The technology for chest 3D modeling aimed to increase the efficacy of diagnostic interventions in phthisiopulmonology

The objective of the study: to increase efficacy of minimally invasive interventions in the diagnosis of limited disseminated and focal pulmonary lesions based on 3D-navigation modeling technologies.

Subjects and methods. The informativeness of transbronchial lung biopsy (TBLB) with 3D navigation and traditional TBLB was compared in 50 patients in two groups. Group 1 included 20 patients with stage I and II sarcoidosis in whom a virtual-navigation map was drawn up using 3D modeling to accompany transbronchial lung biopsy. Group 2 consisted of 30 patients with stage I and II sarcoidosis who underwent standard TBLB. The informativeness of TBLB was evaluated by the results of histological tests of biopsy specimens.

The developed software for positioning thoracoports was tested in 30 patients of two groups who were supposed to undergo lung biopsy with a thoracoscopic minimally invasive intervention for disseminated pulmonary lesions of various genesis. The main group (MG) included 10 patients in whom the developed software was used to determine the location points of the thoracoports. The control group (CG) consisted of 20 patients in whom diagnostic surgery was performed as per standard methods.

Results. In the case of disseminated pulmonary lesions, this technology allows increasing the frequency of the presence of diagnostically significant structures in the specimen obtained by TBLB for histological examination (from 56.3 to 90.0%) and reducing the duration of diagnostic thoracoscopic minimally invasive interventions (from 39.75 to 33.50 min.).

1. Аvdeev S.N. Idiopathetic pulmonary fibrosis. Pulmonoloiya, 2015, vol. 25, no. 5, pp. 600-609. (In Russ.)

2. Аmosov V.I. X-ray diagnosis of rare interstitial pulmonary diseases. Torakalnaya radiologiya: Sb. trudov kongressa. [Thoracic radiology. Congress Abst. Book]. St. Petersburg, 2012, pp. 222-226. (In Russ.)

3. Аmosov V.I., Speranskaya А.А. Luchevaya diagnostika interstitsialnykh zabolevaniy legkikh. [X-ray diagnosis of interstitial pulmonary diseases]. St. Petersburg, 2015, pp. 8-47.

4. Аndreeva А.D., Markina S.E. Review of software of medical data visualization. Molodoy Ucheny, 2013, no. 3, pp. 512-516. (In Russ.)

5. Ershova K.I., Terpigorev S.А., Kuzmichev V.А., Mazurin V.S., Shabaro V.L. Evaluation of efficacy of various methods of lung and chest nodes biopsy in case of sarcoidosis. Аlmanakh Klinicheskoy Meditsiny, 2011, no. 25, pp. 41-47. (In Russ.)

6. Zaytsev N.N., Markina S.E., Filatova E.А. The simulation of the site for specimen collection when performing transbronchial biopsy in disseminated pulmonary lesions (Epub.). Mezhdunarodny Studencheskiy Nauchny Vestnik, 2014, Available: http://www.scienceforum.ru/2014/pdf/1657.pdf (Accessed: 12.12.2015) (In Russ.)

7. Interstitsialnye zabolevaniya lyogkikh. Rukovodstvo dlya vrachey. [Interstitial pulmonary diseases. Doctors' guidelines]. M.M. Ilkovich, A.N. Kokosov, eds. St. Petersburg, Nordmedizdat Publ., 2005, pp. 288-328.

8. Kotlyarov P.M., Yudin А.L., Georgiadi S.G. Differential X-ray diagnostics of diffuse pulmonary diseases. Part 1. Med. Vizualizatsiya, 2003, no. 4, pp. 20-28. (In Russ.)

9. Filatova E.А., Repin D.V., Saveliev А.V., Skornyakov S.N., Chernyaev E.А., Goldshteyn S.L., Markina S.E., Gayniyarov I.M. RF Patent no. 90058 as of 16.09.14. Skhema algoritma podscheta ob”ema izmenennoy tkani pri disseminirovannom porazhenii legkikh (DPL) s primeneniem metoda trekhmernoy rekonstruktsii, UNIIF, UrFU. [The scheme of the algorithm for calculating the volume of pathologic tissue in disseminated lung lesions (DPL) using the method of three-dimensional reconstruction, UNIIF, UrFU].

10. Shmelev E.I. Differential diagnostics of disseminated pulmonary diseases of nonneoplastic nature. RMJ, 2001, no. 21, pp. 940-945. (In Russ.)

11. Austad A., Elle O.J., Røtnes J.S. Computer-aided planning of trocar placement and robot settings in robot-assisted surgery. International congress series. Elsevier Publ., 2001, vol. 1230, pp. 1020-1026.

12. Azimian H., Patel R.V., Naish M.D., Kiaii B. A semi-infinite programming approach to preoperative planning of robotic cardiac surgery under geometric uncertainty. IEEE J. Biomed. Health Inform., 2012, vol. 17, no. 1, pp. 172-182.

13. Enquobahrie A., Shivaprabhu V., Aylward S., Finet J., Cleary K., Alterovitz R. Patient-specific port placement for laparoscopic surgery using atlas-based registration. Medical Imaging 2013: Image-Guided Procedures, Robotic Interventions, and Modeling. International Society for Optics and Photonics, 2013, vol. 8671, pp. 86711M.

14. Felix Ritter Visual Programming for Prototyping. IEEE Visualization 2007.

15. Interstitial Lung Diseases. European Respiratory Society Monograph, vol. 46, 2009, doi: 10.1183/1025448x.ERM4609).

16. Koontz C.H., Joyner L.R., Nelson R.A. Transbronchial lung biopsy via the fiberoptic bronchoscope in sarcoidosis. Ann. Intern. Med., 1976, vol. 85, pp. 64-66.

17. Spagnolo P., Tonelli R., Cocconcelli E., Stefani A., Richeldi L. Idiopathic pulmonary fibrosis: diagnostic pitfalls and therapeutic challenges. Multidisciplinary Respir. Med., 2012, vol. 7, no. 1, pp. 42.

18. Torres L.G., Azimian H., Enquobahrie A. A user-friendly automated port placement planning system for laparoscopic robotic surgery. Medical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling. Intern. Soc. Optics Photonics, 2014, vol. 9036, pp. 903613.