Prostatectomy Evaluation using 3D Visualization and Quantitation

Prostate cancer is a disease with a long natural history. Differences in survival outcomes as indicators of inappropriate surgery would take decades to appear. Therefore, the evaluation of the excised specimen according to defined parameters provides a more reasonable and timely assessment of surgical quality. There are currently a number of very different surgical approaches. Some uniform guidelines and quality assessment measuring readily available parameters would be desirable to establish a standard for comparison of surgical approaches and for individual surgical performance. In this paper, we present a novel methodology to objectively quantify the assessment process utilizing a 3D reconstructed model for the prostate gland. To this end, we discuss the development of a process employing image reconstruction and analysis techniques to assess the percent of capsule covered by soft tissue. A final goal is to develop software for the purpose of a quality assurance assessment for pathologists and surgeons to evaluate the adequacy/appropriateness of each surgical procedure; laparoscopic versus open perineal or retropubic prostatectomy. Results from applying this technique are presented and discussed.