The Basic And Clinical Application Of Thoracic Three-dimensional Digital Modeling

Objective:1. To explore the methods for reconstructing the digital thorax model quickly and accurately based on personal computer (PC) using three-dimensional (3D) reconstruction techniques.2. To explore the methods for accurately constructing the finite element modeling (FEM) of thoracic region on the basis of digital model reconstruction.3. To explore the modeling method of lung cancer and to discuss the clinical value of 3D reconstruction of the lung tumor and related vascular system, and virtual surgery in pneumochirurgia.4. To perform individual 3D printing on the basis of the lung cancer modeling and to explore its clinical significance and feasibility in operation assistance.Methods:1. One healthy middle-aged male volunteer was chosen as the object in this research. The thoracic thin layer CT scanning was performed to collect the DICOM standardized image of the whole CT data sets. The CT images were imported to Mimics 18.0 software and the interested regions were segmented and calculated into 3D objects. Finally, the 3D digital visualized human models of integrated thorax were accurately reconstructed based on personal computer.2. We imported the thoracic 3D geometry surface mesh model, which was constructed using Mimics18.0 software in the first part of our study, directly into 3-matic software, and made the surface mesh optimization and meshing body. Then we transferred the body mesh model to the Mimics18.0 software again to accurately assign materials based on CT values. Finally, we imported it to the Ansys 14.5 software to establish the human thorax FEM.3. The image data of thoracic CT scan was obtained from the patients with lung cancer. Semi automated image segmentation and 3D reconstruction of the tumor were separately performed using Mimics software. At last, the individualized lung cancer model was established. Corresponding software tools were used to make surgical simulation on the model and its clinical application value was discussed.4. We chose 6 cases of lung cancer digital models and imported them into the 3D printer in STL file format. Then we obtained the individual solid model using 3D printing technology. Then, we made preoperative surgical planning and virtual surgery based on the solid model.Results:1. The integrated 3D digital visualized model of thoracic skin, bones, lungs, tracheobronchial tree and pulmonary blood vessels were reconstructed successfully based on PC. The models had highly definition and perfect 3D view, accurately reflecting the complex anatomic structure of the human thorax. Models could be fully edited and be output in a variety of common 3D formats for computer aided design, medical finite element analysis and other follow-up studies.2. Mimics software provided an efficient method to assign material according to the gray value of different tissues. The realistic appearance and structure accuracy of a human thorax FEM was developed successfully. The models included thoracic skin, bones, lung lobes, pulmonary vascular and tracheobronchial tree, which provided accurate model support for 3D finite element analysis.3. The 3D digital model of lung cancer was reconstructed successfully. The models had highly geometrical similarity and perfect 3D view, reflecting the true morphological characteristics of tumor and the spatial relationship among adjacent structures. Moreover, these structures of the thorax model could be moved, separated, combined, displayed and hided so as to perform multi-angle observation, relevant measurement. Based on lung cancer model, performing preoperative plan and virtual surgery could shorten the operation time..4. The structures of the solid model obtained by 3D printing technology accurately reflected the characteristics of the pathological changes and associated anatomical relationship. Based on the solid model, we made the preoperative planning and real-time guiding operation, which was feasible in clinical practice.Conclusion:In this study, the human thoracic 3D digital visualized model was quickly and accurately reconstructed using Mimics software on PC. On this basis, the FEM and lung cancer model were built, and the more intuitive solid model of lung cancer was further obtained using 3D printing technology. The transformation from 2D to 3D, from plane to stereoscopic, from static to dynamic and from virtual to physical were achieved, which had important practical significance in scientific research, teaching and assisted surgery. The softwares used in this study are friendly, can be fully edited, and can be run on a computer with general configuration. Thoracic surgeons can also complete modeling and relevant work through self-study even though they have no science and engineering background. Then modeling cost was saved, economy benefit was acquired and the foundation for some difficult surgery was alsolaid. Therefore, this research has potential for replication in clinical practice.