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

Summary

Head and neck cancer management requires precise intraoperative communication and documentation to achieve tumor clearance and guide postoperative care. Traditional pathology reports often fail to capture the full scope of surgical findings. We present a protocol using 3D scanning, standardized timeouts, and a novel software to enhance intraoperative communication and pathologic reporting.

Abstract

The successful surgical management of head and neck cancer relies on intraoperative communication between surgical and pathological teams to achieve oncologic clearance. Precise documentation of the actions taken and pathological information obtained during surgery is crucial for planning adjuvant treatment and to meaningfully interpret surveillance imaging. Achieving oncologic clearance of the cancer has significant implications with respect to reducing the risk of recurrence, reducing the need for multimodality adjuvant therapy, and improving quality of life. The surgical pathology report guides postoperative care, and yet it falls short of conveying the comprehensive body of information obtained at the time of surgery. We report the use of 3D scanning technology, principles of standardization, and software developments to improve the current surgical workflow and final pathology report. The approach described here integrates dynamic three-dimensional (3D) visuals, a series of intraoperative timeouts, annotated radiographs, and a novel surgical pathology reporting software to improve both intraoperative communication as well as postoperative understanding by medical and radiation oncologists. This unique methodology addresses shortcomings in the current and stagnant standard of care for pathologic documentation, paves the way for significant innovations in surgical pathology reporting, and holds the promise of improving patient outcomes.

Introduction

Head and neck cancers originate from the oral cavity, pharynx, sinonasal tract, salivary glands, skin and larynx¹. These malignancies rank in the top ten most common cancers, accounting for approximately 70,000 new diagnoses and 16,000 deaths annually in the United States, and 900,000 new diagnoses and 450,000 deaths worldwide^2,3. Head and neck cancer treatment often requires long-term multispecialty and multimodality care^4,5. Primary surgical resection followed by adjuvant radiation (RT) or chemoradiation (CRT) is recommended f....

Protocol

This protocol was performed at Mount Sinai West Hospital under IRB#23-0177. A schematic of the protocol is depicted in Figure 1. Scanning is performed by medical trainees and research staff, who also enter information into MV3D. All timeouts, pathological analyses, and discussions are conducted by board-certified pathologists and surgeons.

1. Three-dimensional specimen scan (Figure 2)

NOTE: Detailed instructions for using the scanning hardware and software can be found in Supplementary File 1.

Results

Since the implementation of this novel scanning workflow in January 2023, we have scanned 92 head and neck cancer cases. From August 2024 to April 2025, we successfully integrated MV3D into this workflow in 33 cases. Procedures included mandibulectomy (n = 29), laryngectomy/laryngopharyngectomy (n = 17), glossectomy (n = 14), palatomaxillectomy (n = 12), parotidectomy (n = 9), oral cavity soft tissue resection (n = 6), scalp resection (n = 1), lip resection (n = 1), rhinectomy (n = 1), facial cutaneous malignancy resecti.......

Discussion

While the ultimate goal of oncologic resections is tumor clearance, the methods by which surgeons and pathologists communicate essential pathological information are outdated and inefficient²². The surgeon often scrubs out of the operating room to engage in informal and largely undocumented face-to-face conversations with the pathologist. The processing of surgical specimens involves slicing the tissue, which renders them virtually unrecognizable, leaving crude drawings as the only visual referenc.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
EinScan SP V2	Shining 3D	N/A	Tabletop scanner
Einscan Pro HD	Shining 3D	N/A	Handheld Scanner
EXScan Pro software	Shining 3D	N/A	Handheld scanner software
ExScan S software	Shining 3D	N/A	Tabletop scanner software
ThinkPad P1 Gen 7 Intel (16″) Mobile Workstation	Lenovo	Part Number: 21KV001EUS	Laptop (Minimum System Requirements: PC running Windows 10 with at least 8GB of RAM; Processor such as an Intel® Xeon E3-1230, i5-3470, i7-3770, i7-8700, or higher; Minimum GPU of Nvidia GTX 660 or Quadro P1000 is also recommended
ThinkStation P3 Ultra Small Form Factor Workstation	Lenovo	Part Number 30HACTO1WWUS1	Server