Development of a Three-dimensional Surgical Navigation System with Magnetic Resonance Angiography and a Three-dimensional Printer for Robot-assisted Radical Prostatectomy

We sought to develop a surgical navigation system using magnetic resonance angiography (MRA) and a three-dimensional (3D) printer for robot-assisted radical prostatectomy (RARP). Six patients with pathologically proven localized prostate cancer were prospectively enrolled in this study. Prostate mag...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2018-01, Vol.10 (1), p.e2018-e2018
Main Authors: Jomoto, Wataru, Tanooka, Masao, Doi, Hiroshi, Kikuchi, Keisuke, Mitsuie, Chiemi, Yamada, Yusuke, Suzuki, Toru, Yamano, Toshiko, Ishikura, Reiichi, Kotoura, Noriko, Yamamoto, Shingo
Format: Article
Language:English
Subjects:
3-D printers
Antigens
Bandwidths
Bone surgery
Cancer surgery
Medical imaging
Medical Simulation
Mens health
Navigation systems
NMR
Nuclear magnetic resonance
Prostate cancer
Radiology
Urological surgery
Urology
Work stations
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Summary:We sought to develop a surgical navigation system using magnetic resonance angiography (MRA) and a three-dimensional (3D) printer for robot-assisted radical prostatectomy (RARP). Six patients with pathologically proven localized prostate cancer were prospectively enrolled in this study. Prostate magnetic resonance imaging (MRI), consisting of T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE) and true fast imaging with steady-state precession (true FISP), reconstructed by volume rendering, was followed by dynamic contrast-enhanced MRA performed with a volumetric interpolated breath-hold examination (VIBE) during intravenous bolus injection of gadobutrol. Images of arterial and venous phases were acquired over approximately 210 seconds. Selected images were sent to a workstation for generation of 3D volume-rendered images and standard triangulated language (STL) files for 3D print construction. The neurovascular bundles (NVBs) were found in sequence on non-contrast images. Accessory pudendal arteries (APAs) were found in all cases in the arterial phase of contrast enhancement but were ill-defined on non-contrast enhanced MRA. Dynamic contrast-enhanced MRA helped to detect APAs, suggesting that this 3D system using MRI will be useful in RARP.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.2018