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三维打印导航模板在肺结节定位中的应用:一项初步研究。

Three-dimensional printing of navigational template in localization of pulmonary nodule: A pilot study.

机构信息

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.

出版信息

J Thorac Cardiovasc Surg. 2017 Dec;154(6):2113-2119.e7. doi: 10.1016/j.jtcvs.2017.08.065. Epub 2017 Sep 1.

Abstract

BACKGROUND

Small pulmonary nodules are a common problem, especially with the wide implementation of lung cancer-screening program. This poses a great challenge to thoracic surgeons because of the difficulty of nodule localization. We recently built an efficient, customized navigational template using 3-dimensional (3D) printing technology to facilitate the procedure of lung nodule localization. This study aims to investigate its feasibility in clinical application.

METHODS

Patients with peripheral lung nodules (<2 cm) were enrolled. Preadmission computed tomography images were downloaded and reconstructed into a 3D model. A digital model of the navigational template was designed via computer-aided design software and then exported into 3D printer to produce physical template. The precision of the template-guided nodule localization and associated complications were evaluated.

RESULTS

A total of 16 patients were enrolled, and 18 nodules were localized through template-guided localization. The success rate of lung nodule localization was 100%, and the median time of localization was 13 minutes (range 10-16 minutes). In our series, no significant complication occurred, except for 2 asymptomatic pneumothoraxes. The median deviation between the localizer and the center of the nodule was 10.0 mm, ranging from 5 to 20 mm.

CONCLUSIONS

This novel navigational template created by 3D printing technology is feasible, and it has acceptable accuracy for the application in lung nodule localization. The use of this navigational template could facilitate the procedure of lung nodule localization and may potentially break the dependence of percutaneous localization on computed tomography scanning.

摘要

背景

肺部小结节是一种常见的问题,尤其是在广泛实施肺癌筛查计划后。这对胸外科医生来说是一个巨大的挑战,因为结节定位的难度很大。我们最近使用 3 维(3D)打印技术构建了一种高效、定制的导航模板,以方便肺结节定位的过程。本研究旨在探讨其在临床应用中的可行性。

方法

纳入外周性肺部小结节(<2cm)患者。入院前的 CT 图像被下载并重建为 3D 模型。通过计算机辅助设计软件设计导航模板的数字模型,然后将其导出到 3D 打印机中以生成物理模板。评估模板引导的结节定位的准确性和相关并发症。

结果

共纳入 16 例患者,18 个结节通过模板引导定位。肺结节定位的成功率为 100%,中位定位时间为 13 分钟(范围 10-16 分钟)。在我们的系列中,除了 2 例无症状气胸外,没有发生明显的并发症。定位器与结节中心之间的中位偏差为 10.0mm,范围为 5-20mm。

结论

3D 打印技术制作的新型导航模板是可行的,在肺结节定位中的应用具有可接受的准确性。使用这种导航模板可以方便肺结节定位的过程,并可能打破经皮定位对 CT 扫描的依赖。

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