A preoperative planning tool for lung segmentectomy procedures: a case study
EAES Academy. De Backer P. 07/05/22; 363115; P160
Pieter De Backer
Contributions
Contributions
Abstract
Aim
Both improvements in thoracoscopy and advanced imaging methods make lung segmentectomies increasingly prevalent. Preoperative 3D models aid in making these procedures safer. We set up a program of improving thoracoscopic safety at Ghent University Hospital using 3D models for lung segmentectomies.
Methods:
Patients received a multidetector contrast-enhanced high resolution CT scan (slice-thickness: 1 mm). Mimics Innovation Suite (Materialise, Belgium) was used for creating a 3D model, mainly by using volume rendering methods. In this way, the bone structures, arteries, veins, bronchi, tumor and lung lobes were segmented. The segmentations of the bronchi and the lobe affected by the tumor were then used as input for a preoperative planning tool. Starting from the bronchi, a region growing approach divided the lobe volume into the lung segments. These segments were subsequently visualized on the 3D model, allowing the surgeon to determine the affected segment and the vessels perfusing this segment.
Results:
In Figure 1, a case study of a 56-year old patient with a suspected tumor in the left upper lobe is illustrated. Using the preoperative planning tool, the lung segments were determined (Figure 2, top view). The 3D model aided in the correct identification of the affected segments, the respective bronchus and vascularization, leading to a safe resection of the apical and posterior segments (S1 and S2). The patient had an uncomplicated postoperative course.
Conclusion:
The preoperative planning tool proved to be an added value during a successful first case at our center, providing in-depth insight in the patient-specific anatomy. This is an important step in aiding the surgeon to improve thoracoscopic safety, although further validation of the algorithm is necessary. In the future, surgical resection procedures in other organs, such as e.g. kidney or liver, could also benefit from this approach.
Both improvements in thoracoscopy and advanced imaging methods make lung segmentectomies increasingly prevalent. Preoperative 3D models aid in making these procedures safer. We set up a program of improving thoracoscopic safety at Ghent University Hospital using 3D models for lung segmentectomies.
Methods:
Patients received a multidetector contrast-enhanced high resolution CT scan (slice-thickness: 1 mm). Mimics Innovation Suite (Materialise, Belgium) was used for creating a 3D model, mainly by using volume rendering methods. In this way, the bone structures, arteries, veins, bronchi, tumor and lung lobes were segmented. The segmentations of the bronchi and the lobe affected by the tumor were then used as input for a preoperative planning tool. Starting from the bronchi, a region growing approach divided the lobe volume into the lung segments. These segments were subsequently visualized on the 3D model, allowing the surgeon to determine the affected segment and the vessels perfusing this segment.
Results:
In Figure 1, a case study of a 56-year old patient with a suspected tumor in the left upper lobe is illustrated. Using the preoperative planning tool, the lung segments were determined (Figure 2, top view). The 3D model aided in the correct identification of the affected segments, the respective bronchus and vascularization, leading to a safe resection of the apical and posterior segments (S1 and S2). The patient had an uncomplicated postoperative course.
Conclusion:
The preoperative planning tool proved to be an added value during a successful first case at our center, providing in-depth insight in the patient-specific anatomy. This is an important step in aiding the surgeon to improve thoracoscopic safety, although further validation of the algorithm is necessary. In the future, surgical resection procedures in other organs, such as e.g. kidney or liver, could also benefit from this approach.
Aim
Both improvements in thoracoscopy and advanced imaging methods make lung segmentectomies increasingly prevalent. Preoperative 3D models aid in making these procedures safer. We set up a program of improving thoracoscopic safety at Ghent University Hospital using 3D models for lung segmentectomies.
Methods:
Patients received a multidetector contrast-enhanced high resolution CT scan (slice-thickness: 1 mm). Mimics Innovation Suite (Materialise, Belgium) was used for creating a 3D model, mainly by using volume rendering methods. In this way, the bone structures, arteries, veins, bronchi, tumor and lung lobes were segmented. The segmentations of the bronchi and the lobe affected by the tumor were then used as input for a preoperative planning tool. Starting from the bronchi, a region growing approach divided the lobe volume into the lung segments. These segments were subsequently visualized on the 3D model, allowing the surgeon to determine the affected segment and the vessels perfusing this segment.
Results:
In Figure 1, a case study of a 56-year old patient with a suspected tumor in the left upper lobe is illustrated. Using the preoperative planning tool, the lung segments were determined (Figure 2, top view). The 3D model aided in the correct identification of the affected segments, the respective bronchus and vascularization, leading to a safe resection of the apical and posterior segments (S1 and S2). The patient had an uncomplicated postoperative course.
Conclusion:
The preoperative planning tool proved to be an added value during a successful first case at our center, providing in-depth insight in the patient-specific anatomy. This is an important step in aiding the surgeon to improve thoracoscopic safety, although further validation of the algorithm is necessary. In the future, surgical resection procedures in other organs, such as e.g. kidney or liver, could also benefit from this approach.
Both improvements in thoracoscopy and advanced imaging methods make lung segmentectomies increasingly prevalent. Preoperative 3D models aid in making these procedures safer. We set up a program of improving thoracoscopic safety at Ghent University Hospital using 3D models for lung segmentectomies.
Methods:
Patients received a multidetector contrast-enhanced high resolution CT scan (slice-thickness: 1 mm). Mimics Innovation Suite (Materialise, Belgium) was used for creating a 3D model, mainly by using volume rendering methods. In this way, the bone structures, arteries, veins, bronchi, tumor and lung lobes were segmented. The segmentations of the bronchi and the lobe affected by the tumor were then used as input for a preoperative planning tool. Starting from the bronchi, a region growing approach divided the lobe volume into the lung segments. These segments were subsequently visualized on the 3D model, allowing the surgeon to determine the affected segment and the vessels perfusing this segment.
Results:
In Figure 1, a case study of a 56-year old patient with a suspected tumor in the left upper lobe is illustrated. Using the preoperative planning tool, the lung segments were determined (Figure 2, top view). The 3D model aided in the correct identification of the affected segments, the respective bronchus and vascularization, leading to a safe resection of the apical and posterior segments (S1 and S2). The patient had an uncomplicated postoperative course.
Conclusion:
The preoperative planning tool proved to be an added value during a successful first case at our center, providing in-depth insight in the patient-specific anatomy. This is an important step in aiding the surgeon to improve thoracoscopic safety, although further validation of the algorithm is necessary. In the future, surgical resection procedures in other organs, such as e.g. kidney or liver, could also benefit from this approach.
{{ help_message }}
{{filter}}