How-To: Creating a 3D Reconstruction of Your Patient's CT Scan
There are three main uses for advanced visualization in general thoracic surgery:
1)
Resident Teaching – at the early training levels, 3D reconstructions
are an excellent teaching modality to enhance the learning environment
of students, residents, and fellows.
2) Patient Education – using a
3D reconstruction to describe a patient’s tumor and operative plan
enhances the office visit, increases patient satisfaction, and ensures
that the patient truly understands the extent of their disease process.
3)
Operative Planning – while many general thoracic surgery cases do not
require a 3D reconstruction for planning purposes, these visualizations
are specifically helpful for both complex tumors (Pancoast, chest wall
invasion, re-do surgery) and localization of small lung nodules.
In
this tutorial, Brian Mitzman demonstrates the basic skillset required
to utilize free 3D modeling software and create your own
reconstructions. Once you become proficient, the average time to create a
basic 3D reconstruction is less than 10 minutes. The software used in
this video is called Horos (https://horosproject.org). It is an open
source medical image viewer with advanced post-processing capabilities.
This tutorial is broken into several sections:
1) Why utilize 3D reconstructions?
2) Hardware Requirements
3) Software Packages
4) Step-by-Step Examples
a. Basic Mediastinal Mass Reconstruction
b. Advanced Mediastinal Mass Reconstruction
c. Lung Reconstruction with Multiple Nodules
References
- Smelt JLC, Suri T, Valencia O , Jahangiri M, Rhode K, Nair A, et al. Operative planning in thoracic surgery: a pilot study comparing imaging techniques and three-dimensional printing. Ann Thorac Surg. 2019;107:401-406.
- Hagiwara M, Shimada Y, Kato Y, Nawa K, Makino Y, Furumoto H, et al. High-Quality 3-Dimensional image simulation for pulmonary lobectomy and segmentectomy: results of preoperative assessment of pulmonary vessels and short-term surgical outcomes in consecutive patients undergoing video-assisted thoracic surgery. Eur J Cardiothoracic Surg. 2014;46:120-126.
- Elarref MA, Aljabary A, Shallik NA, Abbas M, Elarif N. (2019) Perspectives in the Current and Future Use of Augmented Reality Visualization in Thoracic Surgery and Pulmonary Interventions. In: Shallik N.A., Moustafa A.H., Marcus M.A.E. (eds) Virtual Endoscopy and 3D Reconstruction in the Airways. Springer, Cham. https://doi.org/10.1007/978-3-030-23253-5_9
- Nia PS, Olsthoom JR, Heuts S, Maessen JG. Interactive 3D reconstruction of pulmonary anatomy for preoperative planning, virtual simulation, and intraoperative guiding in video-assited thoracoscopic lung surgery. Innovations. 2019;14:17-26.