Evaluation of pre-surgical models for uterine surgery by use of three-dimensional printing and mold casting
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We propose an approach to supporting pre-surgical planning for the uterus by integrating medical image analysis and physical model generation based on 3D printing. With our method, we first segment the patient-specific anatomy and lesions of the uterus on MR images; then, we create a 3D physical model, an exact replica of the patient’s uterus in terms of size and softness, with transparency for easy observation of the internal structures of the uterus. In our experiments, we created pre-surgical models of hysterectomy for five patients who had been diagnosed to have uterine endometrial cancer. An experienced radiologist, the surgeons, and all of the patients cooperated in our experiment for carrying out subjective evaluations of the usefulness of our model. The accuracy of the physical models was evaluated quantitatively by comparison between the MR images of the patients and the CT images of the models. The results showed that the mean values of the errors in gap ranged from 1.19 to 2.22 mm, which was satisfactory for the surgeons. The feedback from both surgeons and patients demonstrated the usefulness and convenience of the models for efficient patient explanation understanding and pre-surgical planning by surgeons.
KeywordsMR images Uterine endometrial cancer Uterine surgery support 3D physical models 3D printing
The authors thank members of the Fujita Laboratory and K. Miyaki from Exseal Corporation, Japan, for supplying the casting materials. This research was supported in part by a Grant-in-Aid for Scientific Research on Innovative Areas (Grant No. 26108005), in part by a Grant-in-Aid for Scientific Research (Grant No. C26330134), Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan, and a research grant of Graduate School of Medicine at Gifu University.
Compliance with ethical standards
Conflict of interest
The authors have declared that no competing interests exist.
Statement of human rights and informed consent
This study was approved by the human research committee of the institutional review board and complied with the guidelines of the Health Insurance Portability and Accountability Act of 1999. Written informed consent was obtained, from the five patients with endometrial cancer.