title: Prediction of open urinary tract in laparoscopic partial nephrectomy by virtual resection plane visualization.
abstract: BACKGROUND
  The purpose of this study is presenting a method to predict the presence of an open urinary tract and the position of the opening in laparoscopic partial nephrectomy from three dimensional (3D) computed tomography (CT) images by using novel image segmentation and visualization techniques.
  
  
  METHODS
  From CT images of patients who underwent laparoscopic partial nephrectomy, 3D regions of the kidney, urinary tract, and tumor were segmented. For each patient, multiple virtual resection planes of the kidney with different surgical margins (1 mm to 5 mm, every 1 mm) were generated and the presence of an open urinary tract and the position of the opening were predicted from the images.
  
  
  RESULTS
  We compared the predictions with actual operations in 5 cases by using recorded video of the operations and operative notes. In terms of the presence of an open urinary tract, agreement of the predictions and the intraoperative results was obtained in all patients. The expected positions of the openings were close to those in the actual operations.
  
  
  CONCLUSIONS
  We have developed a method to virtually visualize the resection plane of laparoscopic partial nephrectomy. Image segmentation methods used in this study were precise and effective. The comparison indicated that our method accurately predicted the presence of an open urinary tract and the position of the opening and provided useful preoperative information.
authors.affiliation: Department of Urology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanagawa-ku, Yokohama, Kanagawa 236-0004, Japan. daikochi810903@yahoo.co.jp.
authors.forename: Daiki
authors.initials: D
authors.lastname: Ueno
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Makiyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Ijiri
authors.forename: Hideo
authors.initials: H
authors.lastname: Yokota
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kubota
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014567:Urography / Q000379:methods*; D014584:User-Computer Interface