Fang Chi-Hua, Liu Yu-Bin, Tang Yun-Qiang, Pan Jia-Hui, Peng Feng-Ping, Lu Chao-Min, Bao Su-Su
Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2008 Jun;28(6):926-9.
To assess the feasibility of visual-reality technique for simulating surgical resection of pancreatic tail carcinoma using a 3-dimensional pancreas model reconstructed on the basis of the CT data.
The original image data of 64-slice spiral CT was obtained from a patient with pancreatic tail carcinoma. Using adaptive region growing algorithm, the serial CT images were segmented and automatically extracted for 3-dimensional reconstruction of the pancreas and the anatomically related structures with a self-designed program. The model was then processed with Freeform Modeling System for image modification and smoothing. With the assistance of GHST SDK and PHANTOM software systems, preoperative simulation of surgical resection of the carcinoma was performed on the basis of the established pancreatic model.
The reconstructed 3-dimensional pancreatic model with the related structures clearly visualized the 3-dimensional structures of the pancreas, the pancreatic tail compromised by the carcinoma, and the adjacent organs, displaying also the distribution, courses and the anatomical relations of the ductal systems including the main pancreatic duct, abdominal aorta, portal vein system, and the biliary tract. During simulated surgery for pancreatic tail carcinoma resection, the GHOST SDK system allowed effective application of the virtual surgical instruments, and the use of PHANTOM software produced a surgical experience with high resemblance of that from an actual operation.
The serial CT data-based reconstruction of 3-dimensional pancreas model and simulated operation on this model using virtual-reality technique has great potentials for application in individualized surgical planning and surgical risk assessment in cases of pancreatic tail carcinoma, and also facilitates clinical training of the surgeons.
基于CT数据重建三维胰腺模型，评估虚拟现实技术模拟胰尾癌手术切除的可行性。
获取1例胰尾癌患者的64排螺旋CT原始图像数据。利用自适应区域生长算法，采用自编程序对连续CT图像进行分割并自动提取，重建胰腺及相关解剖结构的三维模型。然后使用Freeform Modeling System对模型进行图像修改和平滑处理。借助GHST SDK和PHANTOM软件系统，在已建立的胰腺模型基础上进行癌灶手术切除的术前模拟。
重建的包含相关结构的三维胰腺模型清晰显示了胰腺的三维结构、受癌灶侵犯的胰尾以及相邻器官，还展示了包括主胰管、腹主动脉、门静脉系统和胆道在内的导管系统的分布、走行及解剖关系。在模拟胰尾癌切除手术过程中，GHOST SDK系统可有效应用虚拟手术器械，PHANTOM软件的使用带来了与实际手术高度相似的手术体验。
基于连续CT数据重建三维胰腺模型并利用虚拟现实技术在此模型上进行模拟手术，在胰尾癌个体化手术规划和手术风险评估中具有巨大的应用潜力，也有助于外科医生的临床培训。
