Evaluating non-contrast 3D reconstructions for pulmonary segmentectomy: a reliable alternative to contrast-enhanced models in thoracic surgery.
[BACKGROUND] Thoracoscopic segmentectomy is increasingly used to treat early-stage non-small cell lung cancer (NSCLC) due to its ability to preserve pulmonary function and maintain quality of life.
APA
Lafouasse C, Essid R, et al. (2025). Evaluating non-contrast 3D reconstructions for pulmonary segmentectomy: a reliable alternative to contrast-enhanced models in thoracic surgery.. Journal of thoracic disease, 17(11), 9885-9894. https://doi.org/10.21037/jtd-2025-716
MLA
Lafouasse C, et al.. "Evaluating non-contrast 3D reconstructions for pulmonary segmentectomy: a reliable alternative to contrast-enhanced models in thoracic surgery.." Journal of thoracic disease, vol. 17, no. 11, 2025, pp. 9885-9894.
PMID
41376970
Abstract
[BACKGROUND] Thoracoscopic segmentectomy is increasingly used to treat early-stage non-small cell lung cancer (NSCLC) due to its ability to preserve pulmonary function and maintain quality of life. Preoperative three-dimensional (3D) reconstructions are essential for planning this procedure, particularly for identifying anatomical variations and ensuring precise resections. While intravenous (contrast-enhanced) (IV) 3D models are the gold standard, they are associated with risks such as allergic reactions, renal impairment, and logistical challenges. The aim of this study was to evaluate whether non-intravenous (non-contrast imaging) (NIV) 3D models can provide an anatomically reliable alternative to IV-based models for preoperative planning in pulmonary segmentectomy.
[METHODS] This mixed-designed study with prospective enrollment and retrospective data analysis evaluated the anatomical equivalence of NIV 3D models by Visible Patient compared to IV-based models in 24 patients scheduled for pulmonary segmentectomy. Postoperative analysis assessed concordance between the models and intraoperative findings, focusing on the impact of any discrepancies on surgical decision-making.
[RESULTS] NIV models demonstrated an 83.3% concordance rate with IV models for major anatomical structures, including significant vascular and bronchial variations. Minor differences, primarily involving small intraparenchymal vessels, were observed in 16.7% of cases but had no impact on surgical strategy. Both models reliably identified complex variants, such as mediastinal lingular arteries, highlighting the clinical utility of NIV reconstructions.
[CONCLUSIONS] NIV 3D models by Visible Patient offer a reliable alternative for preoperative planning, particularly in patients contraindicated for contrast agents. While IV models remain the gold standard, NIV models address critical challenges, including contrast-related risks and logistical inefficiencies, supporting their integration into routine thoracic surgical practice. Further multicenter validation is recommended.
[METHODS] This mixed-designed study with prospective enrollment and retrospective data analysis evaluated the anatomical equivalence of NIV 3D models by Visible Patient compared to IV-based models in 24 patients scheduled for pulmonary segmentectomy. Postoperative analysis assessed concordance between the models and intraoperative findings, focusing on the impact of any discrepancies on surgical decision-making.
[RESULTS] NIV models demonstrated an 83.3% concordance rate with IV models for major anatomical structures, including significant vascular and bronchial variations. Minor differences, primarily involving small intraparenchymal vessels, were observed in 16.7% of cases but had no impact on surgical strategy. Both models reliably identified complex variants, such as mediastinal lingular arteries, highlighting the clinical utility of NIV reconstructions.
[CONCLUSIONS] NIV 3D models by Visible Patient offer a reliable alternative for preoperative planning, particularly in patients contraindicated for contrast agents. While IV models remain the gold standard, NIV models address critical challenges, including contrast-related risks and logistical inefficiencies, supporting their integration into routine thoracic surgical practice. Further multicenter validation is recommended.