Digital measurement of bone tumor volume by CT three-dimensional reconstruction technology

Objective To discuss the measurement of bone tumor volume on the basis of three dimensional images segmentation technology. Methods Twenty patients with lacunar bone tumor from Tianjin Hospital and Tongji Hospital were included in the

Research on CT characteristics reconstruction technology

The traditional computed tomography(CT)reconstruction methods are noisy,low resolution,poor contrast,and generally not suitable to detect the smaller flaws.Besides,the filter design is also difficult.The CT characteristics reconstruction technology was brought forward to improve in these aspects,which is defined to directly reconstruct the characteristics of the projection for the best requirements not the overall image quality.The two-dimension(2D)and three-dimension(3D)CT characteristics reconstruction algorithm were firstly introduced,then by detailed analysis,experimental results and comparsion of parameters calculated,its advantages in keeping better high-frequency feature,better noise immunity,short time-consuming and easier design are verified.

Three-dimensional printing technology for patient-matched instrument in treatment of cubitus varus deformity:A case report

BACKGROUND Recently,medical three-dimensional printing technology(3DPT)has demonstrated potential benefits for the treatment of cubitus varus deformity(CVD)by improving accuracy of the osteotomy through the use of an osteotomy guide,with or without a patient-mated plate.Here,we present an interesting CVD case,involving a patient who was treated with corrective biplanar chevron osteotomy using an innovative customized osteotomy guide and a newly designed patient-matched monoblock crosslink plate created with 3DPT.CASE SUMMARY A 32-year-old female presented with a significant CVD from childhood injury.A computer simulation was processed using images from computerized tomography scans of both upper extremities.The biplanar chevron osteotomy was designed to create identical anatomy between the mirror image of the contralateral distal humerus and the osteotomized distal humerus.Next,the customized osteotomy guide and patient-matched monoblock crosslink plate were designed and printed.A simulation osteotomy was created for the real-sized bone model,and the operation was performed using the posterior paratricipital approach with k-wire positioning from the customized osteotomy guide as a predrilled hole for screw fixation to achieve immediate control of the reduction after osteotomy.Our method allowed for successful treatment of the CVD case,significantly improving the patient’s radiographic and clinical outcomes,with satisfactory result.CONCLUSION 3DPT-created patient-matched osteotomy guide and instrumentation provides accurate control during CVD correction.

Application of digital technology in nasal reconstruction

Nasal defects are facial defects caused by trauma,tumors,or congenital diseases that seriously damage a patient’s physical and mental health.Nasal defects,from skin defects to total nasal defects,require surgical repair and reconstruction to restore the appearance and function of the nose,which have always been challenges for rhinoplasty.The development of digital technology has increased the possibility of nasal reconstruction.Digital technology is involved in the preoperative,intraoperative,and postoperative stages of nasal construction and is of great significance in improving the effect of this surgery.This article reviews the application of major digital technologies,including three-dimensional(3D)imaging technology,computer-assisted surgical navigation,and 3D printing,in nasal reconstruction and discusses the shortcomings of the current application of digital technology.

Three-dimensional digital technology-assisted precise tumor resection and reconstruction of the femoral trochanter and postoperative functional recovery:a retrospective study

