Chinese Society Of Digital Medicine, Liver Cancer Committee Of Chinese Medical Doctor Association, Clinical Precision Medicine Committee Of Chinese Medical Doctor Association, Digital Intelligent Surgery Committee Of Chinese Research Hospital Association
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Mar 30;40(3):297-307. doi: 10.12122/j.issn.1673-4254.2020.03.01.
Virtual resection of liver structures guided by three-dimensional visualization technology (3DVT) has been extensively used in China. This technique provides a safe and effective method for accurate diagnosis of liver tumors and has important applications in preoperative evaluation, surgical planning and intraoperative guidance of liver cancer surgeries. The technical advantages and clinical significance of 3DVT in the diagnosis and treatment of complex liver tumors have been recognized. In order to standardize the application of 3DVT in the precision diagnosis and treatment of complex liver tumors, this guideline provides explanations and recommendations in the following aspects: (1) the establishment of homogenization processing and quality control system of 3D reconstruction; (2) the establishment of 3D reconstructed models of abdominal organs and lesions; (3) the individualized classification and quantitative analysis of blood vessels based on 3DVT; (4) 3DVT-based classification and grading of hepatic vessels in complex hepatic tumors; (5) evaluation system for surgery evaluation after reconstruction of the 3D visualization model; (6) application of 3D printing in complex hepatectomy; (7) virtual reality technology; (8) ICG fluorescence imaging; (9) multi-modal images for real-time navigation; (10) three-dimensional visualization to guide the preoperative surgical planning of precision hepatectomy; (11) application of 3DVT guidance in other therapeutic methods of hepatocellular carcinoma; (12) application of 3DVT in follow-up evaluation of the patients after liver cancer surgeries. 3DVT for visualization of the liver structures has important clinical values for accurate preoperative evaluation, preoperative planning and surgical navigation of complex liver tumors, and it facilitates precision surgeries to improve the outcomes and promote postoperative recovery of the patients.
三维可视化技术（3DVT）引导下的肝脏结构虚拟切除术在中国已得到广泛应用。该技术为肝肿瘤的准确诊断提供了一种安全有效的方法，在肝癌手术的术前评估、手术规划及术中引导方面具有重要应用价值。3DVT在复杂肝肿瘤诊治中的技术优势及临床意义已得到认可。为规范3DVT在复杂肝肿瘤精准诊治中的应用，本指南从以下方面给出解释与建议：（1）三维重建同质化处理及质量控制体系的建立；（2）腹部脏器及病变的三维重建模型构建；（3）基于3DVT的血管个体化分类及定量分析；（4）复杂肝肿瘤中基于3DVT的肝血管分类及分级；（5）三维可视化模型重建后手术评估的评价体系；（6）3D打印在复杂肝切除术中的应用；（7）虚拟现实技术；（8）吲哚菁绿荧光成像；（9）多模态图像实时导航；（10）三维可视化指导精准肝切除术前手术规划；（11）3DVT引导在肝细胞癌其他治疗方法中的应用；（12）3DVT在肝癌手术后患者随访评估中的应用。用于肝脏结构可视化的3DVT对复杂肝肿瘤的准确术前评估、术前规划及手术导航具有重要临床价值，有助于精准手术以改善疗效并促进患者术后恢复。
