BMEO-D-17-00006.pdf

BioMedical Engineering OnLine VIRTUAL SURGERY PLAN AND 3D PRINTING FOR RESECTION OF A HUGE TUMOR ATTACHED TO THE LEFT KIDNEY --Manuscript Draft-Manuscript Number:

BMEO-D-17-00006

Full Title:

VIRTUAL SURGERY PLAN AND 3D PRINTING FOR RESECTION OF A HUGE TUMOR ATTACHED TO THE LEFT KIDNEY

Article Type:

Review

Funding Information: Abstract:

Having good visualization of anatomical complex structures in a "one to one" manner differentiating precisely the pathology from healthy tissues preoperatively, giving the surgeon high fidelity to make the wise decision , thanks to the 3d printed replica of the ROI .

Corresponding Author:

BASHAR SHAMI IBA JORDAN

Corresponding Author Secondary Information: Corresponding Author's Institution:

IBA

Corresponding Author's Secondary Institution: First Author:

BASHAR SHAMI

First Author Secondary Information: Order of Authors:

BASHAR SHAMI

Order of Authors Secondary Information: Opposed Reviewers: Manuscript Classifications:

60: Biomedical Imaging & Image Processing; 190: Modeling Methodologies

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Click here to download Manuscript Case report KIDN1.doc

Case report:

VIRTUAL SURGERY PLAN AND 3D PRINTING FOR RESECTION OF A HUGE TUMOR ATTACHED TO THE LEFT KIDNEY

Bashar H. Shami, AMMAN, JORDAN Ingenieria Biomedica Arte, Biomedical Engineering Department

INTRODUCTION : Having good visualization of anatomical complex structures in a "one to one" manner differentiating precisely the pathology from healthy tissues preoperatively, giving the surgeon high fidelity to make the wise decision , thanks to the 3d printed replica of the ROI .

In this report ,a 40 years old male patient was admitted in a local hospital , suffering severe pain in his lateral back , CT images showed huge tumor structure attached to his left kidney in posterior site , the surgeon needs to make good plan for this surgery as :to visualize the shape and location of the tumor in one to one view , locating attachment points and borders of cut between the healthy kidney tissue and the tumor tissue thus cut margins be accurate, safe and with less time, anesthetics and blood loss .

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MATERIALS AND METHODS:

In this report ,a 40 years old male patient was admitted in a local hospital , suffering severe pain in his lateral back , CT images showed huge tumor structure attached to his left kidney in posterior site , the surgeon needs to make good plan for this surgery as :to visualize the shape and location of the tumor in one to one view , locating attachment points and borders of cut between the healthy kidney tissue and the tumor tissue thus cut margins be accurate, safe and with less time, anesthetics and blood loss .

Patient Dicom CT data were acquired from hospital radiology department, then they were imported to our 3D MEDICAL MODELLING SOFTWARE WORKSTATION , with image processing algorithms we can model the kidney/ tumor rendered surface , using segmentation algorithms , the 3d rendered surface for kidney alone is reconstructed as in Fig. 1 a,b,c The bile is segmented by Boolean operation of subtracting kidney maskFrom ( kidney + tumor) mask , the tumor mask result then is transformed to a 3d surface, Fig 2.

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A )

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B )

C ) Fig. 1 a,b,c

a)

the 3d rendered surface for kidney alone

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b) Fig 2. A,b 3d rendered surface of tumor.

exporting our 3d surface files to STL format (file format for 3d printing ) , we need to make farther image processing operations as to smooth the surfaces and make them more realistic to anatomical morphology and appropriate for the high resolution 3d printing, by processing on their mathematical mesh structures , to do so , we use other IMAGE PROCESSING SOFTWARE WORKING ON MESH STRUCTURES,

We import our stl files one at a time to the software workstation , with choosing Modifiers , we choose Smooth Modifier with power of 2.8 and number of steps are 7 , avoid increasing it above 7 as not to loose the

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anatomical details inside the kidney , we keep same settings for the bile surface too . Fig 3 a,b .

a)

b) Fig3 a,b smoothed 3d rendered surfaces kidney + tumor

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Now our 3d rendered surfaces are ready , exporting each surface to stl file format , we have two stl files ready to be 3d printed , We use technology of FDM ( Fused Deposition Method) for printing , material used is ABS plastic polymer , which can be machined easily if the surgeon needs , Printing time took five hours to print both models , Fig. 4 shows the 3d printed models , we used Chloroform and an ABS filament to fix detached parts by plastic welding.

Fig 4 . the 3d printed models of kidney and tumor

ADDITIONAL WORK: In addition to surgery plan using 3d printed model, surgeon can make virtual surgery simulation measurements using our 3D MEDICAL

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MODELLING SOFTWARE , Fig 5 .

Fig 5 Virtual measurements of bile using the software .

AKNOWLEDGMENT : We like to thank doctor Mazin El-Qar'aan , for his support on this work and for providing us with patient clinical imaging data