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3D visualization of perianal fistulas using parametric models

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Abstract

Background

Magnetic resonance imaging (MRI) is used as a standard for assessment of complex perianal fistulas. Apart from textual description of the case, 3D reconstructed models from MRI further aid in understanding the entire anatomy of the fistula tract and its relation to the pelvic floor. This information is crucial as it helps surgeons to understand the extent and complexity of the disease before surgical treatment. However, 3D model generation from MRI is a time-consuming step for a radiologist as it requires tedious manual delineations to be performed on every slice of the images. The aim of this study was to develop a method that could enable radiologists to present enhanced information to surgeons for treatment of complex perianal fistulas while simultaneously reducing the manual efforts and time required to generate the information.

Methods

A method was proposed to depict relevant anatomies of complex perianal fistula as parametric models in three-dimensional (3D) space. A plugin inside 3D Slicer software was developed for the generation of the parametric models from MRI. The levator ani muscle, internal sphincter, and external sphincter are represented as tubular structures, whereas fistula tracks and abscess are presented as splines.

Results

Parametric models were generated to depict three cases of complex perianal fistulas and similarity measures were computed for ten cases. Visual comparison of the parametric models was made with the 3D models generated by the standard approach. The parametric models took less time to create and were able to visually present enriched information as compared to the 3D models generated by the standard approach.

Conclusions

The proposed method, using parametric models, shows potential for faster generation and better visualization of the 3D information required for the treatment of complex perianal fistula cases.

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Availability of data and material

The research data are not sharable.

Code availability

The code can be made available upon request to corresponding author.

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Acknowledgements

The authors would like to acknowledge Kitware Inc. (USA) in developing 3D Slicer software plugin to demonstrate the proposed method of generating parametric models.

Funding

This work was supported by Internal Research Grant Cycle 3 award (IRGC-03-JI-17-080) from Medical Research Center (MRC) at Hamad Medical Corporation (HMC). All opinions, findings, conclusions or recommendations expressed in this work are those of the authors and do not necessarily reflect the views of our sponsors.

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Authors and Affiliations

  1. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, P.O. 3050, Doha, Qatar

    N. V. Navkar, S. Balakrishnan, S. Kharbech, A. Ahmed & A. Al-Ansari

  2. Department of Clinical Imaging, Hamad Medical Corporation, Doha, Qatar

    M. Sabawi, J. Abinahed, A. Omar & A. Darweesh

  3. Wollongong Diagnostics, Wollongong, NSW, Australia

    M. Khanna

Authors
  1. N. V. Navkar
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  2. S. Balakrishnan
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  3. S. Kharbech
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  4. M. Sabawi
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  5. J. Abinahed
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  6. A. Ahmed
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  7. A. Al-Ansari
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  8. A. Omar
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  9. M. Khanna
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Corresponding author

Correspondence to S. Balakrishnan.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the institutional review board comprising of the ethical committee (Medical Research Center, Doha, Qatar). Approval number is IRGC-03-JI-17-080.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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The MR images used in the study were anonymized and do not lead to identification of the subjects in the publication. Consent to publish anonymized data was obtained from the subjects.

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Navkar, N.V., Balakrishnan, S., Kharbech, S. et al. 3D visualization of perianal fistulas using parametric models. Tech Coloproctol 26, 291–300 (2022). https://doi.org/10.1007/s10151-022-02573-5

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  • DOI: https://doi.org/10.1007/s10151-022-02573-5

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