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[3D-visualization by MRI for surgical planning of Wilms tumors]
1Abteilung Pädiatrische Radiologie, Universitätsklinik Heidelberg. jens-peter_schenk@med.uni-heidelberg.de
Insights
Interactive 3D-animation of MRI scans improves surgical planning for pediatric kidney tumors like Wilms tumor. This visualization enhances understanding of tumor anatomy and relationships, aiding surgeons and potentially reducing complications.
Area of Science:
- Pediatric Radiology
- Surgical Oncology
- Medical Imaging Visualization
Background:
- Pediatric kidney tumors, including Wilms tumor and mesoblastic nephroma, require precise surgical planning.
- Accurate pre-operative assessment of tumor anatomy and its relationship to vital structures is crucial for successful surgical outcomes.
Purpose of the Study:
- To enhance surgical planning for childhood kidney tumors using interactive 3D-animation derived from MRI.
- To improve the transfer of radiological information to surgical teams for better pre-operative preparation.
Main Methods:
- Utilized DICOM MRI data from 7 pediatric patients (mean age 3 years) with kidney tumors.
- Employed raycasting-based 3D-volume-rendering software for interactive visualization.
- Incorporated phase-contrast MR angiography to delineate major abdominal and retroperitoneal vessels.
Main Results:
- Interactive 3D-animation significantly influenced surgical approach in all 7 cases.
- Visualization clearly demonstrated tumor mass effect, anatomical relation to renal hilum, and proximity to critical vessels.
- Surgeons found the 3D visualization facilitated easier translation of anatomical information from MRI to surgical situs.
Conclusions:
- 3D-visualization with animation optimizes surgical preparation for Wilms tumors by improving information transfer between radiologists and surgeons.
- This enhanced pre-operative planning is expected to lead to a reduction in surgical complications.
Purpose:
To improve surgical planning of kidney tumors in childhood (Wilms tumor, mesoblastic nephroma) after radiologic verification of the presumptive diagnosis with interactive colored 3D-animation in MRI.
Materials And Methods:
In 7 children (1 boy, 6 girls) with a mean age of 3 years (1 month to 11 years), the MRI database (DICOM) was processed with a raycasting-based 3D-volume-rendering software (VG Studio Max 1.1/Volume Graphics). The abdominal MRI-sequences (coronal STIR, coronal T1 TSE, transverse T1/T2 TSE, sagittal T2 TSE, transverse and coronal T1 TSE post contrast) were obtained with a 0.5T unit in 4 - 6 mm slices. Additionally, a phase-contrast-MR-angiography was applied to delineate the large abdominal and retroperitoneal vessels. A notebook was used to demonstrate the 3D-visualization for surgical planning before surgery and during the surgical procedure.
Results:
In all 7 cases, the surgical approach was influenced by interactive 3D-animation and the information found useful for surgical planning. Above all, the 3D-visualization demonstrates the mass effect of the Wilms tumor and its anatomical relationship to the renal hilum and to the rest of the kidney as well as the topographic relationship of the tumor to the critical vessels. One rupture of the tumor capsule occurred as a surgical complication. For the surgeon, the transformation of the anatomical situation from MRI to the surgical situs has become much easier.
Conclusion:
For surgical planning of Wilms tumors, the 3D-visualization with 3D-animation of the situs helps to transfer important information from the pediatric radiologist to the pediatric surgeon and optimizes the surgical preparation. A reduction of complications is to be expected.
