Top

Published in:

Open Access 01-03-2020 | Liver Surgery | Original Article

Local, semi-automatic, three-dimensional liver reconstruction or external provider? An analysis of performance and time expense

Authors: Markus Paschold, Florentine Huettl, Werner Kneist, Christian Boedecker, Alicia Poplawski, Tobias Huber, Hauke Lang

Published in: Langenbeck's Archives of Surgery | Issue 2/2020

Abstract

Purpose

In hepatobiliary surgery, preoperative three-dimensional reconstruction based on CT or MRI can be provided externally or by local, semi-automatic software. We analyzed the time expense and quality of external versus local three-dimensional reconstructions.

Methods

Three first-year residents reconstructed data from 20 patients with liver pathologies using a local, semi-automatic, server-based program. Initially, five randomly selected patient datasets were segmented, with the visualization of an established external company available for comparison at all times (learning phase). The other fifteen cases were compared with the external datasets after completing local reconstruction (control phase). Total time expense/case and for specific manual and semi-automated reconstruction steps were recorded. Segmentation quality was analyzed by testing the equivalence for liver and tumor volumes, portal vein sectors, and hepatic vein territories.

Results

The median total reconstruction time was reduced from 2.5 h (learning phase) to 1.5 h (control phase) (− 42%; p < 0.001). Comparing the total and detailed liver volumes (sectors and territories) as well as the tumor volumes in the control phase equivalence was proven. In addition, a highly significant correlation between the external and local analysis was obtained over all analyzed segments with a very high ICC (median [IQR]: 0.98 [0.97; 0.99]; p < 0.01).

Conclusion

Local, semi-automatic reconstruction performed by inexperienced residents was feasible with an expert level time expense and the quality of the three-dimensional images was comparable with those from an external provider.

Endo K, Sata N, Ishiguro Y, Miki A, Sasanuma H, Sakuma Y, Shimizu A, Hyodo M, Lefor A, Yasuda Y (2014) A patient-specific surgical simulator using preoperative imaging data: an interactive simulator using a three-dimensional tactile mouse. J Comput Surg 1:1–8. https://doi.org/10.1186/s40244-014-0010-5 CrossRef

Lang H, Radtke A, Liu C, Fruhauf NR, Peitgen HO, Broelsch CE (2004) Extended left hepatectomy--modified operation planning based on three-dimensional visualization of liver anatomy. Langenbeck’s Arch Surg 389(4):306–310. https://doi.org/10.1007/s00423-003-0441-z CrossRef

Radtke A, Nadalin S, Sotiropoulos GC, Molmenti EP, Schroeder T, Valentin-Gamazo C, Lang H, Bockhorn M, Peitgen HO, Broelsch CE, Malago M (2007) Computer-assisted operative planning in adult living donor liver transplantation: a new way to resolve the dilemma of the middle hepatic vein. World J Surg 31(1):175–185. https://doi.org/10.1007/s00268-005-0718-1 CrossRefPubMed

Lang H, Radtke A, Hindennach M, Schroeder T, Fruhauf NR, Malago M, Bourquain H, Peitgen HO, Oldhafer KJ, Broelsch CE (2005) Impact of virtual tumor resection and computer-assisted risk analysis on operation planning and intraoperative strategy in major hepatic resection. Arch Surg 140(7):629–638; discussion 638. https://doi.org/10.1001/archsurg.140.7.629 CrossRefPubMed

Huber T, Baumgart J, Peterhans M, Weber S, Heinrich S, Lang H (2016) Computer-assisted 3D-navigated laparoscopic resection of a vanished colorectal liver metastasis after chemotherapy. Z Gastroenterol 54(1):40–43. https://doi.org/10.1055/s-0041-107542 CrossRefPubMed

Madurska MJ, Poyade M, Eason D, Rea P, Watson AJ (2017) Development of a patient-specific 3D-printed liver model for preoperative planning. Surg Innov 24(2):145–150. https://doi.org/10.1177/1553350616689414 CrossRefPubMed

Damrah O, Canelo R, Zacharoulis D, Tait P, Jiao LR, Habib N (2006) Three dimensional (3D) computed tomography images reconstruction in liver surgery. In: Karaliotas CC, Broelsch CE, Habib NA (eds) Liver and biliary tract surgery: embryological anatomy to 3D-imaging and transplant innovations. Springer Vienna, Vienna, pp 333–338. https://doi.org/10.1007/978-3-211-49277-2_26 CrossRef

Hogemann D, Stamm G, Shin H, Oldhafer KJ, Schlitt HJ, Selle D, Peitgen HO (2000) Individual planning of liver surgery interventions with a virtual model of the liver and its associated structures. Radiologe 40(3):267–273CrossRef

Lehmann KS, Ritz JP, Valdeig S, Schenk A, Holmer C, Peitgen HO, Buhr HJ, Frericks BB (2008) Portal vein segmentation of a 3D-planning system for liver surgery--in vivo evaluation in a porcine model. Ann Surg Oncol 15(7):1899–1907. https://doi.org/10.1245/s10434-008-9934-x CrossRefPubMed

10.

