A Personalized 3D-Printed Model for Preoperative Evaluation in Thyroid Surgery

Summary

Here, a new method of establishing a personalized 3D-printed model for preoperative evaluation of thyroid surgery is proposed. It is conducive to preoperative discussion, reducing the difficulty of thyroid surgery.

Abstract

The anatomic structure of the surgical area of thyroid cancer is complex. It is very important to comprehensively and carefully evaluate the tumor location and its relation with the capsule, trachea, esophagus, nerves, and blood vessels before operation. This paper introduces an innovative 3D-printed model establishment method based on computerized tomography (CT) DICOM images. We established a personalized 3D-printed model of the cervical thyroid surgery field for each patient who needed thyroid surgery to help clinicians evaluate the key points and difficulties of the surgery and select the operation methods of key parts as a basis. The results showed that this model is conducive to preoperative discussion and the formulation of operation strategies. In particular, as a result of the clear display of the recurrent laryngeal nerve and parathyroid gland locations in the thyroid operation field, injury to them can be avoided during surgery, the difficulty of thyroid surgery reduced, and the incidence of postoperative hypoparathyroidism and complications related to recurrent laryngeal nerve injury reduced too. Moreover, this 3D-printed model is intuitive and aids communication for the signing of informed consent by patients before surgery.

Introduction

Thyroid nodules are one of the most common endocrine diseases, among which thyroid cancer accounts for 14%-21%¹. The preferred treatment for thyroid cancer is surgery. However, because the thyroid gland is located in the anterior cervical area, there are important tissues and organs close to the thyroid gland in the operation area, such as the parathyroid gland, trachea, esophagus, and cervical great vessels and nerves^2,3, making the operation relatively difficult and risky. The most common surgical complications are a decrease in parathyroid function caused by parathyroid function inju....

Protocol

This study did not need approval to perform or any sort of consent from the patients to use and publish their data, because all the data and information in this study and video were anonymized.

1. Collection of image data

1. Scan the patient's thyroid by enhanced computerized tomography (CT) to obtain the image data in DICOM format. Ensure that this process is done within 1 week before the operation and control the slice thickness so that it is ≤1 mm.
<.......

Discussion

Ultrasound may be the only preoperative imaging procedure for most patients undergoing thyroid surgery¹⁵. However, a few well-differentiated cases may suffer from advanced diseases, which invade the surrounding tissues or organs and hinder the operation¹⁶. This model may be more suitable for patients with far-advanced thyroid cancer. When the disease progresses, additional CT scanning is helpful for further diagnosis. This model is based on CT scanning, which provides more .......

Materials

Name	Company	Catalog Number	Comments
3D color printer	Zhuhai Sina 3D Technology Co	J300PLUS	Function support: automatic optimized placement, automatic model typesetting, automatic generation support, real-time layered edge cutting and printing, slice export, custom color thickness, custom placement / scaling, man hour evaluation, material consumption evaluation, print status monitoring, material remaining display, changing materials and colors, managing work queues, full / semi enclosed printing, automatic detection of model interference, layer preview, automatic pause of ink shortage, power failure to resume printing Automatic cleaning nozzle, automatic channel adaptation, ink change, automatic cleaning pipeline, follow-up laying. Range of optional materials: RGD series transparent molding materials, RGD series opaque molding materials, FLX series soft molding materials, ABS like series molding materials, high temperature resistant molding materials, Med series molding materials (first-class medical record certification), ordinary supporting materials, water-soluble supporting materials.
Mimics 21.0 software	Materialise, Belgium		DICOM data processing