Koivuholma Anne, Aro Katri, Mäkitie Antti, Salmi Mika, Mirtti Tuomas, Hagström Jaana, Atula Timo
Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, 00029 HUS Helsinki, Finland.
Department of Pathology, HUSLAB, Helsinki University Hospital and University of Helsinki, P.O. Box 21 Haartmaninkatu 3, 00290 Helsinki, Finland.
Diagnostics (Basel). 2021 Jan 12;11(1):109. doi: 10.3390/diagnostics11010109.
Medical imaging often presents objects in three-dimensional (3D) form to provide better visual understanding. In contrast, histopathology is typically presented as two-dimensional (2D). Our objective was to present the tumor dimensions in 3D by creating a 3D digital model of it and so demonstrate the location of the tumor and the histological slices within the surgical soft tissue resection specimen. We developed a novel method for modeling a tongue squamous cell carcinoma using commonly available instruments. We established our 3D-modeling method by recognizing and solving challenges that concern the selection of the direction of histological slices. Additional steps to standard handling included scanning the specimen prior to grossing and modeling the carcinoma, which required only a table scanner and modeling software. We present challenges and their solutions in modeling the resection specimen and its histological slices. We introduce a finished 3D model of a soft tissue resection specimen and the actual tumor as well as its histopathological grossing sites in 3D digital and printed form. Our novel method provides steps to create a digital model of soft tissue resection specimen and the tumor within. To our knowledge, this is the first attempt to present histopathological margins of a tongue tumor in 3D form, whereas previously, only 2D has been available. The creation of the 3D model does not call for predetermined grossing directions for the pathologist. In addition, it provides a crucial initiative to enhance oncological management. The method allows a better visual understanding of tumor margins, topography, and orientation. It thus provides a tool for an improved postoperative assessment and aids, for example, in the discussion of the need for additional surgery and adjuvant therapy.
医学成像通常以三维（3D）形式呈现物体，以便提供更好的视觉理解。相比之下，组织病理学通常以二维（2D）形式呈现。我们的目标是通过创建肿瘤的3D数字模型以三维形式呈现肿瘤尺寸，从而展示肿瘤在手术软组织切除标本中的位置以及组织切片情况。我们开发了一种使用常用仪器对舌鳞状细胞癌进行建模的新方法。我们通过识别和解决与组织切片方向选择相关的挑战来建立我们的3D建模方法。标准处理的其他步骤包括在大体检查之前扫描标本并对癌进行建模，这仅需要一台桌面扫描仪和建模软件。我们展示了在对切除标本及其组织切片进行建模时遇到的挑战及其解决方案。我们以3D数字和打印形式介绍了软组织切除标本、实际肿瘤及其组织病理学大体检查部位的完整3D模型。我们的新方法提供了创建软组织切除标本及其中肿瘤数字模型的步骤。据我们所知，这是首次尝试以三维形式呈现舌肿瘤的组织病理学切缘，而此前只有二维形式。3D模型的创建并不要求病理学家预先确定大体检查方向。此外，它为加强肿瘤管理提供了关键举措。该方法能让人更好地直观理解肿瘤切缘、地形和方向。因此，它提供了一种用于改进术后评估的工具，并有助于例如讨论是否需要额外手术和辅助治疗。
