Related Experiment Video For computed tomography
Updated: Jul 2, 2026
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
Impact of intraoperative specimen computed tomography imaging on grossing accuracy and margin assessment in pulmonary
Kentaro Miura1, Takahiro Yanagihara2, Nicholas Bernards1
1Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Objective:
To evaluate whether specimen computed tomography imaging (2- or 3-dimensional) influences the accuracy and decision-making in pathological grossing for pulmonary wedge resection.
Methods:
In this randomized prospective study, pulmonary wedge resection specimens were divided into 3 groups: control (no imaging), 2-dimensional computed tomography, and 3-dimensional computed tomography. Pathology assistants performed grossing with or without intraoperative computed tomography guidance per group assignment. A 5-point Likert scale questionnaire assessed perceived usefulness in tumor localization, cut-line location, cut-line angle, and overall grossing impact. Margins measured on 2- and 3-dimensional computed tomography with actual cutting lines were compared with pathological margins. Subgroup analyses were performed for lung cancer and metastatic tumors.
Results:
Across all specimens (n = 45), no parameter reached statistical significance. However, 3-dimensional computed tomography tended to score higher for cut-line angle impact (median 4 [3-4]) and overall grossing impact (median 4 [3-5]) than 2-dimensional computed tomography. In lung cancer cases (n = 16), 3-dimensional computed tomography significantly impacted cut-line angle compared with 2-dimensional computed tomography (median 2.5 [2-3] vs 4 [3-4.25], P = .03). In metastatic tumors (n = 29), 3-dimensional computed tomography showed a nonsignificant trend toward higher overall impact. Correlation analysis revealed strong associations between margins measured on 2-dimensional computed tomography and pathological margins, and between margins reconstructed from actual cutting lines on 3-dimensional computed tomography and pathological margins (r = 0.87 and 0.92, respectively). These correlations were slightly weaker in lung cancer than in metastatic tumors.
Conclusions:
Intraoperative computed tomography imaging demonstrated high accuracy in margin estimation and provided reliable guidance for pathological grossing. Selective computed tomography evaluation may be advantageous for lesions difficult to palpate, such as deeply located small tumors.