Background The trochanter of the femur is a common site for bone tumors.However,locating the specificboundary of bone tumor infiltration and determining the surgical method can be challenging.The objective of thisstudy was to review the diagnosis,treatment,and surgical outcomes of patients with tumors or tumor-like changesin the femoral trochanter after computer-assisted precise tumor resection and hip-preserving reconstruction ofthe trochanter.Methods From January 2005 to September 2020,11 patients with trochanteric tumors(aged:18–53 years;sixmales and five females)were treated in Guangzhou First People’s Hospital.The cases included aneurysmal bonecyst(n=1),giant cell tumor of bone(n=2),fibrous histiocytoma of bone(n=1),endochondroma(n=1),andfibrous dysplasia of bone(n=6).For patients with trochanteric tumors,computed tomography and magnetic resonance imaging scanning were performed before operation to obtain two-dimensional image data of the lesion.Athree-dimensional digital model of bilateral lower limbs was reconstructed by computer technology,the boundary of tumor growth was determined by computer simulation,the process of tumor resection and reconstructionwas simulated,and the personalized guide template was designed.During the operation,the personalized guideplate guided the precise resection of the tumor,and the allogeneic bone was trimmed to match the shape of thebone defect.Results All 11 patients underwent accurate resection of the tumor or tumor-like lesion and reconstruction ofthe hip.In eight cases,the lesion was confined to the trochanter,which was fixed with large segment allogeneicbone,autologous iliac bone,and proximal femoral anatomic plate.In three cases,allogeneic bone,autologousiliac bone,and femoral reconstruction nail were used to fix the tumor under the trochanter.Postoperative Xray examination showed that the repair and reconstruction of the bone defect was effective,and callus bridgingbetween the allogenic bone and autogenous bone was observed 6 months after operation.All patients recoveredtheir walking function 3–6 months after operation.The duration of the follow-up period ranged from 6 monthsto 6 years.A patient experienced recurrence of endochondroma;pathological examination revealed chondrocyticsarcoma.The remaining 10 patients were treated with segmental resection and reconstruction.The operationtime ranged 2.5–4.5 h(average:3.2 h).Intraoperative blood loss ranged from 300 to 500 ml(average:368 ml).The local recurrence rate was 9.1%,and the overall survival rate was 100%.The average Musculoskeletal TumorSociety score was 27(excellent and good for eight and three patients,respectively).Conclusions Three-dimensional computer skeleton modeling and simulation-assisted resection and reconstruction of femoral trochanteric tumor is a new surgical technique,which might markedly improve the surgical effect,shorten the surgical time,increase the overall survival rate of patients with tumors,reduce the local recurrencerate,assist in the digitization and programming of femoral trochanteric tumor surgery,and improve surgicalaccuracy.

Three-Dimensional Volumetric Analysis of Venous Malformations for Assessing the Effectiveness of Percutaneous Sclerotherapy

BACKGROUND Percutaneous sclerotherapy can be used to successfully treat venous malformations(VMs)of the head,neck,and limbs.However,the standard curative effect of sclerotherapy has rarely been analyzed,and there is currently no accurate statistical method to measure the volume of VMs after sclerotherapy.Here,we propose a novel threedimensional(3D)reconstruction method to evaluate this effect.OBJECTIVE To test the feasibility of 3D software(MIMICS 19.0)to evaluate the treatment effect of sclerotherapy.METHODS This retrospective study included patients with VMs on the head,neck,and limbs who were treated with ethanol sclerotherapy or foam sclerotherapy every 8 weeks.MIMICS 19.0 was used to calculate the performance of the lesion after treatment and measure the VM volumes before and after the treatment.The effect of the clinical treatment dose on the lesion was evaluated,and the treatment effect of each patient was recorded.The relationship between the number of treatments and the reduced volume of VMs was analyzed.RESULTS Based on the MIMICS-calculated regions of interest(ROI),we found that 1 mL of ethanol reduced the lesion by 473 mm3 and that one dosage of foam(1 mL of polidocanol and 4 mL air content)reduced the lesion by 2138 mm3,demonstrating that the foam sclerosing agent exhibited greater efficacy in this study.CONCLUSIONS The MIMICS 3D volume reconstruction method can effectively and safely evaluate the efficacy of sclerotherapy and provide a preoperative evaluation.This method is simple,accurate,and feasible.

Digital medical technology based on 64-slice computed tomography in hepatic surgery

Background With the rapid development of computer technology, digital medicine has become a new direction in surgery. The application of digital medicine in hepatic surgery is still at the early stage and less reported in the literature. The aim of this study was to apply digital medical technology in the context of hepatic surgery. Methods Data from 64-slice helical computed tomography of 17 patients, including 13 with hepatocellular carcinoma and 4 with hepatic hemangioma, were imported into independently developed medical image software program, segmentation and three-dimensional reconstruction were performed. The three-dimensional models were then processed with the FreeForm Modeling System. We used virtual surgical instruments to perform surgery on the models. Simulated surgeries included six hepatic segmentectomies, four left hemihepatectomies, three right hemihepatectomies for hepatocellular carcinoma, one hepatic segmentectomy, two stripping surgeries, and one irregular segmentectomy combined with stripping surgery for hemangioma. For resections involving more than three hepatic segments, total and residual functional hepatic volumes were measured before and after simulation surgery, and the resection ratio was calculated.Results The anatomy of the models was distinct and was used to localize lesions. We used virtual surgical instruments to perform simulated surgeries and used the models to optimize actual surgeries. We were able to minimize resection volume as well as surgical risk.Conclusions Digital medical technology is helpful in the diagnosis of hepatic disease and in optimizing surgical plans. Three-dimensional models can decrease surgical risk and help prevent postoperative hepatic failure.