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Assessment of Real-Time 3D Visualization for Cardiothoracic Diagnostic Evaluation and Surgery Planning

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Abstract

Rationale and Objectives

Rationale and Objectives: Three-dimensional (3D) real-time volume rendering has demonstrated improvements in clinical care for several areas of radiological imaging. We test whether advanced real-time rendering techniques combined with an effective user interface will allow radiologists and surgeons to improve their performance for cardiothoracic surgery planning and diagnostic evaluation.

Material and Methods

Materials and Methods: An interactive combination 3D and 2D visualization system developed at the University of North Carolina at Chapel Hill was compared against standard tiled 2D slice presentation on a viewbox. The system was evaluated for 23 complex cardiothoracic computed tomographic (CT) cases including heart–lung and lung transplantation, tumor resection, airway stent placement, repair of congenital heart defects, aortic aneurysm repair, and resection of pulmonary arteriovenous malformation. Radiologists and surgeons recorded their impressions with and without the use of the interactive visualization system.

Results

Results: The cardiothoracic surgeons reported positive benefits to using the 3D visualizations. The addition of the 3D visualization changed the surgical plan (65% of cases), increased the surgeon’s confidence (on average 40% per case), and correlated well with the anatomy found at surgery (95% of cases). The radiologists reported fewer and less major changes than the surgeons in their understanding of the case due to the 3D visualization. They found new findings or additional information about existing findings in 66% of the cases; however, they changed their radiology report in only 14% of the cases.

Conclusion

Conclusion: With the appropriate choice of 3D real-time volume rendering and a well-designed user interface, both surgeons and radiologists benefit from viewing an interactive 3D visualization in addition to 2D images for surgery planning and diagnostic evaluation of complex cardiothoracic cases. This study finds that 3D visualization is especially helpful to the surgeon in understanding the case, and in communicating and planning the surgery. These results suggest that including real-time 3D visualization would be of clinical benefit for complex cardiothoracic CT cases.

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Acknowledgments

This work was supported in part by NIH R01 CA 44060, NIH P01 47982, and NIH R01-CA60193.

Author information

Authors and Affiliations

  1. Department of Radiology and School of Information and Library Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Bradley M. Hemminger PhD

  2. Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Paul L. Molina MD & Joseph K. T. Lee MD

  3. Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Thomas M. Egan MD & Frank C. Detterbeck MD

  4. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Keith E. Muller PhD

  5. Department of Biostatistics, University of Alabama, Alabama, USA

    Christopher S. Coffey PhD

Authors
  1. Bradley M. Hemminger PhD
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  2. Paul L. Molina MD
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  3. Thomas M. Egan MD
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  4. Frank C. Detterbeck MD
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  5. Keith E. Muller PhD
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  6. Christopher S. Coffey PhD
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  7. Joseph K. T. Lee MD
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Corresponding author

Correspondence to Bradley M. Hemminger PhD.

Additional information

Supported in part by NIH RO1-CA 44060, NIH PO1-CA 47982, and NIH RO1-CA 60193.

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Hemminger, B.M., Molina, P.L., Egan, T.M. et al. Assessment of Real-Time 3D Visualization for Cardiothoracic Diagnostic Evaluation and Surgery Planning. J Digit Imaging 18, 145–153 (2005). https://doi.org/10.1007/s10278-004-1909-2

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