Int J Comput Assist Radiol Surg - 3D model-based documentation with the Tumor Therapy Manager (TTM) improves TNM staging of head and neck tumor patients.


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RPOSE: Many treatment approaches are available for head and neck cancer (HNC), leading to challenges for a multidisciplinary medical team in matching each patient with an appropriate regimen. In this effort, primary diagnostics and its reliable documentation are indispensable. A three-dimensional (3D) documentation system was developed and tested to determine its influence on interpretation of these data, especially for TNM classification.METHODS: A total of 42 HNC patient data sets were available, including primary diagnostics such as panendoscopy, performed and evaluated by an experienced head and neck surgeon. In addition to the conventional panendoscopy form and report, a 3D representation was generated with the "Tumor Therapy Manager" (TTM) software. These cases were randomly re-evaluated by 11 experienced otolaryngologists from five hospitals, half with and half without the TTM data. The accuracy of tumor staging was assessed by pre-post comparison of the TNM classification.RESULTS: TNM staging showed no significant differences in tumor classification (T) with and without 3D from TTM. However, there was a significant decrease in standard deviation from 0.86 to 0.63 via TTM ([Formula: see text]). In nodal staging without TTM, the lymph nodes (N) were significantly underestimated with [Formula: see text] classes compared with [Formula: see text] with TTM ([Formula: see text]). Likewise, the standard deviation was reduced from 0.79 to 0.69 ([Formula: see text]). There was no influence of TTM results on the evaluation of distant metastases (M).CONCLUSION: TNM staging was more reproducible and nodal staging more accurate when 3D documentation of HNC primary data was available to experienced otolaryngologists. The more precise assessment of the tumor classification with TTM should provide improved decision-making concerning therapy, especially within the interdisciplinary tumor board.

Resumo Limpo

rpose mani treatment approach avail head neck cancer hnc lead challeng multidisciplinari medic team match patient appropri regimen effort primari diagnost reliabl document indispens threedimension d document system develop test determin influenc interpret data especi tnm classificationmethod total hnc patient data set avail includ primari diagnost panendoscopi perform evalu experienc head neck surgeon addit convent panendoscopi form report d represent generat tumor therapi manag ttm softwar case random reevalu experienc otolaryngologist five hospit half half without ttm data accuraci tumor stage assess prepost comparison tnm classificationresult tnm stage show signific differ tumor classif t without d ttm howev signific decreas standard deviat via ttm formula see text nodal stage without ttm lymph node n signific underestim formula see text class compar formula see text ttm formula see text likewis standard deviat reduc formula see text influenc ttm result evalu distant metastas mconclus tnm stage reproduc nodal stage accur d document hnc primari data avail experienc otolaryngologist precis assess tumor classif ttm provid improv decisionmak concern therapi especi within interdisciplinari tumor board

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