Skip to main content

Advertisement

SpringerLink
Log in

How to obtain a 3D printed model of renal cell carcinoma (RCC) with venous tumor thrombus extension (VTE) for surgical simulation (phase I NCT03738488)

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

This is the phase 1 of a multicenter clinical trial (NCT03738488), which aims to assess the efficacy and efficiency of surgery planning with 3D models of renal cell carcinoma (RCC) with venous tumor thrombus extension (VTE) compared to the standard images (CT). The objective of this phase is to obtain a 3D printed model of RCC with VTE that is feasible, accurate, reproducible, suitable for surgical simulation, and affordable. A specific protocol was developed to obtain the computed tomography (CT) image: early arterial and nephrogenic phase. ITK-snap® and VirSSPA Software® were used to segment the areas of interest. The resulting 3D mesh was processed with MeshMixer® and Cura®. Ten models from seven different cases were segmented and printed using different 3D printers and materials. We evaluated the material, scale, wall thickness, anatomy printed, 3D conformation, accuracy compared to the CT, suitability to perform the surgery, material, cost, and time (segmentation + design + fabrication + finishing). The four selected models were printed with a BQ Witbox FDM printer in polyurethane filament with a 0.8 mm wall thickness and 100% scale. All the relevant anatomical structures could be correctly identified, the 3D conformation was maintained with good accuracy compared to the CT and the surgery could be performed on them. Mean design time, model cost and printing time were 8.3 h, 33.4 €, and 38.5 h respectively. Various feasible 3D models of RCC with VTE were obtained after a few attempts. The final models were proved to be reproducible, accurate compared to the CT, and suitable for surgery simulation. The printing process was standardized making it possible to manufacture affordable 3D printed models.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68:7–30

    Article  Google Scholar 

  2. Psutka SP, Leibovich BC (2015) Management of inferior vena cava tumor thrombus in locally advanced renal cell carcinoma. Ther Adv Urol 7(4):216–229

    Article  Google Scholar 

  3. Reese AC, Whitson JM, Meng MV (2013) Natural history of untreated renal cell carcinoma with venous tumor thrombus. Urol Oncol 31(7):1305–1309

    Article  Google Scholar 

  4. Haddad AQ, Wood CG, Abel EJ, Krabbe LM, Darwish OM, Thompson RH et al (2014) Oncologic outcomes following surgical resection of renal cell carcinoma with inferior vena caval thrombus extending above the hepatic veins: a contemporary multicenter cohort. J Urol 192(4):1050–1056

    Article  Google Scholar 

  5. Pouliot F, Shuch B, Larochelle JC, Pantuck A, Belldegrun AS (2010) Contemporary management of renal tumors with venous tumor thrombus. J Urol 184(3):833–841 (quiz 1235)

    Article  Google Scholar 

  6. Lambert EH, Pierorazio PM, Shabsigh A et al (2007) Prognostic risk stratification and clinical outcomes in patients undergoing surgical treatment for renal cell carcinoma with vascular tumor thrombus. Urology 69:1054

    Article  Google Scholar 

  7. Haferkamp A, Bastian PJ, Jakobi H et al (2007) Renal cell carcinoma with tumor thrombus extension into the vena cava: prospective long-term followup. J Urol 177:1703

    Article  Google Scholar 

  8. Klatte T, Pantuck AJ, Riggs SB et al (2007) Prognostic factors for renal cell carcinoma with tumor thrombus extension. J Urol 178:1189

    Article  Google Scholar 

  9. Moinzadeh A, Libertino JA (2004) Prognostic significance of tumor thrombus level in patients with renal cell carcinoma and venous tumor thrombus extension. Is all T3b the same? J Urol 171:598

    Article  Google Scholar 

  10. Sweeney P, Wood CG, Pisters LL et al (2003) Surgical management of renal cell carcinoma associated with complex inferior vena caval thrombi. Urol Oncol 21:327

