Improving Interdisciplinary Communication and Pathology Reporting for Head and Neck Cancer Resections: 3D Visualizations and Margin Reconciliation.
3D scanning
Frozen section
Human centered design
Multimedia report
Surgical pathology report
Journal
Head and neck pathology
ISSN: 1936-0568
Titre abrégé: Head Neck Pathol
Pays: United States
ID NLM: 101304010
Informations de publication
Date de publication:
17 Aug 2024
17 Aug 2024
Historique:
received:
20
03
2024
accepted:
02
08
2024
medline:
17
8
2024
pubmed:
17
8
2024
entrez:
17
8
2024
Statut:
epublish
Résumé
Surgical pathology reports play an integral role in postoperative management of head and neck cancer patients. Pathology reports of complex head and neck resections must convey critical information to all involved clinicians. Previously, we demonstrated the utility of 3D specimen and defect scanning for communicating margin status and documenting the location of supplemental margins. We introduce a newly designed permanent pathology report which improves documentation of intraoperative margin mapping and extent of corresponding supplemental margins harvested. We test the hypothesis that gaps in understanding exist for head and neck resection pathology reports across providers. A cross-sectional exploratory study using human-centered design was implemented to evaluate the existing permanent pathology report with respect to understanding margin status. Pathologists, surgeons, radiation oncologists, and medical oncologists from United States-based medical institutions were surveyed. The results supported a redesign of our surgical pathology template, incorporating 3D specimen / defect scans and annotated radiographic images indicating the location of inadequate margins requiring supplemental margins, or indicating frankly positive margins discovered on permanent section. Forty-seven physicians completed our survey. Analyzing surgical pathology reports, 28/47 (60%) respondents reported confusion whether re-excised supplemental margins reflected clear margins, 20/47 (43%) reported uncertainty regarding final margin status, and 20/47 (43%) reported the need for clarity regarding the extent of supplemental margins harvested intraoperatively. From this feedback, we designed a new pathology report template; 61 permanent pathology reports were compiled with this new template over a 12-month period. Feedback from survey respondents led to a redesigned permanent pathology report that offers detailed visual anatomic information regarding intraoperative margin findings and exact location/size of harvested supplemental margins. This newly designed report reconciles frozen and permanent section results and includes annotated radiographic images such that clinicians can discern precise actions taken by surgeons to address inadequate margins, as well as to understand the location of areas of concern that may influence adjuvant radiation planning.
Identifiants
pubmed: 39153096
doi: 10.1007/s12105-024-01684-9
pii: 10.1007/s12105-024-01684-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
78Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Powsner SM, Costa J, Homer RJ (2000) Clinicians are from Mars and pathologists are from Venus. Arch Pathol Lab Med 124(7):1040–1046. https://doi.org/10.5858/2000-124-1040-CAFMAP
doi: 10.5858/2000-124-1040-CAFMAP
pubmed: 10888781
Saturno MP, Brandwein-Weber M, Greenberg L, Silberzweig A, Buchbinder D, Dowling EM, Khan MN, Chai R, Urken ML (2023) Utilizing 3D head and neck specimen scanning for intraoperative margin discussions: Proof of concept of our novel approach. Head Neck 45(1):10–21. https://doi.org/10.1002/hed.27171
doi: 10.1002/hed.27171
pubmed: 36065715
Brandwein-Weber M, Urken ML, Topf MC, Lewis JS, Kang SY, Curry JM, Chai R, Khan M, Modica I, Chung D et al (2023) Radical shift in the communication paradigm in head and neck frozen section analysis: intraoperative three-dimensional specimen scanning. Head Neck 45(1):7–9. https://doi.org/10.1002/hed.27247
doi: 10.1002/hed.27247
pubmed: 36377564
Fassler C, Miller A, Sharif K, Prasad K, Aweeda M, Lewis J, Topf MC (2023) Enhanced communication of Tumor margins using 3D scanning and mapping. J Vis Exp (202). DOI: 10.3791/66253 From NLM.
