title: Surgical anatomy imaging associated with cervical cancer treatment: A cadaveric study.
abstract: The objectives of this study were to visualize the surgical anatomical structures in the female pelvis by computed tomography and to investigate the components of the parametrium for anatomical education, radiological diagnosis, and surgical simulation. We surgically dissected fresh female cadavers maintained in precise surgical anatomic positions and examined the anatomical structures using experimental fine cell detector multislice computed tomography (FDCT) with a slice thickness of 0.3125 mm. In addition, we established a three-dimensional (3D) reconstruction model for precise observation of the surgical anatomy using Materialise's Interactive Medical Image Control System (Mimics). We evaluated two-dimensional (2D) images of the surgical anatomical structures in combination with the 3D reconstruction model. The 3D model was reconstructed from 430 serial axial pelvic CT images of a cadaver. The cardinal ligament, uterosacral ligament, paravesical space, and pararectal space were visualized on the CT images obtained from the surgically dissected part. The parametrium components were clearly distinguished on the surgically dissected side. Based on the information from the dissected side, these components on the undissected side could be distinguished as well. We recognized the parametrium components in the area extirpated during radical hysterectomy. The approach using cadavers, experimental FDCT, and 3D software provided excellent visualization of pelvic structures. High-quality images of surgical anatomical structures provide new insight regarding precise surgical anatomy in the female pelvis. The radiological information has practical usefulness for radiotherapeutic planning and surgical simulation.
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Nakamura
authors.forename: Takuma
authors.initials: T
authors.lastname: Fujii
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Imanishi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Jinzaki
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamada
authors.forename: Sachio
authors.initials: S
authors.lastname: Kuribayashi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
mesh_terms: D000290:Adnexa Uteri / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D002102:Cadaver; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008022:Ligaments / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D008197:Lymph Node Excision / Q000379:methods*; D008953:Models, Anatomic; D061330:Multidetector Computed Tomography; D017773:Pelvic Floor / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D010388:Pelvis / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D014599:Uterus / Q000033:anatomy & histology
keywords: cadaver; cervical cancer; radiation therapy; radical hysterectomy; surgical anatomy