Objective:

To evaluate the integration of micro-PET/CT imaging with 3D specimen models for improved margin assessment in head and neck squamous cell carcinoma (HNSCC).

Approach:

• Study Design: This study is performed under Vanderbilt University Medical Center (VUMC) Institutional Review Board approvals (IRB#221597 (3D Scanning) & IRB#242063 (Intraoperative micro-PET/CT)). This is an ongoing study (NCT06915454) that began in September 2025. Eligible patients are adults (≥ 18 years) with biopsy-confirmed solid malignancy of the head and neck scheduled to undergo definitive en bloc resection with curative intent.
• Intraoperative Imaging: Intraoperative metabolic imaging was performed in the operating room using a high-resolution mobile micro-PET/CT scanner (XEOS Aura 10; XEOS Medical, Ghent, Belgium) to assess tumor metabolic activity and support real-time margin assessment.
• 3D Scanning and Mapping: After radioactive decay, resection specimens were prepared for ex vivo surface capture. The specimens' external topography was captured using a commercially available structured-light 3D scanner and turntable (EinScan SP, Shining 3D, Hangzhou, China) and accompanying software (EXScan, Shining 3D).

Key Findings:

• Micro-PET/CT imaging provides metabolic information that may enhance margin assessment compared to traditional frozen section analysis.
• The integration of 3D specimen models allows for precise correlation of micro-PET/CT data with histopathology.

Interpretation:

The study aims to improve surgical outcomes by providing a more accurate method for assessing surgical margins in HNSCC.

Limitations:

• The study is ongoing, and results from intraoperative margin evaluations will be reported separately.
• The sample size and specific outcomes have not yet been detailed.

Conclusion:

The integration of micro-PET/CT imaging with 3D specimen models may enhance the accuracy of margin assessments in HNSCC surgeries.