Decision-making based on 3D printed models in laparoscopic liver resections with intraoperative ultrasound: A prospective observational study

OBJECTIVES: The aim of this study was to evaluate impact of 3D printed models on decision-making in context of laparoscopic liver resections (LLR) performed with intraoperative ultrasound (IOUS) guidance. METHODS: Nineteen patients with liver malignances (74% were colorectal cancer metastases) were prospectively qualified for LLR or radiofrequency ablation in a single center from April 2017 to December 2018. Models were 3DP in all cases based on CT and facilitated optical visualization of tumors\u27 relationships with portal and hepatic veins. Planned surgical extent and its changes were tracked after CT analysis and 3D model inspection, as well as intraoperatively using IOUS. RESULTS: Nineteen patients were included in the analysis. Information from either 3DP or IOUS led to changes in the planned surgical approach in 13/19 (68%) patients. In 5/19 (26%) patients, the 3DP model altered the plan of the surgery preoperatively. In 4/19 (21%) patients, 3DP independently changed the approach. In one patient, IOUS modified the plan post-3DP. In 8/19 (42%) patients, 3DP model did not change the approach, whereas IOUS did. In total, IOUS altered surgical plans in 9 (47%) cases. Most of those changes (6/9; 67%) were caused by detection of additional lesions not visible on CT and 3DP. CONCLUSIONS: 3DP can be helpful in planning complex and major LLRs and led to changes in surgical approach in 26.3% (5/19 patients) in our series. 3DP may serve as a useful adjunct to IOUS. KEY POINTS: • 3D printing can help in decision-making before major and complex resections in patients with liver cancer. • In 5/19 patients, 3D printed model altered surgical plan preoperatively. • Most surgical plan changes based on intraoperative ultrasonography were caused by detection of additional lesions not visible on CT and 3D model

The use of mixed reality in the field of three-dimensional medical image visualization

W artykule przedstawiono wybrane zagadnienia związane z mieszaną rzeczywistością. W szczególności skupiono się na wykorzystaniu mieszanej rzeczywistości w kontekście wizualizacji obrazowych danych medycznych. Technologia została szczegółowo omówiona oraz porównana z wirtualną i rozszerzoną rzeczywistością oraz drukiem 3D. Zaprezentowano szerokie spektrum zastosowań, m.in. wykorzystanie mieszanej rzeczywistości w szkoleniu oraz do wizualizacji danych pacjentów onkologicznych zobrazowanych w tomografii komputerowej oraz w technice PET.This article covers the topics related to the use of the mixed reality in the field of medical data visualization. It enables the user to see the data as a 3D hologram that is a part of the users’ environment. There is a detailed comparison to the virtual and the augmented reality and the relation to the 3D printing. A wide variety of applications of the mixed reality in education and in visualization of the patients’ computed tomography and positron emission tomography data is presented