# Digital localization of intraoperative samples enhances margin analysis precision in oral squamous cell carcinoma

## TL;DR

A new digital method for analyzing cancer margins during surgery improves the accuracy of diagnosing oral squamous cell carcinoma.

## Contribution

A modified intraoperative margin assessment protocol using virtual 3D imaging is introduced to enhance histopathological precision.

## Key findings

- Virtual 3D imaging of resected OSCC allows for more precise intraoperative margin evaluation.
- The modified protocol incorporates margin width into histopathological analysis, improving diagnostic accuracy.
- One case demonstrated the potential of the protocol to influence adjuvant radiotherapy decisions.

## Abstract

The intraoperative margin assessment technique enhances local control of Oral Squamous Cell Carcinoma (OSCC). However, the standard frozen section analysis (FSA) procedure does not allow precise interpretation of the final histopathological results. For this reason, we have developed a modified intraoperative margins (IM) assessment protocol using virtual 3D images of resected OSCC.

The pilot study included 10 patients with OSCC located in the floor of the mouth (FOM, n = 3), tongue (TC, n = 2), maxilla (MT, n = 1), and retromolar triangle (RMT, n = 4). After excision, OSCCs were scanned and mapped, marked on the virtual preparation of the IM collection sites. The modified pathological assessment of the IM enabled the evaluation of dimensions, including the width of the collected IM.

By analyzing virtual OSCC images, we demonstrated the effectiveness of a modified IM assessment methodology. In one case study, the oncological council disqualified the patient from adjuvant radiotherapy.

Leveraging the OSCC’s virtual mapping capabilities and the modified IM pathology methodology, we developed an IM evaluation protocol that enables the incorporation of IM width into the OSCC’s microscopic excision margin, thereby significantly enhancing the diagnostic value and precision of the final OSCC histopathology results.