MRI-Based 3-Dimensional Visualization Workflow for the Preoperative Planning of Nephron-Sparing Surgery in Wilms’ Tumor Surgery: A Pilot Study

Fitski, Matthijs; Meulstee, Jene W.; Littooij, Annemieke S.; Ven, Cornelis P. van de; Steeg, Alida F. W. van der; Wijnen, Marc H. W. A.

doi:10.1155/2020/8899049

Cited by 11 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are limited reports of using VR rendering to plan NSS in a child with BWT 9. Virtual resection, using tools on the console, has been identified as an innovative method to replicate tumour resection 20. Based on the postoperative weight of the specimen one can easily correlate between the actual RRV and the virtual RRV calculated with the software 21.…”

Section: Discussionmentioning

confidence: 99%

Preoperative three-dimensional modelling and virtual reality planning aids nephron sparing surgery in a child with bilateral Wilms tumour

Banerjee,

Babu,

Jayaraman

et al. 2024

BMJ Case Rep

View full text Add to dashboard Cite

Bilateral Wilms tumour (BWT) is a surgically challenging condition. Virtual reality (VR) reconstruction aids surgeons to foresee the anatomy ahead of Nephron Sparing Surgery (NSS). Three-dimensional (3D) visualisation improves the anatomical orientation of surgeons performing NSS. We herewith report a case of BWT where VR planning and 3D printing were used to aid NSS. Conventional imaging is often found to be inadequate while assessing the tumour-organ-vascular anatomy. Advances like VR and 3D printing help surgeons plan better for complex surgeries like bilateral NSS. Next-generation extended reality tools will likely aid robotic-assisted precision NSS and improve patient outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Preoperative three-dimensional modelling and virtual reality planning aids nephron sparing surgery in a child with bilateral Wilms tumour

Banerjee,

Babu,

Jayaraman

et al. 2024

BMJ Case Rep

View full text Add to dashboard Cite

show abstract

“…Although manual segmentation-based volume measurements seem to be more accurate, this process is time-consuming, ranging from one to multiple hours, and is observer dependent [ 11 , 21 , 22 ]. Automating segmentation using deep learning would limit these constraints.…”

Section: Discussionmentioning

confidence: 99%

Radiologic versus Segmentation Measurements to Quantify Wilms Tumor Volume on MRI in Pediatric Patients

Buser

Steeg

Wijnen

et al. 2023

Cancers

Self Cite

View full text Add to dashboard Cite

Wilms tumor is a common pediatric solid tumor. To evaluate tumor response to chemotherapy and decide whether nephron-sparing surgery is possible, tumor volume measurements based on magnetic resonance imaging (MRI) are important. Currently, radiological volume measurements are based on measuring tumor dimensions in three directions. Manual segmentation-based volume measurements might be more accurate, but this process is time-consuming and user-dependent. The aim of this study was to investigate whether manual segmentation-based volume measurements are more accurate and to explore whether these segmentations can be automated using deep learning. We included the MRI images of 45 Wilms tumor patients (age 0–18 years). First, we compared radiological tumor volumes with manual segmentation-based tumor volume measurements. Next, we created an automated segmentation method by training a nnU-Net in a five-fold cross-validation. Segmentation quality was validated by comparing the automated segmentation with the manually created ground truth segmentations, using Dice scores and the 95th percentile of the Hausdorff distances (HD95). On average, manual tumor segmentations result in larger tumor volumes. For automated segmentation, the median dice was 0.90. The median HD95 was 7.2 mm. We showed that radiological volume measurements underestimated tumor volume by about 10% when compared to manual segmentation-based volume measurements. Deep learning can potentially be used to replace manual segmentation to benefit from accurate volume measurements without time and observer constraints.

show abstract

“…In this single-center study, the feasibility of virtual resection was examined as an additional tool for preoperative NSS planning for WT patients using retrospective acquired imaging data. Three dimensional visualizations were prepared with the in-house developed 3D imaging workflow for NSS developed by Fitski et al [ 13 ]. Additionally, the actual RRV of the patient was computed after 3D visualization of the available postoperative magnetic resonance imaging (MRI) scans.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, 3D visualizations were performed with the acquired MRI scans in the 3D Slicer (version: 4.11.20210226) software package [ 14 ]. To determine the actual RRV, a post-contrast fat-suppressed T1-weighted MRI sequence was used in accordance with the visualization protocol developed by Fitski et al [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

Virtual Resection: A New Tool for Preparing for Nephron-Sparing Surgery in Wilms Tumor Patients

et al. 2022

Self Cite

View full text Add to dashboard Cite

Nephron-sparing surgery (NSS) in Wilms tumor (WT) patients is a surgically challenging procedure used in highly selective cases only. Virtual resections can be used for preoperative planning of NSS to estimate the remnant renal volume (RRV) and to virtually mimic radical tumor resection. In this single-center evaluation study, virtual resection for NSS planning and the user experience were evaluated. Virtual resection was performed in nine WT patient cases by two pediatric surgeons and one pediatric urologist. Pre- and postoperative MRI scans were used for 3D visualization. The virtual RRV was acquired after performing virtual resection and a questionnaire was used to assess the ease of use. The actual RRV was derived from the postoperative 3D visualization and compared with the derived virtual RRV. Virtual resection resulted in virtual RRVs that matched nearly perfectly with the actual RRVs. According to the questionnaire, virtual resection appeared to be straightforward and was not considered to be difficult. This study demonstrated the potential of virtual resection as a new planning tool to estimate the RRV after NSS in WT patients. Future research should further evaluate the clinical relevance of virtual resection by relating it to surgical outcome.

show abstract

MRI-Based 3-Dimensional Visualization Workflow for the Preoperative Planning of Nephron-Sparing Surgery in Wilms’ Tumor Surgery: A Pilot Study

Cited by 11 publications

References 19 publications

Preoperative three-dimensional modelling and virtual reality planning aids nephron sparing surgery in a child with bilateral Wilms tumour

Preoperative three-dimensional modelling and virtual reality planning aids nephron sparing surgery in a child with bilateral Wilms tumour

Radiologic versus Segmentation Measurements to Quantify Wilms Tumor Volume on MRI in Pediatric Patients

Virtual Resection: A New Tool for Preparing for Nephron-Sparing Surgery in Wilms Tumor Patients

Contact Info

Product

Resources

About