Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli Studi di Bologna, Bologna, Italy.
Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Università degli Studi di Bologna, Bologna, Italy.
Urol Oncol. 2021 Dec;39(12):836.e1-836.e9. doi: 10.1016/j.urolonc.2021.07.024. Epub 2021 Sep 14.
3D models are increasingly used as additional preoperative tools for renal surgery. We aim to evaluate the impact of 3D renal models in the assessment of PADUA, RENAL, Contact Surface Area (CSA) and Arterial Based Complexity (ABC) for the prediction of complications after Robot assisted Partial Nephrectomy (RAPN).
Overall, 57 patients with T1 and 1 patient with T2 renal mass referred to RAPN, were prospectively enrolled. 3D virtual modelling was obtained from 2D computed tomography (CT). Two radiologists recorded PADUA, RENAL, CSA and ABC by evaluation of 2D images; two bioengineers recorded PADUA, RENAL CSA and ABC by evaluation of the 3D model, using MeshMixer software. To evaluate the concordance between 2D and 3D nephrometry scores, Cohen's j coefficient was calculated. Receiver-operating characteristic (ROC) curves were generated to evaluate the accuracy of 3D and 2D nephrometry scores to predict overall complications. Finally, the impact of 3D model on clamping approach during RAPN was compared to 2D imaging.
PADUA, RENAL CSA and ABC scores had a significant different distribution compared to PADUA, RENAL, CSA and ABC (all p≤0.03). 2D nephrometry scores may be unchanged, reduced or increased after assessment by 3D models: CSA, PADUA, RENAL and ABC were reduced in14%, 26%, 29% and 16% and increased in 16%, 36%, 38% and 29% of cases, respectively. At ROC curve analysis, PADUA, RENAL and ABC showed were significantly better accuracy to predict complications compared to PADUA, RENAL and ABC. PADUA (OR: 1.66), RENAL (OR: 1.69) and ABC (OR: 2.44) revealed a significant correlation with postoperative complications (all P ≤0.03).
Nephrometry scores calculated via 3D models predict complications after RAPN with higher accuracy than conventional 2D imaging.
3D 模型越来越多地被用作肾外科的额外术前工具。我们旨在评估 3D 肾脏模型在评估 PADUA、RENAL、接触表面积 (CSA) 和基于动脉的复杂性 (ABC) 以预测机器人辅助部分肾切除术 (RAPN) 后并发症方面的影响。
共有 57 例 T1 期和 1 例 T2 期肾肿瘤患者前瞻性入组 RAPN。3D 虚拟建模从 2D 计算机断层扫描 (CT) 获得。两名放射科医生通过评估 2D 图像记录 PADUA、RENAL、CSA 和 ABC；两名生物工程师通过使用 MeshMixer 软件评估 3D 模型记录 PADUA、RENAL CSA 和 ABC。为了评估 2D 和 3D 肾脏测量评分之间的一致性，计算了 Cohen's j 系数。生成接收者操作特征 (ROC) 曲线以评估 3D 和 2D 肾脏测量评分预测总体并发症的准确性。最后，将 3D 模型对 RAPN 中夹闭方法的影响与 2D 成像进行了比较。
与 PADUA、RENAL、CSA 和 ABC 相比，PADUA、RENAL CSA 和 ABC 评分的分布有显著差异（均 p≤0.03）。2D 肾脏测量评分可能在 3D 模型评估后保持不变、降低或增加：CSA、PADUA、RENAL 和 ABC 分别在 14%、26%、29%和 16%的病例中降低，在 16%、36%、38%和 29%的病例中增加。在 ROC 曲线分析中，与 PADUA、RENAL 和 ABC 相比，PADUA、RENAL 和 ABC 显示出更高的准确性来预测并发症。PADUA（OR：1.66）、RENAL（OR：1.69）和 ABC（OR：2.44）与术后并发症显著相关（均 P≤0.03）。
通过 3D 模型计算的肾脏测量评分预测 RAPN 后并发症的准确性高于传统的 2D 成像。
