title: The use of three-dimensional computed tomography for assessing patients before laparoscopic adrenal-sparing surgery.
abstract: OBJECTIVE
  To evaluate the efficacy of three-dimensional computed tomography (3D-CT) in delineating the relationship of the adrenal mass to adjacent normal structures in preparation for laparoscopic partial adrenalectomy.
  
  
  METHODS
  Multislice CT (1 mm slices, 0.5 s rotation time) was used to evaluate 12 patients before adrenal-sparing surgery for aldosterone-producing adenoma or phaeochromocytoma. The CT data were reconstructed using two rendering techniques; (i) volume rendering with the modified VOLREN software (Johns Hopkins Hospital, Baltimore, MD, USA) which allowed interactive 3D examination of the whole data volume within a few minutes; (ii) surface representations only of the interesting structures (kidney, adrenal tumour, vessels) represented in different colours and depicted together in a 3D scene using the software package 3DVIEWNIX.
  
  
  RESULTS
  In all, 14 adrenal masses in 12 patients were evaluated with 3D-CT; the number and location of lesions was accurate in all cases with both rendering techniques. The coloured surface-rendered images showed a consistently better delineation of the adrenal tumour from the normal tissue than did the volume-rendering technique. From this information all laparoscopic partial adrenalectomies could be completed as planned.
  
  
  CONCLUSIONS
  Interactive visualization of volume-rendered CT images was helpful for the planning and successful performance of the procedure, but coloured surface-rendered CT provided more convenient, immediate and accurate intraoperative information.
authors.affiliation: Department of Urology, Medical University Innsbruck, Austria. micheal.mitterberger@uibk.ac.at
authors.forename: Michael
authors.initials: M
authors.lastname: Mitterberger
authors.forename: Germar-Michael
authors.initials: GM
authors.lastname: Pinggera
authors.forename: Reinhard
authors.initials: R
authors.lastname: Peschel
authors.forename: Georg
authors.initials: G
authors.lastname: Bartsch
authors.forename: Leo
authors.initials: L
authors.lastname: Pallwein
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Frauscher
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging* / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods; D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000378:metabolism; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D000450:Aldosterone