作者
Christian Cotsoglou,Giuseppina Di Stefano,Benjamin Ly Serena,Bagnardi Vincenzo,Pugliese Raffaele,Grazi Gian Luca,Guglielmi Alfredo,Ruzzenente Andrea,Aldrighetti Luca,Francesca Ratti,De Carlis Luciano,Riccardo De Carlis,Costantino Leonardo,De Nicola,Memeo Riccardo,Delvecchio Antonella,Felli Emanuele,Francesco Izzo,Andrea Barp,Renato Pascale,Ettorre Giuseppe Maria,Berardi Giammauro,Di Benedetto Fabrizio,Di Sandro Stefano,Romano Fabrizio,Mattia Garancini,Alessandro Sciarra,Bianchi Giorgio,Germini Alessandro,Gjoni Elson,Bonomi Alessandro,Bruno Federica,Paleino Sissi,P. Comi Giacomo
摘要
IntroductionThree-dimensional liver modeling can lead to substantial changes in choosing the type and extension of liver resection. This study aimed to explore whether 3D reconstruction helps to better understand the relationship between liver tumors and neighboring vascular structures compared to standard 2D CT scan images.MethodsContrast-enhanced CT scan images of 11 patients suffering from primary and secondary hepatic tumors were selected. Twenty-three experienced HBP surgeons participated to the survey. A standardized questionnaire outlining 16 different vascular structures (items) having a potential relationship with the tumor was provided. Intraoperative and histopathological findings were used as the reference standard. The proper hypothesis was that 3D accuracy is greater than 2D. As a secondary endpoint, inter-raters’ agreement was explored.ResultsThe mean difference between 3D and 2D, was 2.6 points (SE: 0.40; 95% CI: 1.7-3.5; p < 0.0001). After sensitivity analyis, the results favored 3D visualization as well (mean difference 1.7 points; SE: 0.32; 95% CI: 1.0-2.5; p = 0.0004). The inter-raters’ agreement was moderate for both methods (2D: W = 0.45; 3D: W = 0.44).Conclusion3D reconstruction may give a significant contribution to better understanding liver vascular anatomy and the precise relationship between the tumor and the neighboring structures.