International Urogynecology Journal

, Volume 26, Issue 10, pp 1459–1465 | Cite as

Three-dimensional analysis of implanted magnetic-resonance-visible meshes

  • Nikhil Sindhwani
  • Andrew Feola
  • Frederik De Keyzer
  • Filip Claus
  • Geertje Callewaert
  • Iva Urbankova
  • Sebastien Ourselin
  • Jan D’hooge
  • Jan DeprestEmail author
Original Article



Our primary objective was to develop relevant algorithms for quantification of mesh position and 3D shape in magnetic resonance (MR) images.


In this proof-of-principle study, one patient with severe anterior vaginal wall prolapse was implanted with an MR-visible mesh. High-resolution MR images of the pelvis were acquired 6 weeks and 8 months postsurgery. 3D models were created using semiautomatic segmentation techniques. Conformational changes were recorded quantitatively using part-comparison analysis. An ellipticity measure is proposed to record longitudinal conformational changes in the mesh arms. The surface that is the effective reinforcement provided by the mesh is calculated using a novel methodology. The area of this surface is the effective support area (ESA).


MR-visible mesh was clearly outlined in the images, which allowed us to longitudinally quantify mesh configuration between 6 weeks and 8 months after implantation. No significant changes were found in mesh position, effective support area, conformation of the mesh’s main body, and arm length during the period of observation. Ellipticity profiles show longitudinal conformational changes in posterior arms.


This paper proposes novel methodologies for a systematic 3D assessment of the position and morphology of MR-visible meshes. A novel semiautomatic tool was developed to calculate the effective area of support provided by the mesh, a potentially clinically important parameter.


Magnetic Resonance Mesh Prolapse Semiautomatic analysis Graft-related complication Contraction Conformational measurements 



JD is a fundamental clinical researcher for the Fonds Wetenschappelijk Onderzoek Vlaanderen ( AF is recipient of a Marie Curie Industria-Academia Partnership Programme-postdoctoral grant (251356), and NS of a doctoral grant in the Bip-Upy project (NMP3-LA-2012-310389; FP7), both funded by the European Commission.

Conflicts of interest

Our laboratory has received unconditional translational research grants from Johnson & Johnson Medical, Covidien, Bard, FEG Textiltechnik, American Medical Systems. JD has been consulting for AMS, Johnson & Johnson, and Bard.

Author contributions

Nikhil Sindhwani: project development, methodology development, manuscript writing

Andrew Feola: project development, methodology development

Frederik De Keyzer: data collection

Filip Claus: data collection, project development

Geertje Callewaert: clinical guidance

Iva Urbankova: clinical guidance

Sebastien Ourselin: project development

Jan D’Hooge: project development

Jan Deprest: project development, clinical guidance

Supplementary material

192_2015_2681_MOESM1_ESM.doc (613 kb)
ESM 1 (DOC 613 kb)


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Copyright information

© The International Urogynecological Association 2015

Authors and Affiliations

  • Nikhil Sindhwani
    • 1
    • 2
  • Andrew Feola
    • 1
    • 2
  • Frederik De Keyzer
    • 4
  • Filip Claus
    • 4
  • Geertje Callewaert
    • 1
    • 2
  • Iva Urbankova
    • 1
    • 2
  • Sebastien Ourselin
    • 5
  • Jan D’hooge
    • 6
  • Jan Deprest
    • 1
    • 3
    • 7
    Email author
  1. 1.Department of Development and Regeneration, Cluster Organ Systems, Faculty of MedicineKU, LeuvenLeuvenBelgium
  2. 2.Interdepartmental Center for Surgical Technologies, Faculty of MedicineKU LeuvenLeuvenBelgium
  3. 3.Pelvic Floor UnitUniversity Hospitals LeuvenLeuvenBelgium
  4. 4.Department of RadiologyUniversity Hospitals LeuvenLeuvenBelgium
  5. 5.Centre for Medical Image Computing (CMIC)University College LondonLondonUK
  6. 6.Laboratory on Cardiovascular Imaging and Dynamics, Department of Cardiovascular Sciences, Faculty of MedicineKU LeuvenLeuvenBelgium
  7. 7.Department of Obstetrics and GynaecologyUniversity Hospitals, KU LeuvenLeuvenBelgium

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