Holographic Reconstructions for Preoperative Planning before Partial Nephrectomy: A Head-to-Head Comparison with Standard CT Scan

Urol Int. 2019;102(2):212-217. doi: 10.1159/000495618. Epub 2018 Dec 12.

Abstract

Background: Preoperative surgical planning before partial nephrectomy (PN) is a time-consuming and fragmentary process.

Objectives: To evaluate the differences in the perception of renal anatomy between holographic reconstruction (HR) versus computed tomography (CT) in patients who are candidate to PN.

Methods: CT scans of 10 consecutive patients with intermediate/high complexity renal masses (R.E.N.A.L. score > 8) scheduled for robot-assisted PN were translated into HR. Seven raters independently described how they interpreted several anatomical details from CT and HR respectively. The exams were presented unpaired and randomly. Inter-observer agreement and evaluation time were assessed. A questionnaire inquired clinical utility of CT and HR. Inter-observer agreement was measured by the Cohen's kappa test. Evaluation time for CT and HR was compared by the Kruskal-Wallis test, overall and per rater. Examiners answered to the questionnaire following a Likert scale.

Results: HR showed a higher inter-observer agreement, reaching a good level (k > 0.6) for almost all the anatomical details considered. Conversely, CT generally provided a fair or poor agreement (k < 0.6). The evaluation time was shorter for HR (mean 1.7 vs. 3.4 min, p < 0.0001). All raters declared that HR could facilitate preoperative planning before PN.

Conclusions: HR can be useful for preoperative surgical planning before PN to ease the understanding of anatomy.

Keywords: Computed tomography; Hologram; Partial nephrectomy; Robotic surgery; Surgical planning.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Clinical Decision-Making
  • Female
  • Holography*
  • Humans
  • Kidney Neoplasms / diagnostic imaging*
  • Kidney Neoplasms / surgery*
  • Male
  • Middle Aged
  • Nephrectomy / methods*
  • Observer Variation
  • Patient-Specific Modeling
  • Pilot Projects
  • Predictive Value of Tests
  • Radiographic Image Interpretation, Computer-Assisted
  • Reproducibility of Results
  • Robotic Surgical Procedures / methods*
  • Tomography, X-Ray Computed*
  • Tumor Burden