Related Experiment Video
Updated: Mar 11, 2026
Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer
Published on: June 9, 2023
MarginView3D: Extending Novel 3D Surgical Pathology Reporting for Use in Invasive pT4 Thyroid Cancer and Other
Sabrina R Comess1,2, Jacob E Kapustin1,2, Margaret Nurimba2
1THANC (Thyroid, Head and Neck Cancer) Foundation, New York, New York, USA.
Background:
The American Thyroid Association's most recent clinical practice guidelines include margin status as a key factor to estimate risk of recurrence. Unlike most thyroid cancers, the successful resection of invasive pT4 thyroid cancers necessitates the use of frozen section analysis (FSA). There is no standardized method for intraoperative surgical margin assessment. We developed a novel intraoperative workflow and software platform, MarginView3DTM (MV3D), to enhance the precision of FSA and improve surgical pathology reporting in head and neck cancer. Here, we demonstrate its use in invasive thyroid cancer.
Methods:
We describe the MV3DTM surgical pathology reporting software and detail our surgical workflow, which incorporates 3D scanning technology and standardized "timeouts" to facilitate intraoperative communication and pathologic documentation. This approach was utilized in five invasive pT4 thyroid cancer cases.
Results:
MV3DTM was used to guide intraoperative margin assessment, communication, and pathologic documentation in four tracheal resections and one sternal mass resection. A final surgical pathology report was generated for each case, integrating 3D scans, annotated radiographs, and audiovisual summaries into a dynamic interface for multidisciplinary use. We highlight case 5, where MV3DTM facilitated bidirectional communication between the surgeon and pathologist to guide precise harvesting of supplemental margins. The surgeon and pathologist collaborated in real time to address at-risk areas requiring immediate re-resection. An R0 resection was achieved, and all relevant details were captured within MV3DTM.
Conclusions:
We have utilized our novel approach extensively in head and neck cancer. Here, we highlight it as a tool for the management of invasive pT4 thyroid cancer. As a brief summary of new and innovative research, this study introduces MV3DTM as a novel and scalable approach to intraoperative margin assessment and documentation in advanced thyroid cancer, with the potential to inform future practice in surgical oncology.
Insights
A new MarginView3D software enhances frozen section analysis for invasive thyroid cancer. This technology improves intraoperative margin assessment and documentation, aiding surgeons and pathologists in achieving complete tumor resection.
Area of Science:
- Surgical Oncology
- Pathology
- Medical Technology
Background:
- Thyroid cancer recurrence risk is assessed using margin status per American Thyroid Association guidelines.
- Invasive pT4 thyroid cancers require frozen section analysis (FSA) for successful resection.
- Standardized intraoperative margin assessment methods are lacking.
Purpose of the Study:
- To demonstrate the utility of MarginView3D (MV3D), a novel intraoperative workflow and software platform, in invasive thyroid cancer.
- To enhance the precision of FSA and improve surgical pathology reporting.
- To adapt MV3D, previously used in head and neck cancer, for advanced thyroid cancer management.
Main Methods:
- Description of the MV3D surgical pathology reporting software.
- Implementation of a surgical workflow integrating 3D scanning and standardized communication protocols.
- Application of the workflow in five invasive pT4 thyroid cancer cases.
Main Results:
- MV3D guided intraoperative margin assessment, communication, and documentation in complex resections.
- Generated surgical pathology reports integrated 3D scans, radiographs, and audiovisual summaries.
- Facilitated real-time surgeon-pathologist collaboration, leading to precise margin harvesting and R0 resection in a highlighted case.
Conclusions:
- MV3D offers a novel and scalable approach to intraoperative margin assessment and documentation in advanced thyroid cancer.
- The technology, previously validated in head and neck cancers, shows potential for improving surgical oncology practices.
- This study highlights MV3D as a valuable tool for managing invasive pT4 thyroid cancer.
