Usefulness of Three-Dimensional Modeling in Surgical Planning, Resident Training, and Patient Education.
BACKGROUND
Imaging has a critical impact on surgical decision making and three-dimensional (3D) digital models of patient pathology can now be made commercially. We developed a 3D digital model of a cancer of the head of the pancreas by integrating actual CT data with 3D modeling process. After this process, the virtual pancreatic model was also produced using a high-quality 3D printer.


METHODS
A 56-year-old female with pancreatic head adenocarcinoma presented with biliary obstruction and jaundice. The CT scan showed a borderline resectable tumor with a clear involvement of the gastroduodenal artery but doubtful relationships with the hepatic artery. Our team in collaboration with the Immersive Touch team used multiple series from the CT and segmented the relevant anatomy to understand the physical location of the tumor. An STL file was then developed and printed.


RESULTS
Reconstructing and compositing the different series together enhanced the imaging, which allowed clearer observations of the relationship between the mass and the blood vessels, and evidence that the tumor was unresectable. Data files were converted for printing a 100% size rendering model, used for didactic purposes and to discuss with the patient.


CONCLUSIONS
This study showed that (1) reconstructing enhanced traditional imaging by merging and modeling different series together for a 3D view with diverse angles and transparency, allowing the observation of previously unapparent anatomical details; (2) with this new technology surgeons and residents can preobserve their planned surgical intervention, explore the patient-specific anatomy, and sharpen their procedure choices; (3) high-quality 3D printed models are increasingly useful not only in the clinical realm but also for personalized patient education.
1 Department of Surgery, University of Chicago Pritzker School of Medicine , Chicago, Illinois.
Ciro
C
Andolfi
1 Department of Surgery, University of Chicago Pritzker School of Medicine , Chicago, Illinois.
Alejandro
A
Plana
2 ImmersiveTouch, Inc. , Chicago, Illinois.
Patrick
P
Kania
3 Center for Simulation, University of Chicago and ImmersiveTouch, Inc. , Chicago, Illinois.
P Pat
PP
Banerjee
4 Department of Anesthesia and Critical Care, Center for Simulation, University of Chicago Medicine , Chicago, Illinois.
Stephen
S
Small
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000601:surgery; D000075204:Contraindications, Procedure; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D007396:Internship and Residency; D008875:Middle Aged; D008953:Models, Anatomic; D010180:Pancreatectomy / Q000009:adverse effects; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D010347:Patient Care Planning; D010353:Patient Education as Topic; D066330:Printing, Three-Dimensional; D014057:Tomography, X-Ray Computed
3D imaging; 3D modeling; 3D printing; augmented reality; immersive reality; pancreatic cancer; surgical planning