Aweeda Marina, Fassler Carly, Perez Alexander N, Miller Alexis, Prasad Kavita, Sharif Kayvon F, Lewis James S, Ely Kim A, Mehrad Mitra, Rohde Sarah L, Langerman Alexander J, Mannion Kyle, Sinard Robert J, Netterville James L, Rosenthal Eben L, Topf Michael C
Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
J Pathol Inform. 2024 Oct 28;15:100404. doi: 10.1016/j.jpi.2024.100404. eCollection 2024 Dec.
Positive margins are frequently observed in total laryngectomy (TL) specimens. Effective communication of margin sampling sites and final margin status between surgeons and pathologists is crucial. In this study, we evaluate the utility of multimedia visual pathology reports to facilitate interdisciplinary discussion of margin status in laryngeal cancer surgery.
Ex vivo laryngeal cancer surgical specimens were three-dimensional (3D) scanned before standard of care pathological analysis. Using computer-aided design software, the 3D model was annotated to reflect inking, sectioning, and margin sampling sites, generating a visual pathology report. These reports were distributed to head and neck surgeons and pathologists postoperatively.
Fifteen laryngeal cancer surgical specimens were 3D scanned and virtually annotated from January 2022 to December 2023. Most specimens (73.3%) were squamous cell carcinomas (SCCs). Among the cases, 26.7% had final positive surgical margins, whereas 13.3% had close margins, defined as <5 mm. The visual pathology report demonstrated sites of close or positive margins on the 3D specimens and was used to facilitate postoperative communication between surgeons and pathologists in 85.7% of these cases. Visual pathology reports were presented in multidisciplinary tumor board discussions (20%), email correspondences (13.3%), and teleconferences (6.7%), and were referenced in the final written pathology reports (26.7%).
3D scanning and virtual annotation of laryngeal cancer specimens for the creation of visual pathology reports is an innovative approach for postoperative pathology documentation, margin analysis, and surgeon-pathologist communication.
在全喉切除术（TL）标本中经常观察到切缘阳性。外科医生和病理学家之间有效沟通切缘取样部位和最终切缘状态至关重要。在本研究中，我们评估多媒体视觉病理报告在促进喉癌手术切缘状态跨学科讨论方面的效用。
在进行标准治疗病理分析之前，对离体喉癌手术标本进行三维（3D）扫描。使用计算机辅助设计软件，对3D模型进行标注以反映墨水标记、切片和切缘取样部位，生成视觉病理报告。这些报告在术后分发给头颈外科医生和病理学家。
2022年1月至2023年12月期间，对15例喉癌手术标本进行了3D扫描并进行虚拟标注。大多数标本（73.3%）为鳞状细胞癌（SCC）。在这些病例中，26.7%的患者手术切缘最终为阳性，而13.3%的患者切缘接近阳性，定义为<5毫米。视觉病理报告在3D标本上显示了接近或阳性切缘的部位，并在85.7%的此类病例中用于促进外科医生和病理学家之间的术后沟通。视觉病理报告在多学科肿瘤委员会讨论（20%）、电子邮件通信（13.3%）和电话会议（6.7%）中展示，并在最终书面病理报告中被引用（26.7%）。
对喉癌标本进行3D扫描和虚拟标注以创建视觉病理报告，是术后病理记录、切缘分析以及外科医生与病理学家沟通的一种创新方法。