Frericks BB, Caldarone FC, Nashan B, Savellano DH, Stamm G, Kirchhoff TD, Shin HO, Schenk A, Selle D, Spindler W, Klempnauer J, Peitgen HO, Galanski M (2004) 3D CT modeling of hepatic vessel architecture and volume calculation in living donated liver transplantation. Eur Radiol 14(2):326–333. https://doi.org/10.1007/s00330-003-2161-8 CrossRefPubMed

11.

Wang Y, Zhang Y, Peitgen HO, Schenk A, Yuan L, Wei G, Sun Y (2012) Precise local resection for hepatocellular carcinoma based on tumor-surrounding vascular anatomy revealed by 3D analysis. Dig Surg 29(2):99–106. https://doi.org/10.1159/000336289 CrossRefPubMed

12.

Prodhomme O, Seguret F, Martrille L, Pidoux O, Cambonie G, Couture A, Rouleau C (2012) Organ volume measurements: comparison between MRI and autopsy findings in infants following sudden unexpected death. Arch Dis Child Fetal Neonatal Ed 97(6):F434–F438. https://doi.org/10.1136/fetalneonatal-2011-301309 CrossRefPubMed

13.

Hiroshige S, Shimada M, Harada N, Shiotani S, Ninomiya M, Minagawa R, Soejima Y, Suehiro T, Honda H, Hashizume M, Sugimachi K (2003) Accurate preoperative estimation of liver-graft volumetry using three-dimensional computed tomography. Transplantation 75(9):1561–1564. https://doi.org/10.1097/01.tp.0000053755.08825.12 CrossRefPubMed

14.

Hallet J, Gayet B, Tsung A, Wakabayashi G, Pessaux P (2015) Systematic review of the use of pre-operative simulation and navigation for hepatectomy: current status and future perspectives. J Hepatobiliary Pancreat Sci 22(5):353–362. https://doi.org/10.1002/jhbp.220 CrossRefPubMed

15.

Sboarina A, Foroni RI, Minicozzi A, Antiga L, Lupidi F, Longhi M, Ganau M, Nicolato A, Ricciardi GK, Fenzi A, Gerosa M, De Simone A, Fracastoro G, Guglielmi A, Cordiano C (2010) Software for hepatic vessel classification: feasibility study for virtual surgery. Int J Comput Assist Radiol Surg 5(1):39–48. https://doi.org/10.1007/s11548-009-0380-4 CrossRefPubMed

16.

Karcaaltincaba M, Akhan O (2007) Imaging of hepatic steatosis and fatty sparing. Eur J Radiol 61(1):33–43. https://doi.org/10.1016/j.ejrad.2006.11.005 CrossRefPubMed

17.

Oliva MR, Mortele KJ, Segatto E, Glickman JN, Erturk SM, Ros PR, Silverman SG (2006) Computed tomography features of nonalcoholic steatohepatitis with histopathologic correlation. J Comput Assist Tomogr 30(1):37–43CrossRef

18.

Alirr OI, Rahni AAA (2019) Survey on liver tumour resection planning system: steps, techniques, and parameters. J Digit Imaging:1–20. https://doi.org/10.1007/s10278-019-00262-8 CrossRef

Title: Local, semi-automatic, three-dimensional liver reconstruction or external provider? An analysis of performance and time expense
Authors: Markus Paschold
Florentine Huettl
Werner Kneist
Christian Boedecker
Alicia Poplawski
Tobias Huber
Hauke Lang
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Liver Surgery
Liver Surgery
Published in: Langenbeck's Archives of Surgery / Issue 2/2020
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-020-01862-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Local, semi-automatic, three-dimensional liver reconstruction or external provider? An analysis of performance and time expense

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2020

How to reduce anastomotic leakage in colorectal surgery—report from German expert meeting

A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection

A retrospective case control study identifies peripheral blood mononuclear cell albumin RNA expression as a biomarker for non-alcoholic fatty liver disease

Interdisciplinary approach allows minimally invasive, nerve-sparing removal of retroperitoneal peripheral nerve sheath tumors

Endoscopic transpapillary stenting for the management of acute cholecystitis

Long-term outcome of surgical resection in patients with gastroenteropancreatic neuroendocrine neoplasia: results from a German nation-wide multi-centric registry