Abstract 1848P
Background
Renal Cell Cancer (RCC) accounts for 3-5% of all adults malignancies, and up to 10% are presented with venous thrombus extension (VTE). This worsens prognosis and represents a therapeutic challenge. 3D biomodels are printed copies of patients´ radiological images with visual and tactile components that enhance understanding of anatomy and may improve surgical planning, communication and training. This is a Multicenter Clinical Trial (NCT03738488), which aims to assess the efficacy and efficiency of surgery planning with 3D in RCC with VTE. The objective of the phase I is to obtain a feasible, affordable, accurate and suitable for surgical simulation 3D model.
Methods
A CT image in early arterial and nephrogenic phase was obtained. ITK-snap ® and VirSSPA Software ® were used for segmentation. The resulting 3D mesh was processed with MeshMixer ®. Multiple models were printed using different 3D printers and materials. We evaluated: material, scale, thickness, accuracy, suitability for surgery, cost and printing time. 6 urologists completed a satisfaction questionnaire.
Results
4 models were discarded (Table). The selected one was printed with BQ Witbox FDM printer in polyurethane filament with a 0.8mm thickness and 100% scale. All anatomical structures could be correctly identified with a good accuracy compared to the CT (< 5mm deviation) and the surgery could be performed on it. Model cost was 15€ and whole processing and printing time 48h. 100% of urologists thought that the obtained 3D model could be useful for surgery planning and simulation. Table: 1848P
| 3D | Model adequacy (yes / no) | Cost (€) | Printing time (h) | Discarded (yes/no) | Reason for discard | ||||||
| Printer | Material | Material | Scale | Thickness | Accuracy | Surgery performance | |||||
| 1 | BQ Witbox | Rigid PLA | No | No | Yes | No | No | 15 | 48 | Yes | Material |
| 2 | BQ Witbox | Flexible PU | Yes | No | Yes | No | Yes | 15 | 48 | Yes | Structures identification |
| 3 | BQ Witbox | Flexible PU | Yes | Yes | No | Yes | Yes | 15 | 48 | Yes | Thickness |
| 4 | Stratasys Polyjet | Agilus flexible | No | Yes | No | No | No | 180 | 72 | Yes | Precision |
| BQ Witbox | Flexible PU | ||||||||||
| 5 | BQ Witbox | Flexible PU | Yes | Yes | Yes | Yes | Yes | 15 | 48 | No | - |
Conclusions
A feasible and affordable 3D printed model of RCC with VTE was obtained. It was accurate compared to the CT and suitable for surgery simulation. Urologists thought it could be useful for surgery planning and simulation.
Clinical trial identification
NCT03738488.
Editorial acknowledgement
Legal entity responsible for the study
FISEVI.
Funding
Pfizer.
Disclosure
All authors have declared no conflicts of interest.