgery provides a precise, safe surgical method with real-time excellent anatomic orientation. Regarding the advantages of computer-assisted surgery, this technique will play a major part in craniofacial reconstructive surgery and will address widespread general methodologic solutions that are of great interest in multidisciplinary oncologic treatment.

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“…Navigation-assisted oncology surgery based on PET-CT images has been described previously as facilitating biopsy 2 , detecting local recurrence in areas of disrupted anatomy from previous treatment 3 and providing control of resection margins 4 . The majority involved the diagnosis of squamous cell carcinoma 3,4 apart from one case of aspergilloma 2 .…”

Section: Discussionmentioning

confidence: 99%

Navigation-assisted localisation and resection of subclinical metastatic malignant melanoma of unknown primary based on 18-fluorodeoxyglcose positron emission tomography computed tomography fusion imaging

Ghazali

Collyer

Tighe

2012

International Journal of Oral and Maxillofacial Surgery

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Intraoperative control of resection margins in advanced head and neck cancer using a 3D-navigation system based on PET/CT image fusion

Cited by 69 publications

References 18 publications

Intraoperative frozen section histological analysis of resection samples is useful for the control of primary lesions in patients with oral squamous cell carcinoma

Intraoperative frozen section histological analysis of resection samples is useful for the control of primary lesions in patients with oral squamous cell carcinoma

Advances and Innovations in Computer-Assisted Head and Neck Oncologic Surgery

Navigation-assisted localisation and resection of subclinical metastatic malignant melanoma of unknown primary based on 18-fluorodeoxyglcose positron emission tomography computed tomography fusion imaging

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