The Predictive Value of 3D Imaging Reconstruction Models in Patients with Vascular Resection for Pancreatic Surgery.

Abstract

Abstract Introduction Vascular infiltration in pancreatic cancer represents the main limitation for surgery in locally advanced disease. Therefore an accurate preoperative study is mandatory to plan the most adequate surgical strategy. In the latest years, medical image fusion and three dimensional reconstruction models have gained wider acceptance in general surgery, especially in the hepatic field. Also for what concernes the pancreatic surgery, 3D reconstruction may allow a better preoperative staging if compared to traditional imaging studies. The aim of this study is to compare 3D imaging reconstruction model with conventional CT scan, MRI and Ecoendoscopy performance in patients undergoing pancreatic surgery with associated vascular resection. Materials and Methods Patients with pancreatic cancer who underwent surgery with vascular resection at the Sanchinarro University Hospital from June 2020 to June 2021 were retrospectively reviewed. For each patient a preoperative 3D reconstruction with 3D Cella Medical Solutions (3D-MSP®) model was realised and then compared with traditional imaging methods (CT, MRI and Eco endoscopy). Results We enrolled 10 patients who underwent pancreatic surgery with associated vascular resection. The diagnostic accuracy in detection of celiac trunk involvement was of 100%, 80%, 70% and 90% for 3D-reconstruction, CT Scan, MRI and Ecoendoscopy groups respectively. On the other hand, in relation to the portal-mesenteric trunk invasion, 3D-reconstruction has demonstrated a 100% rate of accuracy comparing with an accuracy of 25%, 50% and 30% of CT scan, MRI and Ecoendoscopy respectively. As concerning the precision in estabilishing the tumor size, 3D model was superior to the CT and MRI at the Bland–Altman comparison. Conclusion 3D imaging reconstruction technique is a helpful preoperatory tool in patients affected by pancreatic cancer with vascular involvement. More studies with larger series are needed to confirm these preliminary results.