Accuracy of a 3-Dimensionally Printed Navigational Template for Localizing Small Pulmonary Nodules

Zhang, Lei; Wang, Long; Kadeer, Xiermaimaiti; Li, Zeyao; Sun, Xuejun; Sun, Weinan; She, Yunlang; Xie, Dong; Zou, Liling; Rocco, Gaetano; Yang, Ping; Chen, Chang; Liu, Chia‐Chuan; Petersen, René Horsleben; Ng, Calvin S.H.; Parrish, Scott; Zhang, Yu Shrike; Giordano, Raffaele; Tommaso, Luigi Di

doi:10.1001/jamasurg.2018.4872

Cited by 31 publications

(34 citation statements)

References 31 publications

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“…The mean procedural durations were 7.4 minutes for the template-guided group and 9.5 minutes for the CT-guided group (P < 0.001). The mean CT related radiation dose was 229 mGy × cm in the template-guided group and 313 mGy × cm in CT-guided group (p < .001) [17]. Indicating that the use of the 3D-PT for localization showed e cacy and safety that were not substantially worse than those with the CT-guided alone, while signi cantly simplifying the procedure and decreasing patient CT related radiation exposure.…”

Section: Discussionmentioning

confidence: 90%

“…Since the introduction of 3D-PT in the clinical practice, few studies investigate the accuracy of 3D-PT assisted needle related interventions [14,17]. As revealed by a non-inferiority randomized clinical trial that enrolled 200 patients for localizing small pulmonary nodules [17], localizer deviation did not signi cantly differ between the 3D-PT group and CT-guided group (mean, 8.7 vs. 9.6 mm; p = 0.36). The mean procedural durations were 7.4 minutes for the template-guided group and 9.5 minutes for the CT-guided group (P < 0.001).…”

Section: Discussionmentioning

confidence: 98%

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The Accuracy of Individualized Three Dimensional-printing Template Assisted I125 Radioactive Seed Implantation for Recurrent head and Neck Cancer

Qiu

Jiang

et al. 2020

Preprint

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Background:Individualized threedimensional-printing template(3D-PT) is developed to facilitate I125radioactive seed implantation (RSI) for recurrent head and neck cancer, while most of the previous studies were focused on the efficacy and safety profiles, study on the accuracy of I125 RSI is lacking. Therefore, the aim of this study is to evaluate the accuracy involvingneedle puncture and dosimetry of individualized 3D-printing template (3D-PT) assisted I125 radioactive seed implantation (RSI) for head and neck cancer.Materials and Methods: From February 2017 to January 2020, clinical data of 41 patients (mean age, 58.5 ± 16.1 years; 28 males) with recurrent primary (48.8%)/secondary (51.2%) head and neck cancer underwent individualized 3D-PT assisted I125 RSI under CT guidance in our institute were retrospectively reviewed.Results:A total of 430 [mean, 10.5 (range 3–17) per patient] needles were inserted. Technical success rate was 100% without major complication. The mean entrance deviation was 0.090 cm (95% Confidence Interval, 0.081–0.098), whichwas significantly larger in patients with primary cancer than patients with secondary cancer (0.107 ± 0.012 vs. 0.072 ± 0.012 cm, p ＜ 0.001).The mean intraoperative depth and angular of the needle were consistent with planned depth and angular (6.23 ± 0.24 vs. 6.21 ± 0.24 cm, p = 0.903; 83.14 ± 3.64 vs. 83.09 ± 3.66 degrees, p = 0.985, respectively). The mean deviation between planned and intraoperative depth and angular of the needle were 0.168 ± 0.024 cm and 1.56 ± 0.14 degrees, respectively, without significant difference involving cancer type and implantation site (p = 0.065 and 0.092, respectively). The post-plan dosimetry parameters, including D90, D100, V100, V150, V200, conformity index, external index, and homogeneity index, were all well coordinate with planned dosimetry without significant deference (all p ＞ 0.05).Conclusions:Individualized 3D-PT assisted I125 RSI may be accurate with consistent planed and post-plan dosimetry for patients with recurrent head and neck cancer, further prospective study is warranted.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 98%

The Accuracy of Individualized Three Dimensional-printing Template Assisted I125 Radioactive Seed Implantation for Recurrent head and Neck Cancer

Qiu

Jiang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The mean procedural durations were 7.4 minutes for the 3D-PT assisted group and 9.5 minutes for the CT-guided group (P < 0.001). The mean CT related radiation dose was 229 mGy × cm in the 3D-PT assisted group and 313 mGy × cm in CT-guided group (p < .001) [17]. Indicating that the use of the 3D-PT for placement of pulmonary localizer showed e cacy and safety that were not substantially worse than those with the CT-guided alone, while signi cantly simplifying the procedure and decreasing patient CT related radiation exposure.…”

Section: Discussionmentioning

confidence: 91%

“…Since the introduction of 3D-PT in the clinical practice, few studies investigate the accuracy of needle puncture during 3D-PT assisted needle related interventions [14,17]. As revealed by a non-inferiority randomized clinical trial that enrolled 200 patients for localizing small pulmonary nodules [17], localizer deviation did not signi cantly differ between the 3D-PT assisted group and CT-guided group (mean, 8.7 vs. 9.6 mm; p = 0.36). The mean procedural durations were 7.4 minutes for the 3D-PT assisted group and 9.5 minutes for the CT-guided group (P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

