Clinical Implementation of In-House Developed MR-Based Patient-Specific 3D Models of Liver Anatomy

被引:3
作者
Ivashchenko, Oleksandra, V [1 ,2 ]
Smit, Jasper N. [1 ]
Nijkamp, Jasper [1 ]
ter Beek, Leon C. [3 ]
Rijkhorst, Erik-Jan [3 ]
Kok, Niels F. M. [1 ]
Ruers, Theo J. M. [1 ,4 ]
Kuhlmann, Koert F. D. [1 ]
机构
[1] Antoni van Leeuwenhoek Hosp, Dept Surg Oncol, Netherlands Canc Inst, Amsterdam, Netherlands
[2] Leiden Univ, Dept Radiol, Med Phys Grp, Med Ctr, K4-44,Albinusdreef 2, NL-2333 ZA Leiden, Netherlands
[3] Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Med Phys & Technol, Amsterdam, Netherlands
[4] Univ Twente, Fac Sci & Technol TNW, Nanobiophys Grp NBP, Enschede, Netherlands
关键词
Preoperative planning; Image-guided surgery; Anatomical models; Liver surgery; 3D anatomy;
D O I
10.1159/000513335
中图分类号
R61 [外科手术学];
学科分类号
摘要
Knowledge of patient-specific liver anatomy is key to patient safety during major hepatobiliary surgery. Three-dimensional (3D) models of patient-specific liver anatomy based on diagnostic MRI images can provide essential vascular and biliary anatomical insight during surgery. However, a method for generating these is not yet publicly available. This paper describes how these 3D models of the liver can be generated using open source software, and then subsequently integrated into a sterile surgical environment. The most common image quality aspects that degrade the quality of the 3D models as well possible ways of eliminating these are also discussed. Per patient, a single diagnostic multiphase MRI scan with hepatospecific contrast agent was used for automated segmentation of liver contour, arterial, portal, and venous anatomy, and the biliary tree. Subsequently, lesions were delineated manually. The resulting interactive 3D model could be accessed during surgery on a sterile covered tablet. Up to now, such models have been used in 335 surgical procedures. Their use simplified the surgical treatment of patients with a high number of liver metastases and contributed to the localization of vanished lesions in cases of a radiological complete response to neoadjuvant treatment. They facilitated perioperative verification of the relationship of tumors and the surrounding vascular and biliary anatomy, and eased decision-making before and during surgery.
引用
收藏
页码:143 / 152
页数:10
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