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- Title
Comparison of 3-Dimensional and Augmented Reality Kidney Models With Conventional Imaging Data in the Preoperative Assessment of Children With Wilms Tumors.
- Authors
Wellens, Lianne M.; Meulstee, Jene; van de Ven, Cornelis P.; Terwisscha van Scheltinga, C. E. J.; Littooij, Annemieke S.; van den Heuvel-Eibrink, Marry M.; Fiocco, Marta; Rios, Anne C.; Maal, Thomas; Wijnen, Marc H. W. A.
- Abstract
Key Points: Question: What is the value of 3-dimensional (3-D) visualization methods, augmented reality holograms, and 3-D printing for the preoperative assessment of anatomical structures in children with Wilms tumors? Findings: In this survey study of 7 pediatric surgeons for which 10 personalized, augmented reality holograms and 3-D prints of children with Wilms tumors were created, there was a significant added value from the 3-D visualization methods compared with conventional imaging for the preoperative assessment. Meaning: Three-dimensional visualizations may provide added value for the pediatric surgeon in the anatomical assessment of Wilms tumors, may help in future preoperative planning of nephron-sparing surgery, and may be considered an innovative supplementary visualization in clinical care. This study compares conventional imaging, augmented reality holograms, and 3-dimensional printing of kidney models to assess the added value of each imaging method for preoperative evaluation of children with Wilms tumors. Importance: Nephron-sparing surgery can be considered in well-defined cases of unilateral and bilateral Wilms tumors, but the surgical procedure can be very challenging for the pediatric surgeon to perform. Objective: To assess the added value of personalized 3-dimensional (3-D) kidney models derived from conventional imaging data to enhance preoperative surgical planning. Design, Setting, and Participants: In a survey study, the conventional imaging data of 10 Dutch children with Wilms tumors were converted to 3-D prints and augmented reality (AR) holograms and a panel of pediatric oncology surgeons (n = 7) assessed the quality of the different imaging methods during preoperative evaluation. Kidney models were created with 3-D printing and AR using a mixed reality headset for visualization. Main Outcomes and Measures: Differences in the assessment of 4 anatomical structures (tumor, arteries, veins, and urinary collecting structures) using questionnaires. A Likert scale measured differences between the imaging methods, with scores ranging from 1 (completely disagree) to 5 (completely agree). Results: Of the 10 patients, 7 were girls, and the mean (SD) age was 3.7 (1.7) years. Compared with conventional imaging, the 3-D print and the AR hologram models were evaluated by the surgeons to be superior for all anatomical structures: tumor (median scores for conventional imaging, 4.07; interquartile range [IQR], 3.62-4.15 vs 3-D print, 4.67; IQR, 4.14-4.71; P =.008 and AR hologram, 4.71; IQR, 4.26-4.75; P =.002); arteries (conventional imaging, 3.62; IQR, 3.43-3.93 vs 3-D print, 4.54; IQR, 4.32-4.71; P =.002 and AR hologram, 4.83; IQR, 4.64-4.86; P <.001), veins (conventional imaging, 3.46; IQR 3.39-3.62 vs 3-D print, 4.50; IQR, 4.39-4.68; P <.001 and AR hologram, 4.83; IQR, 4.71-4.86; P <.001), and urinary collecting structures (conventional imaging, 2.76; IQR, 2.42-3.00 vs 3-D print, 3.86; IQR, 3.64-4.39; P <.001 and AR hologram, 4.00; IQR, 3.93-4.58; P <.001). There were no differences in anatomical assessment between the two 3-D techniques (the 3-D print and AR hologram). Conclusions and Relevance: In this study, the 3-D kidney models were associated with improved anatomical understanding among the surgeons and can be helpful in future preoperative planning of nephron-sparing surgery for Wilms tumors. These models may be considered as a supplementary visualization in clinical care.
- Subjects
NETHERLANDS; NEPHROBLASTOMA; COMPARATIVE studies; COMPUTED tomography; HOLOGRAPHY; MAGNETIC resonance imaging; PREOPERATIVE care; QUALITY assurance; QUESTIONNAIRES; RESEARCH funding; SCALE analysis (Psychology); STRUCTURAL models; SURGEONS; THREE-dimensional printing; DATA analysis software; COMPUTER-assisted surgery; AUGMENTED reality; DESCRIPTIVE statistics; MANN Whitney U Test; CHILDREN; DIAGNOSIS
- Publication
JAMA Network Open, 2019, Vol 2, Issue 4, pe192633
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2019.2633