3d scanner set up and specimen handling for scanning and virtual mapping of cancer resections

用于癌症护理手术切缘分析的高级 CAD 成像

The goal of oncologic resection is the complete removal of cancer with surgical margins microscopically clear of tumor cells. In head and neck cancer, the surgical margin status is the most important pathologic risk factor1. A positive surgical margin increases the risk of 5-year local recurrence and all-cause mortality by &#62;90%2. Despite advances in medical technology and surgical techniques in recent years, positive margin rates in head and neck cancer remain high3. For locally advanced oral cavity cancers, the positive margin rate within the United States is 18.1%4.
For head and neck surgeons to ensure complete oncologic resection while minimizing disruption of surrounding structures, intraoperative sampling of margins via frozen section analysis (FSA) is performed. FSA provides a rapid intraoperative pathology consultation that is widely used and is the standard of care5,6,7,8,9. Fresh tissue is frozen, thinly sliced, placed on a glass slide, and stained for immediate interpretation while the patient is still under anesthesia.
Head and neck oncologic specimens present several distinct challenges in accurately assessing margin status, including the anatomic complexity of head and neck cancer specimens, the minimal reserve in the head and neck region for wide excision given the proximity to vital structures such as the eyes, face, and important nerves and vasculature, and the multiple tissue types often present in the resected specimen (i.e., mucosa, cartilage, muscle, bone)10,11. Thus, a specimen-based approach to margin analysis requires an enhanced level of communication between surgeon and pathologist12. A face-to-face conversation is often warranted to ensure correct specimen orientation and discussion of concerning margins. However, this is not always safe or feasible as it requires either the surgeon to leave the operating room (OR) while the patient remains under general anesthesia or the pathologist to leave the gross pathology lab, interrupting their workflow. In addition, there may be a significant travel time between the OR and the pathology lab, or in some cases, the pathology lab may be off-site altogether.
Following FSA, the oncologic specimen is fixed in formalin and formally processed through inking, sectioning, and margin sampling. Slides are created and microscopically interpreted by the pathologist to create a final pathology report. For complex head and neck cancer resection, this can often take 1-2 weeks. Unfortunately, processing of the specimen commonly results in the destruction of the resected cancer specimen. This may create further confusion as the final pathology report, multidisciplinary tumor board discussions, adjuvant radiation therapy planning, and re-resection in the setting of positive margins, must all proceed without a visual record of the oncologic specimen and its pathologic processing.
To address this clinical unmet need, we have developed a 3D scanning and specimen mapping protocol to enhance communication between surgeons, pathologists, and other members of the multidisciplinary cancer care team.

作者聚焦：3D 扫描和增强现实增强癌症手术沟通

使用 3D 扫描和映射增强肿瘤边缘的通信

The scope of our research is to use 3D scanning and augmented reality technology to improve communication of cancer surgery results among the multidisciplinary cancer care team. More specifically, we're hoping to allow for a surgeon to re-resect cancer more precisely and allow for more precise radiation therapy. In the hospital environment, space is often limited, and finding additional room for extra personnel and equipment can be difficult.The learning curve on this protocol can also be challenging, especially for those without prior experience in 3D scanning and computer-aided design. We've created a 3D scanning and virtual mapping protocol for cancer specimens, providing a permanent visual record to go alongside written pathology reports. This is a powerful communication tool for the entire cancer care team and is now being investigated in multidisciplinary tumor board discussions, as well as adjuvant radiation therapy treatment planning.When a surgical specimen is processed for pathologic analysis, it is often destroyed, without any visual documentation. This results in lengthy written pathology reports and can often lead to challenging clinical scenarios in cases of a close or positive margin. Our research protocol creates an interactive, permanent visual record of the resected cancer specimen.Our protocol offers a novel visual representation of a surgically resected oncologic specimen and a map of how it was processed pathologically. This data previously did not exist and now allows providers to look back at a specimen for reference, multidisciplinary care discussions, and future treatment planning.

3D扫描仪设置和标本处理，用于癌症切除的扫描和虚拟映射

首先，在平面工作站上设置三足相机三脚架。小心地将 3D 扫描相机放入三脚架中，然后将相机以 60 度角向下倾斜到工作站。将两段式电源线连接到外部电源和相机背面。将扫描仪转盘放在 3D 相机和三脚架设置前方一英尺处。使用微型USB线将转盘连接到相机。然后，使用USB线将相机连接到笔记本电脑。接下来，从手术团队获取切除的肿瘤标本。用水冲洗标本以去除切除术中的任何血液或多余凝块，然后轻轻将其垫干。将试样放在平坦、干净的表面上。使用智能手机相机或数码相机，获得标本前表面的高质量2D图像。将试样翻转 180 度，然后拍摄后表面的第二张照片。

Research

JoVE Journal

Medicine

3D Scanner Set Up and Specimen Handling for Scanning and Virtual Mapping of Cancer Resections

Enhanced Communication of Tumor Margins Using 3D Scanning and Mapping

After oncologic resection of malignant tumors, specimens are sent to pathology for processing to determine the surgical margin status. These results are ...

科研

医学

3D Scanning Following En Bloc Resection of Solid Tumor for Virtual Mapping of Cancer Resections

实体瘤整体切除后的 3D 扫描，用于癌症切除的虚拟映射

Creating a Virtual 3D Specimen Map of Cancer Resections to Improve Multidisciplinary Care

创建癌症切除的虚拟 3D 标本地图以改善多学科护理