Multi-modal 3-Dimensional Visualization of Pediatric Neuroblastoma: Aiding Surgical Planning Beyond Anatomical Information

Patient-specific 3D models of neuroblastoma and relevant anatomy are useful tools for surgical planning. However, these models do not represent the heterogenous biology of neuroblastoma. This heterogeneity is visualized with the ADC and 123I-MIGB-SPECT-CT imaging. Combining these multi-modal data in...

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Bibliographic Details
Published in:Journal of pediatric surgery 2024-08, Vol.59 (8), p.1575-1581
Main Authors: Simons, Dominique C., Buser, Myrthe A.D., Fitski, Matthijs, van de Ven, Cornelis P., ten Haken, Bernhard, Wijnen, Marc H.W.A., Tan, Can Ozan, van der Steeg, Alida F.W.
Format: Article
Language:English
Subjects:
MIBG
MRI
Neuroblastoma
Pediatric oncology
SPECT
Surgery
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Summary:Patient-specific 3D models of neuroblastoma and relevant anatomy are useful tools for surgical planning. However, these models do not represent the heterogenous biology of neuroblastoma. This heterogeneity is visualized with the ADC and 123I-MIGB-SPECT-CT imaging. Combining these multi-modal data into preoperative 3D heatmaps, may allow differentiation of the areas of vital and non-vital tumor tissue. We developed a workflow to create multi-modal preoperative 3D models for neuroblastoma surgery. We included 7 patients who underwent neuroblastoma surgery between 2022 and 2023. We developed 3D models based on the contrast enhanced T1-weighted MRI scans. Subsequently, we aligned the corresponding ADC and 123I-MIBG-SPECT-CT images using rigid transformation. We estimated registration precision using the Dice score and the target registration error (TRE). 3D heatmaps were computed based on ADC and 123I-MIBG uptake. The registration algorithm had a median Dice score of 0.81 (0.75–0.90) for ADC and 0.77 (0.65–0.91) for 123I-MIBG-SPECT. For the ADC registration, the median TRE of renal vessels was 4.90 mm (0.86–10.18) and of the aorta 4.67 mm (1.59–12.20). For the 123I -MIBG-SPECT imaging the TRE of the renal vessels was 5.52 mm (1.71–10.97) and 5.28 mm (3.33–16.77) for the aorta. We successfully developed a registration workflow to create multi-modal 3D models which allows the surgeon to visualize the tumor and its biological behavior in relation to the surrounding tissue. Future research will include linking of pathological results to imaging data, to validate these multi-modal 3D models. Level IV. Clinical Research.
ISSN:0022-3468
1531-5037
1531-5037
DOI:10.1016/j.jpedsurg.2024.02.025