TY - JOUR
T1 - Development and clinical applicability of MRI-based 3D prostate models in the planning of nerve-sparing robot-assisted radical prostatectomy
AU - Veerman, Hans
AU - Boellaard, Thierry N.
AU - van der Eijk, Jari A.
AU - Sluijter, Judith H.
AU - Roeleveld, Ton A.
AU - van der Sluis, Tim M.
AU - Nieuwenhuijzen, Jakko A.
AU - Wit, Esther
AU - van Alphen, Maarten J. A.
AU - van Veen, Robert L. P.
AU - Vis, André N.
AU - van der Poel, Henk G.
AU - van Leeuwen, Pim J.
N1 - Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.
PY - 2022
Y1 - 2022
N2 - The interpretation of conventional MRI may be limited by the two-dimensional presentation of the images. To develop patient-specific MRI prostate-based virtual and three-dimensional (3D)-printed models. To assess the association between 3D imaging and the pathological outcome of RARP specimen. To assess the clinical applicability of 3D models to guide nerve-sparing robot-assisted radical prostatectomy (RARP). We created virtual 3D and 3D-printed 3D models of 20 prostate cancer patients retrospectively. A comparison was made between conventional MRI and 3D-reconstructed images. The concordance between tumour lesion location in 3D models and pathology reporting of RARP specimens was assessed. Seven urologists assessed the side-specific extent of nerve-sparing based on (1) conventional MR images, (2) virtual 3D models, and (3) 3D-printed models. Clinically relevant changes in nerve-sparing and the absolute agreement between observers was analyzed using the Chi-square test and intra-class correlation coefficient (ICC). The index lesion was correctly visualized in 19/20 (95%) 3D models and the expected location of extraprostatic extension was correctly visualized in all 3D models. Clinically relevant changes in the planned extent of nerve-sparing between MRI and virtual 3D models and MRI and 3D-printed models were found in 25% and 26%. The ICC of the planned extent of nerve-sparing between urologists was 0.40 (95% CI 0.28–0.55) for conventional MRI, 0.52 (95% CI 0.39–0.66) for virtual 3D models and 0.58 (95% CI 0.45–0.71) for 3D-printed models. 3D models of the MRI prostate to guide RARP could aid urologists in the planning of nerve-sparing surgery as shown by a higher inter-observer agreement.
AB - The interpretation of conventional MRI may be limited by the two-dimensional presentation of the images. To develop patient-specific MRI prostate-based virtual and three-dimensional (3D)-printed models. To assess the association between 3D imaging and the pathological outcome of RARP specimen. To assess the clinical applicability of 3D models to guide nerve-sparing robot-assisted radical prostatectomy (RARP). We created virtual 3D and 3D-printed 3D models of 20 prostate cancer patients retrospectively. A comparison was made between conventional MRI and 3D-reconstructed images. The concordance between tumour lesion location in 3D models and pathology reporting of RARP specimens was assessed. Seven urologists assessed the side-specific extent of nerve-sparing based on (1) conventional MR images, (2) virtual 3D models, and (3) 3D-printed models. Clinically relevant changes in nerve-sparing and the absolute agreement between observers was analyzed using the Chi-square test and intra-class correlation coefficient (ICC). The index lesion was correctly visualized in 19/20 (95%) 3D models and the expected location of extraprostatic extension was correctly visualized in all 3D models. Clinically relevant changes in the planned extent of nerve-sparing between MRI and virtual 3D models and MRI and 3D-printed models were found in 25% and 26%. The ICC of the planned extent of nerve-sparing between urologists was 0.40 (95% CI 0.28–0.55) for conventional MRI, 0.52 (95% CI 0.39–0.66) for virtual 3D models and 0.58 (95% CI 0.45–0.71) for 3D-printed models. 3D models of the MRI prostate to guide RARP could aid urologists in the planning of nerve-sparing surgery as shown by a higher inter-observer agreement.
KW - Magnetic resonance imaging
KW - Nerve-sparing
KW - Prostate cancer
KW - Prostatectomy
KW - Three-dimensional images
UR - http://www.scopus.com/inward/record.url?scp=85134261410&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s11701-022-01443-4
DO - https://doi.org/10.1007/s11701-022-01443-4
M3 - Article
C2 - 35819591
SN - 1863-2483
JO - Journal of Robotic Surgery
JF - Journal of Robotic Surgery
ER -