Contribution of 3D virtual modeling in locating hepatic metastases, particularly “vanishing tumors”: a pilot study

Abstract

Aim: This article aims to explore how three dimensions (3D) virtual modeling enhances accuracy and efficiency in detecting hepatic metastases, with a specific focus on “vanishing tumors” that are difficult to detect using traditional imaging techniques. It also aims to demonstrate the potential impact of these advanced technologies on improving diagnostic and treatment strategies for patients with liver cancer.

Methods: Eight patients with liver metastases from colorectal cancer were studied using magnetic resonance imaging (MRI) and 3D virtual modeling to enhance surgical planning by accurately locating lesions. The concordance between these imaging techniques and the Gold Standard was assessed using Gwet’s AC1 coefficient, with statistical analysis performed through resampling methods and non-parametric tests due to non-normal AC1 distribution. Liver segmentation was conducted semi-automatically using IntelliSpace Portal (ISP). The study’s evaluation model involved questionnaires for medical professionals across four cohorts, aiming to determine the 3D model’s effectiveness in identifying lesion locations for surgery.

Results: This study investigated the efficacy of 3D virtual modeling in identifying hepatic metastases, particularly comparing its accuracy with traditional MRI in locating lesions. The findings indicate that MRI generally provided better concordance with the Gold Standard for lesion localization, except for a few experienced users who had prior familiarity with the 3D models. Despite the mixed results in accuracy, the study suggests potential benefits of 3D modeling in enhancing surgical planning and execution, particularly in detecting “vanishing” liver metastases that are difficult to visualize with standard imaging techniques. The research aligns with broader evidence indicating the utility of 3D models in improving outcomes in hepatic surgery by enabling more precise resections and reducing postoperative complications. However, the study also notes the challenge of quantifying the added value of 3D modeling due to the unique nature of each surgical case and the potential bias in the user experience with the technology.

Conclusion: The conclusion of this study underscores the significant potential of 3D virtual modeling in enhancing the precision of locating and resecting hepatic metastases, particularly those elusive “vanishing tumors”. This research underscores the value of integrating advanced 3D imaging techniques into surgical practice, suggesting a paradigm shift toward more accurate and less invasive liver surgeries. Future studies should aim to further quantify the benefits of 3D modeling in surgical outcomes, investigate its utility across different surgical experiences, and explore the integration of artificial intelligence (AI) to maximize its effectiveness in clinical settings.

Keywords

Liver / 3D virtual reconstruction / surgery / 3D models

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