Three-dimensional stereoscopic volume rendering of malignant pleural mesothelioma

Our plain-English summary of Three-dimensional stereoscopic volume rendering of malignant pleural mesothelioma, by N.M. Mollberg, N.M. Parsad, S.G. Armato, et al (International Surgery, 2012).

The study

• Authors: N.M. Mollberg, N.M. Parsad, S.G. Armato, J. Vigneswaran, H.L. Kindler, W.F. Sensakovic, R. Salgia, J.C. Silverstein, W.T. Vigneswaran
• Journal: International Surgery
• Published: 2012;97(1):65-70
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Our objective was to investigate the application of three-dimensional (3D) stereoscopic volume rendering with perceptual colorization on preoperative imaging for malignant pleural mesothelioma. At present, we have prospectively enrolled 6 patients being considered for resection of malignant pleural mesothelioma that have undergone a multidetector-row computed tomography (CT) scan of the chest. The CT data sets were volume rendered without preprocessing. The resultant 3D rendering was displayed stereoscopically and used to provide information regarding tumor extent, morphology, and anatomic involvement. To demonstrate this technique, this information was compared with the corresponding two-dimensional CT grayscale axial images from two of these patients. Three-dimensional stereoscopic reconstructions of the CT data sets provided detailed information regarding the local extent of tumor that could be used for preoperative surgical planning. Three-dimensional stereoscopic volume rendering for malignant pleural mesothelioma is a novel approach. Combined with our innovative perceptual colorization algorithm, stereoscopic volumetric analysis potentially allows for the accurate determination of the extent of pleural mesothelioma with results difficult to duplicate using grayscale, multiplanar CT images.

In plain English

This article described a computer system that shows chest CT scans of malignant pleural mesothelioma as three-dimensional stereoscopic images with a special color scheme, and demonstrated it on patients. The system was applied to the CT scans of 6 patients with malignant pleural mesothelioma (5 men and 1 woman, ages 49 to 89) who had surgery at The University of Chicago Medical Center. Of these, 2 had extrapleural pneumonectomy and 4 had radical pleurectomy with decortication. For 2 patients, the 3D images were compared with standard two-dimensional grayscale CT images. In the first patient, the authors reported that the 3D image showed the tumor's relationship to the airways, and bulky disease in the mediastinum despite minimal disease in the parietal pleura. In the second, it showed bulky tumor involving the lung fissure and extensive involvement of the diaphragm and parietal pleura. The authors stated that they planned to compare 3D findings with pathology reports and surgical notes to test the technique's reliability. The authors concluded that the approach potentially allows accurate determination of tumor extent. The article did not discuss asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Technical description of an imaging system with a demonstration on a small series of patients (two shown as examples)
• Who was studied: 6 patients with malignant pleural mesothelioma (5 men and 1 woman; ages 49 to 89, median age 70.5) who had surgery at The University of Chicago Medical Center. Two of them (patients 1 and 2) were used for the image comparison.
• Exposure: Not reported. The article does not discuss asbestos or any other exposure. It studied an imaging technique: 3D stereoscopic volume rendering of chest CT scans.
• Main results:
  • Of the 6 patients, 2 underwent extrapleural pneumonectomy (EPP) and 4 underwent radical pleurectomy with decortication (radical P/D).
  • The CT scans were taken an average of 24.7 days (range 5 to 59 days) before surgery.
  • Patient 1 (79-year-old man, radical P/D): the authors reported that the 3D image showed the tumor and its relationship to the tracheobronchial tree and subcarina, and bulky mediastinal disease despite minimal disease in the parietal pleura.
  • Patient 2 (70-year-old man, EPP): the authors reported that the 3D volume showed bulky tumor within the lung involving the fissure, and extensive involvement of the diaphragm and parietal pleura.
  • Loading and displaying the rendered volumes took about 20 seconds for these CT data sets.
• The authors' conclusion: The authors concluded that 3D stereoscopic volume rendering for malignant pleural mesothelioma is a novel approach. In their view, combined with their colorization algorithm, it potentially allows accurate determination of the extent of pleural mesothelioma, with results difficult to duplicate using grayscale CT images.
• Limitations the authors state:
  • The reliability of the technique in predicting extent of disease and choice of operation had not yet been tested. The authors planned to compare 3D observations with pathology reports and surgical notes.
  • The printed figures cannot accurately show the stereoscopic images.
  • Performance of the remote web-based viewing depends on internet bandwidth.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

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