Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer

Summary

In diagnosing and treating locally advanced thyroid cancer, the application of computer-aided three-dimensional reconstruction can provide additional information regarding the tumor scope and anatomic characteristics, thereby assisting in risk assessment and surgical planning.

Abstract

The diagnosis and treatment of locally advanced thyroid carcinoma are challenging. The challenge lies in the evaluation of the tumor scope and the formulation of an individualized treatment plan. Three-dimensional (3D) visualization has a wide range of applications in the field of medicine, although there are limited applications in thyroid cancer. We previously applied 3D visualization for the diagnosis and treatment of thyroid cancer. Through data collection, 3D modeling, and preoperative evaluation, we can obtain 3D information regarding the tumor outline, determine the extent of tumor invasion, and conduct adequate preoperative preparation and surgical risk assessment. This study aimed to demonstrate the feasibility of 3D visualization in locally advanced thyroid cancer. Computer-aided 3D visualization can be an effective method for accurate preoperative evaluation, the development of surgical methods, shortening the surgical time, and reducing the surgical risks. Furthermore, it can contribute to medical education and doctor-patient communication. We believe that the application of 3D visualization technology can improve outcomes and quality of life in patients with locally advanced thyroid cancer.

Introduction

Thyroid cancer is the seventh most common malignancy in China¹, and surgery is the most important treatment method^2,3. Complete resection of the tumor is strongly associated with high survival rates and a good quality of life in patients with locally advanced thyroid cancer^3,4; however, this type of resection is challenging. The neck contains important organs and tissues, such as the trachea, esophagus, and common carotid artery. Resection for advanced thyroid cancer is even more risky and difficult considering the proximity of ....

Protocol

This study protocol was approved by the Ethics Committee of Sichuan Cancer Hospital (Approval date: September 27, 2019). All the procedures involving human participants were performed in accordance with the ethical standards of the institutional and national research committees, as well as the 1964 Declaration of Helsinki and its later amendments. Written informed consent was obtained from all the patients before surgery.

1. Inclusion and exclusion criteria

1. Include patients if (1) they have pathologically confirmed thyroid cancer and require surgical treatment; (2) they have extensive local tumor infiltration, s....

Results

From December 2017 to July 2021, 23 patients with locally advanced thyroid cancer underwent 3D modeling. Of these 23 patients, 4 were excluded from surgery owing to surgical risks, and the remaining 19 patients were treated with surgery following 3D modeling (Table 1). All 19 patients had locally advanced thyroid cancer, including 14 for whom this was the initial diagnosis, 16 who had varying degrees of dyspnea, and 18 who had large tumors in the neck (primary thyroid tumor or metastatic lymph node) that.......

Discussion

For recurrent and metastatic differentiated thyroid carcinoma (DTC), surgical treatment is still preferred¹⁷. The 5 year disease-specific survival rate of patients with DTC and R0 resection is 94.4%, which is significantly higher than that of patients with R1 resection (67.9 %)². Achieving disease control in the neck is crucial for attaining a better quality of life and disease-specific survival for patients⁴. Medullary thyroid carcinoma is mainly tr.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Brilliance 256-layer spiral CT system	Philips Healthcare, Andover, MA, USA	N/A	Used for plain and enhanced CT imaging
3D-Matic digital medical software application	Anhui King Star Digital S&T Co. Ltd.	N/A	Used for computer-aided 3D visualization reconstruction