用增强现实技术精准定位头颈癌手术切缘，提升二次切除准确性。
All-in-One Augmented Reality Guided Head and Neck Tumor Resection
- 基于HoloLens 2实现无标记表面配准，自动重定位切缘位置。
- 术中引导误差从14.2mm降至3.2mm，全部在5mm内。
- 适合外科医生培训与精准肿瘤切除场景。
头颈鳞状细胞癌常出现切缘阳性，但术中再次切除往往不精确，因切缘位置通常依赖病理口头传达。本文提出一种一体化增强现实（AR）系统，利用HoloLens 2深度感知与全自动无标记表面配准，将切除标本上的阳性切缘重新定位至术区并实时可视化。在六名医学训练员参与的硅胶假体实验中，无标记配准的靶点注册误差与基于标记的基准相当（中位数1.8 mm vs. 1.7 mm；最大<4 mm）。在切缘重定位任务中，相比口头指导（中位数14.2 mm误差），AR引导将误差降低至数毫米（中位数3.2 mm），所有定位误差均小于5 mm。结果表明，无标记AR切缘引导具备可行性，可实现更精准的术中再切除。
原文摘要 · Abstract (English)
Positive margins are common in head and neck squamous cell carcinoma, yet intraoperative re-resection is often imprecise because margin locations are typically communicated verbally from pathology. We present an all-in-one augmented reality (AR) system that relocalizes positive margins from a resected specimen to the resection bed and visualizes them in situ using HoloLens 2 depth sensing and fully automated markerless surface registration. In a silicone phantom study with six medical trainees, markerless registration achieved target registration errors comparable to a marker-based baseline (median 1.8 mm vs. 1.7 mm; maximum < 4 mm). In a margin relocalization task, AR guidance reduced error from verbal guidance (median 14.2 mm) to a few millimeters (median 3.2 mm), with all AR localizations within 5 mm error. These results support the feasibility of markerless AR margin guidance for more precise intraoperative re-excision.
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