Digital simulation of kidney collecting system and stone: geometry and texture mapping

Digital simulation is the first step in many, virtual reality, computer vision, and automation pipelines. However, to our knowledge, no open source highly realistic three-dimensional (3D) models of a kidney with a textured collecting system exists. Herein we describe our technique for rendering a high-fidelity digital shadow of the human kidney collecting system with kidney stone.

Using medical imaging data, iterative 3D modeling, and advanced texture mapping, an anatomically accurate and visually realistic kidney collecting system was produced. Similarly, we generated calcium oxalate monohydrate (COM) and uric acid (UA) stones. The workflow included computed tomography (CT)-derived geometry correction, custom texture design and shader-based rendering. The structures were sent to twenty-three urologists who were given a Likert-rating scale to rate the fidelity of the renderings in terms of the kidney and stone, geometry and texture. Average, median and intraclass correlation coefficients (ICCs) for the responses were calculated to characterize the responses and reliability.

Fifteen urologists responded to each question. The simulated collecting system was generally evaluated as realistic {median 4 [interquartile range (IQR): 3, 5]}. UA stone texture was significantly more realistic than COM texture [median: 4 (IQR: 4, 5) vs. 3 (IQR: 3, 4); U=47.50, P=0.005]. Similarly, there was a trend for more realistic UA vs. COM stone geometry [Median:4 (IQR: 4, 5) vs. Median: 4 (IQR: 3, 4); U=69.5, P=0.06]. Although individual ratings varied widely [ICC (2, 1) =0.10], the aggregated expert consensus was moderate [ICC (2, k) =0.63], supporting overall consensus in model realism.

This work addresses a key gap in realistic anatomical modeling for ureteroscopy, which may support improved training and potentially enable simulation of kidney stone removal procedures. While the simulation was evaluated favorably especially for the UA stone, there is room for improvement of the urothelial mucosa, and texture of the renal papillae, and COM stone.