Three-dimensional analysis of implanted magnetic-resonance-visible meshes
- 352 Downloads
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.
KeywordsMagnetic Resonance Mesh Prolapse Semiautomatic analysis Graft-related complication Contraction Conformational measurements
JD is a fundamental clinical researcher for the Fonds Wetenschappelijk Onderzoek Vlaanderen (1.8.012.07). 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.
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
- 15.Sandaite I, Claus F, Müllen A, De Ridder D, Deprest J (2011) Experimental MRI-contrast imaging of suture and mesh materials with -containing polivinylidenefluoride polymers designed for pelvic floor surgery. Neurourol Urodyn:1114–15Google Scholar
- 19.Alizai PH, Schmid S, Otto J, Klink CD, Roeth A, Nolting J et al (2014) Biomechanical analyses of prosthetic mesh repair in a hiatal hernia model. J Biomed Mater Res Part B 00B:000–000Google Scholar
- 23.Kraemer NA, Donker HCW, Kuehnert N, Otto J, Schrading S, Krombach GA et al (2013) In vivo visualization of polymer-based mesh implants using conventional magnetic resonance imaging and positive-contrast susceptibility imaging. Invest Radiol 48–4:200–5Google Scholar
- 24.Endo M, Feola A, Sindhwani N, Manodoro S, Vlacil J, Engels AC et al (2014) Mesh Contraction: In-vivo Documentation of Changes in Apparent Surface Area Utilizing Magnetic Resonance Image Visible Meshes in the Rabbit Abdominal Wall Model. Int Urogynecology JGoogle Scholar