Abstract | OBJECTIVE: DESIGN: Enhanced 3D rendering methods can be used to transform computed tomographic scan images into a model for 3D VNE. In addition to a standard imaging modality, 3D VNE was performed in all patients and used to preoperatively plan minimally invasive parathyroidectomy. All preoperative localization studies were analyzed for their sensitivity, specificity, positive predictive value, and negative predictive value for the correct side of the adenoma(s) (lateralization) and the correct quadrant of the neck (localization). The 3D VNE model was used to generate intraoperative augmented reality in 3 cases. SETTING: Tertiary care center. PATIENTS: RESULTS: The accuracy of 3D VNE in lateralization and localization was 77.2% and 64.9%, respectively. Virtual neck exploration had superior sensitivity to ultrasonography (P.001), sestamibi scanning (P=.07), and standard computed tomography (P.001). Use of the 3D model for intraoperative augmented reality was feasible. CONCLUSIONS: 3-Dimensional VNE is an excellent tool in preoperative localization of parathyroid adenomas with sensitivity, specificity, and diagnostic accuracy commensurate with accepted first-line imaging modalities. The added value of 3D VNE includes enhanced preoperative planning and intraoperative augmented reality to enable less-invasive image-guided surgery.
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Authors | Jacopo D'Agostino, James Wall, Luc Soler, Michel Vix, Quan-Yang Duh, Jacques Marescaux |
Journal | JAMA surgery
(JAMA Surg)
Vol. 148
Issue 3
Pg. 232-8; discussion 238
(Mar 2013)
ISSN: 2168-6262 [Electronic] United States |
PMID | 23682370
(Publication Type: Journal Article)
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Topics |
- Adenoma
(complications, surgery)
- Adult
- Aged
- Aged, 80 and over
- Feasibility Studies
- Female
- Humans
- Hyperparathyroidism, Primary
(complications)
- Imaging, Three-Dimensional
- Male
- Middle Aged
- Minimally Invasive Surgical Procedures
(methods)
- Neck
- Parathyroid Neoplasms
(complications, surgery)
- Surgery, Computer-Assisted
- Young Adult
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