Miller A, Prasad K, Sharif KF, Adams DJ, Garbow L, Roberts E, Lewis JS Jr., Ely KA, Mehrad M, Rohde SL et al (2024) Virtual 3D specimen mapping in Head & Neck oncologic surgery. Laryngoscope 134(1):191–197. https://doi.org/10.1002/lary.30881 From NLM
doi: 10.1002/lary.30881
pubmed: 37466329
Perez AN, Sharif KF, Guelfi E, Li S, Miller A, Prasad K, Sinard RJ, Lewis JS Jr., Topf MC (2023) Ex vivo 3D scanning and specimen mapping in anatomic pathology. J Pathol Inf 14:100186. https://doi.org/10.1016/j.jpi.2022.100186 From NLM
doi: 10.1016/j.jpi.2022.100186
Sharif KF, Lewis JS Jr., Ely KA, Mehrad M, Pruthi S, Netterville JL, Rohde SL, Langerman A, Mannion K, Sinard RJ et al (2023) The computer-aided design margin: ex vivo 3D specimen mapping to improve communication between surgeons and pathologists. Head Neck 45(1):22–31. https://doi.org/10.1002/hed.27201 From NLM
doi: 10.1002/hed.27201
pubmed: 36156327
Sharif KF, Prasad K, Miller A, McPeak S, Denney JE, Lewis JS Jr., Topf MC (2023) Enhanced Intraoperative Communication of Tumor margins using 3D scanning and mapping: the computer-aided design margin. Laryngoscope 133(8):1914–1918. https://doi.org/10.1002/lary.30511 From NLM
doi: 10.1002/lary.30511
pubmed: 36533659
Urken ML, Yun J, Saturno MP, Greenberg LA, Chai RL, Sharif K, Brandwein-Weber M (2023) Frozen Section Analysis in Head and Neck Surgical Pathology: a narrative review of the past, Present, and Future of Intraoperative Pathologic Consultation. Oral Oncol 143:106445. https://doi.org/10.1016/j.oraloncology.2023.106445 From NLM
doi: 10.1016/j.oraloncology.2023.106445
pubmed: 37285683
Colazo JM, Prasad K, Miller A, Sharif K, Aweeda M, Fassler C, Singh R, Schwartz HS, Lawrenz JM, Holt GE et al (2024) 3D specimen scanning and mapping in Musculoskeletal Oncology: a feasibility study. Ann Surg Oncol 31(3):2051–2060. https://doi.org/10.1245/s10434-023-14757-w From NLM
doi: 10.1245/s10434-023-14757-w
pubmed: 38133863
Sharif KF, Perez AN, Sharbel DD, Griffith B, Pruthi S, Rohde SL, Lewis JS Jr., Topf MC (2022) Multimodal virtual 3D representation of a giant cell tumor of the thyroid cartilage. Ear Nose Throat J 1455613221091090. https://doi.org/10.1177/01455613221091090 From NLM
Yun J, Su V, Kapustin D, Rubin SJ, Brandwein-Weber M, Khan MN, Chai R, Doyle S, Karasick M, Urken ML (2023) Intraoperative three-dimensional scanning of head and neck surgical defects: enhanced communication and documentation of harvested supplemental margins. Head Neck 45(10):2690–2699. https://doi.org/10.1002/hed.27498 From NLM
doi: 10.1002/hed.27498
pubmed: 37638591
Kapustin D, Su V, Yun J, Rubin SJ, Chung D, Modica I, Khan MN, Chai RL, Karasick M, Doyle S et al (2024) iPad annotation of 3D Surgical models using Procreate
doi: 10.1002/lary.31144
pubmed: 37921378
Bazzano AN, Martin J, Hicks E, Faughnan M, Murphy L (2017) Human-centred design in global health: a scoping review of applications and contexts. PLoS ONE 12(11):e0186744. https://doi.org/10.1371/journal.pone.0186744
doi: 10.1371/journal.pone.0186744
pubmed: 29091935
pmcid: 5665524
Noy C (2008) Sampling knowledge: the hermeneutics of Snowball Sampling in qualitative research. Int J Soc Res Methodol 11:327–344
doi: 10.1080/13645570701401305
Kapustin DA, Yun J, Su V, Rubin SJ, Modica I, Chung D, Fan J, Khan MN, Chai RL, Karasick M et al (2023) Frozen section timeout: pilot study to reconcile margins using 3D resected specimen and defect scans. Laryngoscope. https://doi.org/10.1002/lary.30892
doi: 10.1002/lary.30892
pubmed: 37933810
Ku B, Lupton E (2020) Health Design thinking: creating products and Services for Better Health. The MIT Press
Schiro J, Pelayo S, Martinot A, Dubos F, Beuscart-Zéphir MC, Marcilly R (2020) Applying a human-centered design to develop a patient prioritization Tool for a Pediatric Emergency Department: detailed case study of First iterations. JMIR Hum Factors 7(3). https://doi.org/10.2196/18427 . e18427
Mossanen M, True LD, Wright JL, Vakar-Lopez F, Lavallee D, Gore JL (2014) Surgical pathology and the patient: a systematic review evaluating the primary audience of pathology reports. Hum Pathol 45(11):2192–2201. https://doi.org/10.1016/j.humpath.2014.07.008
doi: 10.1016/j.humpath.2014.07.008
pubmed: 25149550
Wick MR (2007) Medicolegal liability in surgical pathology: a consideration of underlying causes and selected pertinent concepts. Semin Diagn Pathol 24(2):89–97. https://doi.org/10.1053/j.semdp.2007.03.003 From NLM
doi: 10.1053/j.semdp.2007.03.003
pubmed: 17633350
Magliocca KR, Surgical, Margins (2017) The perspective of Pathology. Oral Maxillofac Surg Clin North Am 29(3):367–375. https://doi.org/10.1016/j.coms.2017.05.002 From NLM
doi: 10.1016/j.coms.2017.05.002
pubmed: 28709535
Maxwell JH, Thompson LD, Brandwein-Gensler MS, Weiss BG, Canis M, Purgina B, Prabhu AV, Lai C, Shuai Y, Carroll WR et al (2015) Early oral Tongue squamous cell carcinoma: sampling of margins from Tumor Bed and worse local control. JAMA Otolaryngol Head Neck Surg 141(12):1104–1110. https://doi.org/10.1001/jamaoto.2015.1351
doi: 10.1001/jamaoto.2015.1351
pubmed: 26225798
pmcid: 5242089
Boero IJ, Paravati AJ, Xu B, Cohen EE, Mell LK, Le QT, Murphy JD (2016) Importance of Radiation oncologist experience among patients with Head-and-Neck Cancer treated with intensity-modulated Radiation Therapy. J Clin Oncol 34(7):684–690. https://doi.org/10.1200/jco.2015.63.9898 From NLM
doi: 10.1200/jco.2015.63.9898
pubmed: 26729432
pmcid: 4872027