Pelvicaliceal biomodeling as an aid to achieving optimal access in percutaneous nephrolithotripsy.
OBJECTIVE
To investigate prospectively the benefits of three-dimensional stereolithographic biomodeling produced from CT data as an aid to achieving optimal access for percutaneous nephrolithotripsy (PCNL).


METHODS
Eight patients with complex urinary calculi were selected. Multislice CT scans of the kidney in native and excretory phases were acquired with the patient in the prone position to simulate the position during surgery. Contiguous reconstructed slices were produced from the data volume. The data of interest were processed to transform them into a format acceptable for production of a biomodel. Exact plastic replicas of the pelvicaliceal system and the calculi were created and used for morphologic assessment, preoperative planning, patient education, and surgical navigation.


RESULTS
The survey results were based on subjective opinions rather than objective data. The biomodels enhanced the ability to visualize a patient's unique anatomy before surgery. This aided the planning and rehearsal of endourologic procedures.


CONCLUSIONS
Although this study is only a preliminary investigation, we postulate that biomodeling has the advantage of allowing imaging data to be displayed in a physical form. In difficult cases, this technique may improve treatment, operative planning, and communication with colleagues and patients. The limitations of the technology include the manufacturing time and cost, but more accurate puncture-site selection may reduce costs by saving operating time.
Radecka
E
E
Department of Radiology, University Hospital of Uppsala, Uppsala, Sweden. eva.radecka@akademiska.se
Brehmer
M
M
Holmgren
K
K
Palm
G
G
Magnusson
P
P
Magnusson
A
A
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007670:Kidney Calices / Q000000981:diagnostic imaging*; D007682:Kidney Pelvis / Q000000981:diagnostic imaging*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014545:Urinary Calculi / Q000000981:diagnostic imaging* / Q000628:therapy