    Article  Google Scholar 

  11. Wagner B, Patard JJ, Mejean A et al (2009) Prognostic value of renal vein and inferior vena cava involvement in renal cell carcinoma. Eur Urol 55:452

    Article  Google Scholar 

  12. Cacciamani G, Okhunov Z, Dourado Meneses A, Rodriguez Socarras ME, Gómez Rivas J, Porpligia F, Liatsikos E, Veneziano D (2019) Impact of three-dimensional printing in urology: state of the art and future perspectives. A systematic review by ESUT-YAUWP group. Eur Urol 76(2):209–221. https://doi.org/10.1016/j.eururo.2019.04.044

    Article  PubMed  Google Scholar 

  13. Libby RS, Silberstein JL (2017) Physical model of clear-cell renal carcinoma with inferior vena cava extension created from a 3-dimensional printer to aid in surgical resection: a case report. Clin Genitourin Cancer 15(5):867–869

    Article  Google Scholar 

  14. Golab A, Slojewski M, Brykczynski M, Lukowiak M, Boehlke M, Matias D, Smektala T (2016) Three-dimensional printing as an interdisciplinary communication tool: preparing for removal of a giant tumor and atrium neoplastic mass. Heart Surg Forum 19(4):185–186

    Article  Google Scholar 

  15. Suárez-Mejías C, Gomez-Ciriza G, Valverde I, Parra CC, Gómez-Cía T (2015) New technologies applied to surgical processes: virtual reality and rapid prototyping. Stud Health Technol Inform 210:669–671

    PubMed  Google Scholar 

  16. Valverde I, Gómez-Ciriza G, Hussain T, Suarez-Mejías C, Velasco-Forte MN, Byrne N, Ordoñez A, González-Calle A, Anderson D, Hazekamp MG, Roest AA (2017) Three-dimensional printed models for surgical planning of complex congenital heart defects: an international multicentre study. Eur J Cardio-Thorac Surg 52(6):1139–1148

    Article  Google Scholar 

  17. Frame M, Huntley JS (2012) Rapid prototyping in orthopaedic surgery: a user's guide. Sci World J 2012:838575. https://doi.org/10.1100/2012/838575

    Article  Google Scholar 

  18. Farré-Guasch E, Wolff J, Helder MN, Schulten EA, Forouzanfar T, Klein-Nulend J (2015) Application of additive manufacturing in oral and maxillofacial surgery. J Oral Maxillofac Surg 73(12):2408–2418

    Article  Google Scholar 

  19. Infante-Cossio P, Gacto-Sanchez P, Gomez-Cia T, Gomez-Ciriza G (2012) Stereolithographic cutting guide for fibula osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol 113(6):712–713

    Article  Google Scholar 

  20. Valverde I, Gomez G, Coserria JF et al (2015) 3D printed models for planning endovascular stenting in transverse aortic arch hypoplasia. Catheter Cardiovasc Interv 85:1006–1012

    Article  Google Scholar 

  21. Valverde I (2017) Impresión tridimensional de modelos cardiacos: aplicaciones en el campo de la educación médica, la cirugía cardiaca y el intervencionismo estructural. Rev Esp Cardiol 70(4):282–291

    Article  Google Scholar 

  22. Valverde I, Gomez G, Gonzalez A et al (2015) Three-dimensional patient-specific cardiac model for surgical planning in Nikaidoh procedure. Cardiol Young 25:698–704

    Article  Google Scholar 

  23. Gomez-Ciriza G, Hussain T, Gomez-Cia T et al (2015) Potential of 3D-printed models in planning structural interventional procedures. Interv Cardiol 7:343–350

    Article  Google Scholar 

  24. Leng S, McGee K, Morris J, Alexander A, Kuhlmann J, Vrieze T, McCollough H et al (2017) Anatomic modeling using 3D printing quality assurance and optimization. 3D Print Med 3:6

