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3D ultrasound in evaluating resection margins during salivary gland tumour surgery
Mads Bøgh1, Benedicte Parm Ulhøi2, Nelson Fuentes Martinez2
1Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.
Background:
Achieving clear margins in salivary gland tumour surgery is challenging. An accurate intraoperative method for specimen margin assessment is needed.
Aims/Objectives:
To evaluate the accuracy of three-dimensional (3D) ultrasound (US) for intraoperative margin assessment in salivary gland tumour surgery.
Materials And Methods:
Patients undergoing surgery for pleomorphic adenomas or suspected malignant tumours of the parotid or submandibular gland were prospectively included. After tumour resection, 3D US imaging of the specimen was performed using a novel setup. Tumour measurements and resection margins were assessed and compared with histopathology. Margin status was categorised using a predefined 1-mm cut-off.
Results:
Twenty-eight patients were included. Margin status was correctly classified by 3D US in 26 cases (93%). Using a 1-mm cut-off, sensitivity was 96%, specificity 75%, positive predictive value (PPV) 96%, and negative predictive value (NPV) 75%. For images corresponding to histopathological slices, sensitivity was 96%, specificity 92%, PPV 98%, and NPV 85%. Tumour area and smallest margin per slice correlated strongly with histopathology (r = 0.99 and r = 0.95, respectively).
Conclusions:
3D US enables accurate intraoperative classification of margin status and provides tumour and margin measurements in close agreement with histopathology.
Significance:
This low-cost, accessible technique may support real-time decision-making, improve surgical radicality, and reduce the need for re-interventions.
