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

Abstract

Abstract Introduction Vascular infiltration in pancreatic cancer represents the main limitation of resecability in locally advanced disease and an accurate preoperative study is mandatory to planning the most adequate surgical strategy. In recent years medical image fusion and three dimensional reconstruction models have gained acceptant in general surgery, especially in hepatic field. Also in pancreatic pathology, 3D reconstruction mayallow a better preoperative staging, comparing to traditional imaging modality. The aim of this study is to compared 3D imaging reconstruction model with conventional CT scan, MRI and Eco endoscopy performance in patients undergoing pancreatic surgery with associated vascular resection. Materials and Methods Patients with pancreatic cancer who underwent vascular resection at 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 subjected to pancreatic and vascular resection. The diagnostic accuracy in detection of celiac trunk involvent was 100% for 3D , 80% for CT scan, 70% for MRI and 90% for encoendoscopy. With respect to the portal mesenteric trunk involvement, 3D had an accuracy of 100% comparing with an accuracy of 25%, 50% and 30% of r CT scan, MRI and ecoendoscopy respectively. In the analysis of 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 study method in patients affected by pancreatic cancer with vascular involvement. Future studies are needed to confirm these preliminary results.