Dreidimensionale Darstellung von CT-Datensätzen des Halses für die chirurgische Planung: Eine Machbarkeitsstudie

Background: Surgical planning in ENT profits from computer assisted praeoperative visualization and planning. The informative capability is to be improved by three-dimensional illustrating of the praeoperativ available data. The possibility of a 3-D-visualization of lymph nodes stands in the center of the interest. Methods: 16 CT data sets with a tumor-classification of T1N1 or higher were included. Altogether 720 pseudo-3-D-illustrations were provided with an average of 9.3 objects. Current algorithms were used for the segmentation and visualization and the results were divided in three classes. Results: The average time requirement for visualization and segmenting amounted to 122 minutes, the minimum value is at 61 minutes per data set. Automatic segmenting succeeded only with structures with clear grey tone differences to the environment. In all other cases an additional manual interaction had to take place. Conclusions: 3-D-Visualisierung of CT of the neck represents a new quality in preoperative planning. A clear trend at increasing detail loyalty and information efficiency showed up in the groups of B and C. It is possible to make from these pictures a quantitative statement on surgery relevant infiltration. Likewise conceivable are the postoperative quality control or planning and process control of a postoperative radio-chemotherapy. The automatic algorithms can be estimated as reliable. Application is still far from a clinically efficient use. With the rising efficiency of the computing systems, the improved software and the imaging systems the problems mentioned are, however, solvable.