The Accuracy and Dosimetry of Individualized 3D-Printing Template Assisted I125 Radioactive Seed Implantation for Recurrent/Secondary Head and Neck Cancer

Qiu¹,

Jiang²,

Ji³

et al. 2020

Preprint

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Background: Individualized 3D-printing template (3D-PT) is developed to facilitate I125 radioactive seed implantation (RSI), while most of the previous studies were focused on the efficacy and safety profiles, study on the accuracy of I125 RSI is lacking. Therefore, the aim of this study is to evaluate the accuracy of intraoperative needle puncture and post-plan dosimetry of individualized 3D-PT assisted I125 RSI for recurrent/secondary head and neck cancer.Methods: From February 2017 to January 2020, clinical data of 41 patients (mean age, 58.5 ± 16.1 years; 28 males) with recurrent (48.8%)/secondary (51.2%) head and neck cancer underwent individualized 3D-PT assisted I125 RSI under CT guidance in our institute were retrospectively reviewed.Results: A total of 430 needles [mean, 10.5 (range 3–17) per patient] were inserted. Technical success rate was 100% without major complication. The mean needle’s entrance deviation was 0.090 cm (95% Confidence Interval, 0.081–0.098). The mean intraoperative depth and angular of the needle were consistent with that of pre-plan (6.23 ± 0.24 vs. 6.21 ± 0.24 cm, p = 0.903; 83.14 ± 3.64 vs. 83.09 ± 3.66 degrees, p = 0.985, respectively). The mean deviation between the needle’s pre-planned and intraoperative depth and angular were 0.168 ± 0.024 cm and 1.56 ± 0.14 degrees, respectively. The post-plan dosimetry parameters, including D90, D100, V100, V150, V200, conformity index, external index, and homogeneity index, were all well coordinate with pre-planned dosimetry without significant deference (all p ＞ 0.05).Conclusion: Within the limitation of this study, individualized 3D-PT assisted I125 RSI may be accurate obtaining favorable post-plan dosimetry for patients with recurrent/secondary head and neck cancer, further prospective study is warranted.

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“…7 In recent years, the three-dimensional (3D) printing technique has been gradually applied to clinical therapy. Zhang et al 8,9 developed a localization method for small pulmonary nodules, using a 3D-printed navigational template to mark the puncture site and angle. The 3D-printed template-guided (3D-G) localization they performed was printed with nylon (PA3200), assisted by hookwire, and required pre-evaluation by CT scanning.…”

Section: Introductionmentioning

confidence: 99%

Three‐dimensional printed navigational template for localizing small pulmonary nodules: A case‐controlled study

Chai

Zhang

et al. 2020

Thoracic Cancer

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Background Localization of small pulmonary nodules is an inevitable challenge for the thoracic surgeon. This study aimed to investigate the accuracy of three‐dimensional (3D) printing technology for localizing small pulmonary nodules, especially ground‐glass nodules (GGNs). Methods This study enrolled patients with peripheral small pulmonary nodules (≤ 2 cm) who required preoperative localization. In the comparison period, patients underwent both computed tomography‐guided (CT‐G) and 3D‐printing template guided (3D‐G) localization to compare the accuracies of the two methods. In the testing period, the 3D‐printing technique was implemented alone. The 3D‐printing physical navigational template was designed based on data from perioperative CT images. Clinical data, imaging data, surgical data, and evaluation index were collected for further analysis. The learning curve of the 3D‐printing localization technique was assessed using cumulative sum (CUSUM) analysis and multiple linear regression analysis. Results In the comparison period (n = 14), the success rates of CT‐G and 3D‐G were 100% and 92.9% (P = 0.31), respectively; in the testing period (n = 23), the success rate of 3D‐G was 95.6%. The localization times of CT‐G, 3D‐G (comparison), and 3D‐G (testing) were 23.6 ± 5.3, 19.3 ± 6.8, and 9.8 ± 4.6 minutes, respectively. The CUSUM learning curve was modeled using the equation: Y = 0.48X2 − 0.013X − 0.454 (R2 = 0.89). The learning curve was composed of two phases, phase 1 (the initial 20 patients) and phase 2 (the remaining 17 patients). Conclusions 3D printing localization has adequate accuracy and is a feasible and accessible strategy for use in localizing small pulmonary nodules, especially in right upper lobe. The use of this technique could facilitate lung nodule localization prior to surgery.

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Accuracy of a 3-Dimensionally Printed Navigational Template for Localizing Small Pulmonary Nodules

Cited by 31 publications

References 31 publications

The Accuracy of Individualized Three Dimensional-printing Template Assisted I125 Radioactive Seed Implantation for Recurrent head and Neck Cancer

The Accuracy of Individualized Three Dimensional-printing Template Assisted I125 Radioactive Seed Implantation for Recurrent head and Neck Cancer

The Accuracy and Dosimetry of Individualized 3D-Printing Template Assisted I125 Radioactive Seed Implantation for Recurrent/Secondary Head and Neck Cancer

Three‐dimensional printed navigational template for localizing small pulmonary nodules: A case‐controlled study

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