# Augmented Reality to Guide Head and Neck Cancer Surgery

> **NIH NIH K08** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2024 · $216,771

## Abstract

PROJECT SUMMARY
For head and neck cancer patients, a positive surgical margin results in treatment intensification, increased cost,
and an increased risk of recurrence and death. Positive surgical margin rates in oral cavity cancer are the highest
among solid malignancies and have not improved over the past two decades. If a positive margin is identified
intraoperatively, the surgeon relies on verbal descriptions during a phone call with the pathologist to relocate the
margin and resect additional tissue. Relocating the positive margin site using current protocols with no visual aid
is difficult in the head and neck due to complex 3D anatomy. Therefore, it is not surprising that re-resection fails
to improve oncologic outcomes. To address this unmet need, I have developed a protocol to create a virtual 3D
model of the resected cancer specimen that shows the sites of margin sampling. In a prior cadaveric study, I
established the feasibility of placing the 3D specimen model into an augmented reality (AR) environment to guide
re-resection. AR superimposes a computer-generated image on a user's view of the real world, thus providing a
composite view. The goal of this project is to determine the accuracy of placing a 3D specimen hologram into
the surgical defect in actual head and neck cancer patients and develop custom AR software to improve time
and accuracy of alignment. In Aim 1, I will determine the accuracy of alignment of the projected 3D specimen
model into the surgical defect. The tumor will be resected per standard of care, 3D scanned, and uploaded into
the AR environment. The surgeon will wear the Microsoft HoloLens 2, a portable, handsfree, AR headset. The
surgeon will align the 3D specimen hologram into the resection bed and accuracy will be measured. In Aim 2, I
will develop a custom AR surgery platform to improve time and accuracy of alignment. The existing AR software
has significant limitations for surgical use, including limited voice commands, inability to adjust transparency,
and lack of a lock-in-place feature. To address this, I am creating custom AR software in collaboration with the
Vanderbilt Institute for Surgery and Engineering. In a cadaveric study, surgeons will align the 3D specimen
hologram into the resection bed using both the custom and existing AR software. Time and accuracy of alignment
will be measured. During this project I will benefit from the guidance of my primary mentor, who is an established
surgeon-scientist with substantial experience in bringing new technologies into the operating room, as well as
three co-mentors with expertise in specific areas. Additionally, I will undertake advanced training in AR systems,
surgical pathology processing, and clinical trial design, which will provide a strong foundation for pursuing my
career goal of becoming a surgeon-scientist focused on implementation of AR systems to improve the
effectiveness of oncologic surgery. This project will lay the groundwork for a future R01...

## Key facts

- **NIH application ID:** 10950144
- **Project number:** 1K08CA293255-01
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Michael Topf
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $216,771
- **Award type:** 1
- **Project period:** 2024-09-01 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10950144

## Citation

> US National Institutes of Health, RePORTER application 10950144, Augmented Reality to Guide Head and Neck Cancer Surgery (1K08CA293255-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10950144. Licensed CC0.

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