Integration of Three-Dimensional Liver Models in a Multimodal Image-Guided Robotic Liver Surgery Cockpit
Abstract
:1. Introduction
2. Materials and Methods
2.1. Development and Validation of the 3DeliverS Software
2.1.1. Image Registration Methods and 3D Modeling
2.1.2. Validation
2.2. Implementation of 3D Rendered Models
2.2.1. Patients and Imaging
2.2.2. Clinical Measurements and Preoperative Planning
2.2.3. Intraoperative Multimodality Imaging Platform—The Robotic Liver Surgery Cockpit
2.3. Questionnaire
2.4. Data Analysis
3. Results
3.1. Software Validation
3.2. Implementation
3.2.1. Imaging Modalities and 3D Modeling
3.2.2. Intraoperative Implementation of the Robotic Liver Surgery Cockpit
3.2.3. Surgical Outcomes and Clinical Measurements
3.2.4. Questionnaire
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Sphere 1 | Sphere 2 | Sphere 3 | Sphere 4 | Sphere 5 | Sphere 6 | |
---|---|---|---|---|---|---|
NEMA-2012 | ||||||
Volume (mm3) Largest axial diameter (mm) | 26,522 ± 2151 37.0 ± 1 | 11,494 ± 1232 28.0 ± 1 | 5575 ± 761 22.0 ± 1 | 2572 ± 227 17.0 ± 0.5 | 1150 ± 133 13.0 ± 0.5 | 524 ± 79 10.0 ± 0.5 |
Observer 1 | ||||||
Volume (mm3) Largest axial diameter (mm) | 25,342 37.4 | 11,570 28.1 | 5230 22.3 | 2319 17.5 | 1215 13.4 | 522 10.6 |
Observer 2 | ||||||
Volume (mm3) Largest axial diameter (mm) | 26,921 38.2 | 11,463 28.5 | 5874 22.3 | 2624 17.7 | 1188 13.5 | 521 10.4 |
DSC vDSC DoS | 0.96 0.96 1.00 | 0.95 0.96 1.00 | 0.92 0.94 1.00 | 0.88 0.91 0.99 | 0.90 0.93 1.00 | 0.87 0.89 1.00 |
Patient Characteristics | |
---|---|
Age at surgery, median, (IQR) | 64 |
Sex, No. (%) Male Female | 11 (73) 4 (27) |
Histological diagnosis, No. (%) CRLM CCA FNH | 13 (87) 1 (6.5) 1 (6.5) |
No. of target lesions (mean) | 23 (1.5) |
No. malignant lesions resected (mean) R0 (%) R1 (%) Expected R1 based on ICG (%) | 21 (1.6) 17 (81) 4 (19) 3 (75) |
Type of resection, No. (%) Anatomic Non-anatomic N.A. | 5 (33) 9 (60) 1 (7) |
Operation time (min), median (IQR) | 192 (135–263) |
Estimated blood loss (mL), median (IQR) | 200 (10–350) |
Length of stay (days), mean (SD) | 3 (3.035) |
Longest Tumor Diameter (mm) | Mean Difference (mm) | p-Value (95% CI) | Correlation | |
---|---|---|---|---|
On CT 3DeliverS | 35.83 35.13 | 0.696 | 0.265 (−0.565–1.956) | 0.989 (p < 0.01) |
On CT 3D measurement | 35.83 36.65 | 0.826 | 0.416 (−2.894–1.242) | 0.973 (p < 0.01) |
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Bijlstra, O.D.; Broersen, A.; Oosterveer, T.T.M.; Faber, R.A.; Achterberg, F.B.; Hurks, R.; Burgmans, M.C.; Dijkstra, J.; Mieog, J.S.D.; Vahrmeijer, A.L.; et al. Integration of Three-Dimensional Liver Models in a Multimodal Image-Guided Robotic Liver Surgery Cockpit. Life 2022, 12, 667. https://doi.org/10.3390/life12050667
Bijlstra OD, Broersen A, Oosterveer TTM, Faber RA, Achterberg FB, Hurks R, Burgmans MC, Dijkstra J, Mieog JSD, Vahrmeijer AL, et al. Integration of Three-Dimensional Liver Models in a Multimodal Image-Guided Robotic Liver Surgery Cockpit. Life. 2022; 12(5):667. https://doi.org/10.3390/life12050667
Chicago/Turabian StyleBijlstra, Okker D., Alexander Broersen, Timo T. M. Oosterveer, Robin A. Faber, Friso B. Achterberg, Rob Hurks, Mark C. Burgmans, Jouke Dijkstra, J. Sven D. Mieog, Alexander L. Vahrmeijer, and et al. 2022. "Integration of Three-Dimensional Liver Models in a Multimodal Image-Guided Robotic Liver Surgery Cockpit" Life 12, no. 5: 667. https://doi.org/10.3390/life12050667
APA StyleBijlstra, O. D., Broersen, A., Oosterveer, T. T. M., Faber, R. A., Achterberg, F. B., Hurks, R., Burgmans, M. C., Dijkstra, J., Mieog, J. S. D., Vahrmeijer, A. L., & Swijnenburg, R.-J. (2022). Integration of Three-Dimensional Liver Models in a Multimodal Image-Guided Robotic Liver Surgery Cockpit. Life, 12(5), 667. https://doi.org/10.3390/life12050667