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.
@article{arxiv.2603.29495,
title = {All-in-One Augmented Reality Guided Head and Neck Tumor Resection},
author = {Yue Yang and Matthieu Chabanas and Carrie Reale and Annie Benson and Jason Slagle and Matthew Weinger and Michael Topf and Jie Ying Wu},
journal= {arXiv preprint arXiv:2603.29495},
year = {2026}
}