title: Virtual segmentectomy based on high-quality three-dimensional lung modelling from computed tomography images.
abstract: OBJECTIVE
  The aim of this study was to demonstrate the feasibility and efficacy of a novel simulation software called, virtual segmentectomy.
  
  
  METHODS
  We developed the segmentectomy simulation system, which was programmed to analyse the detailed 3D bronchovascular structure and to predict the appropriate segmental surface and surgical margin, based on lung modelling from CT images.
  
  
  RESULTS
  We have attempted this novel technique for 3 cases of pulmonary metastases and 1 case of multiple lung cancer. For validation, the predicted resection margin was compared with the actual resected specimen. The surgical surface, as estimated by the simulation, was compared with the surface of the specimen and a surgical video. To test its feasibility, the operation time, blood loss, durations of chest tube placement and hospitalization as well as pathological findings were assessed.
  
  
  CONCLUSIONS
  Preoperative simulation and intraoperative guidance by virtual segmentectomy could contribute significantly to determining the most appropriate anatomical segmentectomy and curative resection.
authors.affiliation: Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan. saji-q@ya2.so-net.ne.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Saji
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Inoue
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Kato
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Shimada
authors.forename: Masaru
authors.initials: M
authors.lastname: Hagiwara
authors.forename: Yujin
authors.initials: Y
authors.lastname: Kudo
authors.forename: Soichi
authors.initials: S
authors.lastname: Akata
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008297:Male; D061330:Multidetector Computed Tomography; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012984:Software; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D016896:Treatment Outcome
keywords: 3D computed tomography; Computer applications; Lung segmentectomy; Simulation; Surgical techniques