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Evaluating three-dimensional lung reconstructions for thoracoscopic lung resections using open-source software: a

Iris E W G Laven1, Vincent P S Oosterhoff1,2, Aimée J P M Franssen1

  • 1Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, the Netherlands.

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Summary

Open-source software creates usable and effective three-dimensional (3D) lung reconstructions for uniportal video-assisted thoracoscopic surgery (VATS). These 3D models improve anatomical accuracy and surgical planning compared to traditional 2D CT scans.

Keywords:
Video-assisted thoracoscopic surgery (VATS)lung canceropen-source softwarethree-dimensional reconstructionthree-dimensional simulation

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Area of Science:

  • Thoracic Surgery
  • Medical Imaging
  • Open-Source Software Applications

Background:

  • Preoperative three-dimensional (3D) lung reconstructions offer benefits like reduced blood loss and operation time in thoracic surgery.
  • Commercial 3D reconstruction software is often expensive, limiting accessibility.
  • There is a need for cost-effective alternatives for creating 3D lung models.

Purpose of the Study:

  • To evaluate the usability and performance of preoperative 3D lung reconstructions generated using open-source software.
  • To compare the accuracy and insights provided by open-source 3D reconstructions against traditional 2D CT scans.

Main Methods:

  • Prospective pilot study of patients undergoing uniportal video-assisted thoracoscopic surgery (VATS) lobectomy or segmentectomy.
  • 3D lung reconstructions created using open-source 3D Slicer software.
  • Usability assessed via System Usability Score (SUS); performance evaluated by anatomical validity and comparison with 2D CT and operative findings.

Main Results:

  • Eighty-three percent of 3D reconstructions achieved above-average usability scores (SUS >68).
  • 3D reconstructions improved lung nodule location accuracy by 38% and revealed unrecognised anatomical variations in 62% of cases.
  • Surgeons gained procedural insights from 62% of 3D reconstructions, though one case had an incomplete arterial visualization.

Conclusions:

  • Open-source software provides a usable and effective solution for creating 3D lung reconstructions for uniportal VATS anatomical resections.
  • This approach enhances surgical planning and accuracy in thoracic procedures.
  • Further validation may be beneficial for complex anatomical variations.