advancing-surgical-pathology-reporting-head-neck-cancer-through-3d

Advancing Surgical Pathology Reporting in Head and Neck Cancer through 3D Visualization, Dynamic Documentation, and Optimized Communication

The successful surgical management of head and neck cancer relies on intraoperative communication between surgical and pathological teams to achieve ...

THANC (Thyroid, Head and Neck Cancer) Foundation

Opportunities exist to improve intraoperative communication and documentation of resection margin details. We instituted a "frozen section timeout" that centers around visualization of the paired resection specimen and surgical defect-facilitating effective, bidirectional exchange of information.

Frozen Section Timeout: Pilot Study to Reconcile Margins Using 3D Resected Specimen and Defect Scans.

We 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.

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

We present a novel, efficient approach to demonstrating supplemental margins during oncologic resection. Surgeons and pathologists annotated 10 virtual models of surgical defects and resection specimens in 3D using an iPad-based application, Procreate®. Incorporating this method into the surgical workflow can improve interdepartmental communication and provide visual documentation of surgical steps taken to address at-risk margins. Laryngoscope, 134:2783-2786, 2024.

iPad Annotation of 3D Surgical Models Using Procreate®: Novel Documentation of Supplemental Margins.

Surgical pathology reports play an integral role in postoperative management of head and neck cancer patients. Pathology reports of complex head and neck resections must convey critical information to all involved clinicians. Previously, we demonstrated the utility of 3D specimen and defect scanning for communicating margin status and documenting the location of supplemental margins. We introduce a newly designed permanent pathology report which improves documentation of intraoperative margin mapping and extent of corresponding supplemental margins harvested.

Improving Interdisciplinary Communication and Pathology Reporting for Head and Neck Cancer Resections: 3D Visualizations and Margin Reconciliation.

Contemporary cancer management relies on the precise transfer of information regarding disease and treatment details between a range of providers and facilities. The time of surgery is uniquely responsible for many ambiguities in this oncological information flow, as intraoperative communication and documentation are often unregimented and imprecise. Downstream providers such as radiation oncologists, medical oncologists, and radiologists rely on surgical pathology reports for planning postoperative treatment and surveillance. However, traditional pathology reports lack critical details about the actions taken during surgery and do not make the oncologic clearance status explicit. We identified agents of change to improve information transfer and designed an improved surgical workflow and pathology report that make use of a novel pathologic reporting software to address gaps in the oncologic care timeline. Our updated workflow results in a dynamic final pathology report that integrates annotated 3D scans of the surgical specimen and extirpative defect, unequivocal reconciliation of at-risk and supplemental margins, highlighted preoperative radiographs, and brief narrative summaries by the surgeon and pathologist. These tangible changes aim to improve clarity and continuity in oncologic care.

Identifying and closing information gaps in head and neck cancer surgery.

Surgical pathology reports are crucial to the delivery of personalized and coordinated cancer management. However, traditional reports often lack clarity and comprehensiveness, which can lead to misinterpretation or suboptimal therapeutic planning. To address these issues, we developed MarginView3D (MV3D), a novel surgical pathology reporting software. This software integrates real-time three-dimensional (3D) visualizations of surgical specimens, surgical defects, anatomic models, annotated radiographs, and audiovisual narrative summaries from surgeons and pathologists to enhance the care of patients with head and neck cancer.

MarginView3D: A Novel Software Enabling Comprehensive Three-Dimensional Surgical Pathology Documentation for Improved Intra- and Postoperative Cancer Care.

Article	Year
Frozen Section Timeout: Pilot Study to Reconcile Margins Using 3D Resected Specimen and Defect Scans. The Laryngoscope\| PubMed ID: 37466312	2024
Intraoperative three-dimensional scanning of head and neck surgical defects: Enhanced communication and documentation of harvested supplemental margins. Head & neck\| PubMed ID: 37638591	2023
iPad Annotation of 3D Surgical Models Using Procreate®: Novel Documentation of Supplemental Margins. The Laryngoscope\| PubMed ID: 37921378	2024
Improving Interdisciplinary Communication and Pathology Reporting for Head and Neck Cancer Resections: 3D Visualizations and Margin Reconciliation. Head and neck pathology\| PubMed ID: 39153096	2024
Identifying and closing information gaps in head and neck cancer surgery. Seminars in oncology\| PubMed ID: 40505388	2025
MarginView3D: A Novel Software Enabling Comprehensive Three-Dimensional Surgical Pathology Documentation for Improved Intra- and Postoperative Cancer Care. Annals of surgical oncology\| PubMed ID: 40616761	2025

Michael Karasick

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