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. 2024 Jan;134(1):191-197.
doi: 10.1002/lary.30881. Epub 2023 Jul 19.

Virtual 3D Specimen Mapping in Head & Neck Oncologic Surgery

Alexis Miller  1 , Kavita Prasad  1 , Kayvon F Sharif  2 , Destinee J Adams  3 , Lily Garbow  3 , Emily Roberts  3 , James S Lewis Jr  1   3 , Kim A Ely  3 , Mitra Mehrad  3 , Sarah L Rohde  1 , Alexander J Langerman  1 , Kyle Mannion  1 , Robert J Sinard  1 , James L Netterville  1 , Eben L Rosenthal  1 , Michael C Topf  1
Affiliations

Virtual 3D Specimen Mapping in Head & Neck Oncologic Surgery

Alexis Miller et al. Laryngoscope. 2024 Jan.

Abstract

Objectives: Virtual 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.

Methods: A 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.

Results: A 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.

Conclusion: Post-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 evidence: 4 Laryngoscope, 134:191-197, 2024.

Keywords: 3D scanning; head and neck cancer; pathology communication; surgical margins.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Research team member works alongside pathologists’ assistant during specimen processing to virtually map inking of specimen and sites of margin sampling.
Figure 2.
Figure 2.
Completed three-dimensional (3D) specimen map in the computer-aided design software used to virtually annotate the specimen model.
Figure 3.
Figure 3.
Example of a video distributed to members of the oncologic care team after specimen mapping is completed and prior to release of final pathology report. The video contains a key and the virtual three-dimensional (3D) specimen which is rotated in the video to show all aspects.
Figure 4.
Figure 4.
Virtual three-dimensional (3D) specimen map is used as a communication tool and visual reference in a teleconference between surgeons and pathologists establishing the final diagnosis for a given case.
Figure 5.
Figure 5.
Virtual three-dimensional (3D) specimen map from a mandibular alveolar ridge oral cavity composite resection. A close margin, indicated by the red circle, was localized on the specimen map by the pathologist and communicated via email to the surgeon.
Figure 6.
Figure 6.
Pathologist co-registers and compares the positive margin on a histology slide and the margin location on the three-dimensional (3D) specimen map.
Figure 7.
Figure 7.
Virtual three-dimensional (3D) specimen map of an oral cavity composite resection with mandibulectomy. Site of an indeterminate margin indicated by red arrow. After postoperative discussion between surgeon and pathologist, this margin was determined to be superseded by another specimen.
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