Accuracy research of the Three-dimensional visualization imaging system for preoperative imaging in malignant tumors of the head and neck

<title>Abstract</title> <p> <bold>Background</bold> Three-dimensional visualization imaging technology serves as a novel adjunct in maxillofacial surgery. This study aims to assess the accuracy of the Three-dimensional Visualization Imaging System (3D-VIS) in preoperative imaging for patients with head and neck malignancies. Methods: Thirty-four patients undergoing neck dissection received 256-Slice Multi-Detector Computed Tomography (256-MDCT) scans, with data processed through 3D-VIS for segmentation and reconstruction. The resultant 3D models were systematically compared against the original CT images and intraoperative findings. Results: The 3D models effectively delineated the location and characteristics of primary lesions and lymph nodes, with 3D-VIS localization strongly correlating with surgical findings (к &gt; 0.8). Moreover, no significant differences in lymph node long-axis diameters (P &gt; 0.05) among 3D, CT, and intraoperative measurements. System-calculated and intraoperative lymph node volumes showed no significant difference (P &gt; 0.05). The simple regression equation is given by ALNV = 1.014×3DPLNV-0.005; (r = 0.997; p &lt; 0.001). 3D-predicted significant lymph node volume (3DPELV) (Intraclass Correlation Coefficient = 0.997) achieved excellent agreement with the actual significant lymph node volume (ALNV), demonstrating statistical significance (P &lt; 0.001). 53 of 56 dots fell within the 95% confidence interval in Bland-Altman analyses. Conclusions: The 3D-VIS demonstrates exceptional imaging accuracy in the preoperative assessment of head and neck malignancies, providing comprehensive preoperative evaluation for personalized surgical planning. (Trial registration: Chinese Clinical Trial Registry, ChiCTR2500105077. Registered 27 June 2025.) <bold>Trial registration</bold> Chinese Clinical Trial Registry, ChiCTR2500105077. Registered 27 June 2025. </p>