发表机构
Vanderbilt University; Vanderbilt University Medical Center（范德堡大学; 范德堡大学医学中心）
机构由 AI 辅助整理，请以论文原文为准。AI 中文总结
研究针对头颈部肿瘤手术中阳性切缘定位难题，提出无标记增强现实工作流程，结合多种技术实现标本扫描到切除床的映射，经实验验证该方法能有效降低定位误差，支持更精确肿瘤切除。
AI 中文摘要
头颈部肿瘤手术中的阳性切缘需要将标本侧的病理结果映射到患者的切除床。这具有挑战性，因为病理学家在切除的变形标本切片上识别阳性切缘，而外科医生必须仅通过口头描述且无视觉引导在切除床上重新定位相应部位。我们提出了一种无标记增强现实（AR）工作流程，用于将三维标本扫描中的切缘标签映射到切除床。该方法结合了轮廓约束变形、与深度扫描的残余对齐、与头戴式显示器的基于表面的融合以及在重建床上的目标投影。珠子 - 缝线对应关系估计标本变形，而患者到显示器的融合不需要外部基准标记。在形成性实验之后，五名住院医生和外科医生在口头指导、口头指导并检查标本以及AR指导下进行了尸体脸颊和头皮再切除任务。脸颊的变形目标误差为$7.63 \pm 3.74$毫米，头皮为$3.72 \pm 1.02$毫米；标本到床的残余距离分别为$2.43 \pm 2.15$毫米和$2.19 \pm 1.06$毫米。在两种尸体上，无标记和基于标记的方法之间的融合误差没有显著差异；总体无标记融合误差为$2.15 \pm 0.87$毫米。端到端的切缘定位误差从口头指导时的$21.40 \pm 3.84$毫米和检查标本时的$16.09 \pm 4.30$毫米降至AR指导时的$6.19 \pm 1.79$毫米（$p < 0.001$）。在线融合需要$5.23 \pm 0.34$秒。这些结果证明了无标记AR指导对阳性切缘定位的有效性，并支持更精确的肿瘤切除。
英文摘要
Positive margins in head and neck oncologic surgery require mapping specimen-side pathology findings to the patient resection bed. This is challenging because pathologists identify the positive margin on slices of the resected, deformed specimen, while surgeons must relocate the corresponding site on the resection bed using only verbal descriptions and no visual guidance. We present a marker-free augmented reality (AR) workflow for mapping a margin label from a three-dimensional specimen scan to the resection bed. The method combines contour-constrained deformation, residual alignment to a depth scan, surface-based fusion to a head-mounted display, and target projection onto the reconstructed bed. Bead-suture correspondences estimate specimen deformation, whereas patient-to-display fusion does not require external fiducial markers. Following formative experiments, five residents and surgeons performed cadaveric cheek and scalp re-resection tasks under verbal guidance, verbal guidance with specimen examination, and AR guidance. Deformation target errors were $7.63 \pm 3.74$ mm for the cheek and $3.72 \pm 1.02$ mm for the scalp; residual specimen-to-bed distances were $2.43 \pm 2.15$ mm and $2.19 \pm 1.06$ mm, respectively. Fusion error did not differ significantly between marker-free and marker-based methods on either cadaver; overall marker-free fusion error was $2.15 \pm 0.87$ mm. End-to-end margin localization error decreased from $21.40 \pm 3.84$ mm with verbal guidance and $16.09 \pm 4.30$ mm with specimen examination to $6.19 \pm 1.79$ mm with AR guidance ($p < 0.001$). Online fusion required $5.23 \pm 0.34$ s. These results demonstrate effective marker-free AR guidance for positive-margin localization and support more precise tumor resection.
