Abstract
The quality of the interdisciplinary interface in oncological treatment between surgery, pathology and radiotherapy is mainly dependent on reliable anatomical three-dimensional (3D) allocation of specimen and their context sensitive interpretation which defines further treatment protocols. Computer-assisted preoperative planning (CAPP) allows for outlining macroscopical tumor size and margins. A new technique facilitates the 3D virtual marking and mapping of frozen sections and resection margins or important surgical intraoperative information. These data could be stored in DICOM format (Digital Imaging and Communication in Medicine) in terms of augmented reality and transferred to communicate patient's specific tumor information (invasion to vessels and nerves, non-resectable tumor) to oncologists, radiotherapists and pathologists.
Highlights
Three of the most challenging interfaces in oncologic treatment in head and neck cancer exist between surgeon and pathologist just as between surgeon and radiotherapist and/or oncologist
The recording and naming of frozen sections or resection margins does often not allow for later well-defined three-dimensional (3D) orientation. Due to this 3Dcomplexity in between written words and the real location pathologists are not able to rule out residual tumor without consultation of the surgeon, who sometimes has to stitch more to his personal memory than to reliable recorded information
Assessing resection margins intraoperatively is possible by means of frozen sections
Summary
Three of the most challenging interfaces in oncologic treatment in head and neck cancer exist between surgeon and pathologist just as between surgeon and radiotherapist and/or oncologist. The recording and naming of frozen sections or resection margins does often not allow for later well-defined three-dimensional (3D) orientation. Due to this 3Dcomplexity in between written words and the real location pathologists are not able to rule out residual tumor without consultation of the surgeon, who sometimes has to stitch more to his personal memory than to reliable recorded information. If there is an indication for adjuvant radiation therapy, such as minimal tumor residuals (R1-resection), the same problem discounts for radiation therapy planning to be challenging: the radiotherapist could not gain access to reliable intra-operative information and uses. The minor additional expenses to enable intra-operative navigation ease anatomical orientation and true-to-original reconstruction after ablative surgery [2,3,4,5]
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