    Article  Google Scholar 

  25. Maddox MM, Feibus A, Liu J, Wang J, Thomas R, Silberstein JL (2018) 3D-printed soft-tissue physical models of renal malignancies for individualized surgical simulation: a feasibility study. J Robot Surg 12(1):27–33

    Article  Google Scholar 

  26. Zhang Y, Ge HW, Li NC, Yu CF, Guo HF, Jin SH, Na YQ (2016) Evaluation of three-dimensional printing for laparoscopic partial nephrectomy of renal tumors: a preliminary report. World J Urol 34(4):533–537

    Article  Google Scholar 

  27. Wake N, Rude T, Kang SK, Stifelman MD, Borin JF, Sodickson DK, Chandarana H (2017) 3D printed renal cancer models derived from MRI data: application in pre-surgical planning. Abdom Radiol 42(5):1501–1509

    Article  Google Scholar 

  28. Manning TG, O’Brien JS, Christidis D, Perera M, Coles-Black J, Chuen J (2018) Three dimensional models in uro-oncology: a future built with additive fabrication. World J Urol. https://doi.org/10.1007/s00345-018-2201-2

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Urology and Nephrology Department, Virgen del Rocío University Hospital, Manuel Siurot s/n, Seville, Spain

    Inés Rivero Belenchón, Carmen Belén Congregado Ruíz, Ignacio Osmán García, José Manuel Conde Sánchez & Rafael Antonio Medina López

  2. Biomedical Institute of Seville (IBiS)/Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain

    Inés Rivero Belenchón, Carmen Belén Congregado Ruíz, Ignacio Osmán García, José Manuel Conde Sánchez & Rafael Antonio Medina López

  3. FABLAB, Biomedical Institute of Seville (IBiS)/Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain

    Gorka Gómez Ciriza & José Antonio Rivas González

  4. Urology Department, Ramón y Cajal University Hospital, Madrid, Spain

    Victoria Gómez Dos Santos & Francisco Javier Burgos Revilla

  5. Radiology Department, Virgen del Rocío University Hospital, Seville, Spain

    Carlos Gálvez García

  6. Radiology Department, Ramón y Cajal University Hospital, Madrid, Spain

    María Cristina González Gordaliza

  7. IRYCIS, Madrid, Spain

    Victoria Gómez Dos Santos & Francisco Javier Burgos Revilla

Authors
  1. Inés Rivero Belenchón
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carmen Belén Congregado Ruíz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gorka Gómez Ciriza
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Victoria Gómez Dos Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. José Antonio Rivas González
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carlos Gálvez García
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. María Cristina González Gordaliza
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ignacio Osmán García
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. José Manuel Conde Sánchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Francisco Javier Burgos Revilla
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Rafael Antonio Medina López
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

IRB: study design; data collection; paper redaction. CBCR: Study design; paper revision. GGC: data collection; paper redaction; 3D printing. VGDS: data collection. JARG: 3D printing. CGG: segmentation. CGG: segmentation. IOG: data collection. JMCS: data collection. FJBR: Study revision. RAML: study and paper revision.

Corresponding author

Correspondence to Inés Rivero Belenchón.

Ethics declarations

Conflict of interest

The manuscript has been approved by all authors and is solely the work of the authors named. Our paper is not under consideration in any other journal. None of its contents has been published before. We state we have not any relation with industry. We have neither Conflict of Interest nor any financial attachments.

Research involving human participants and/or animals

This study involves human participants; therefore, it went through an ethical committee.

Informed consent

Informed consent was obtained from the individual participant included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rivero Belenchón, I., Congregado Ruíz, C.B., Gómez Ciriza, G. et al. How to obtain a 3D printed model of renal cell carcinoma (RCC) with venous tumor thrombus extension (VTE) for surgical simulation (phase I NCT03738488). Updates Surg 72, 1237–1246 (2020). https://doi.org/10.1007/s13304-020-00806-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-020-00806-6

Keywords

Search

Navigation