Virtual anatomical three-dimensional fit trial for intra-thoracically implanted medical devices.

ABSTRACT

Our purpose is to develop a system that converts computed tomography (CT) scans into an interactive three-dimensional (3-D) model of the thoracic cavity. This study will allow for the preoperative determination of optimal anatomical fit of intra-thoracically implanted medical equipment such as circulatory support devices. From the radiology data bank, we consecutively selected 34 cardiac and 42 noncardiac patients who had CT scans of the chest. Anatomical structures of the electronic CT scans were manually extracted using software. These structures included the thoracic cage, lungs, heart, and the great vessels. The information was converted into a 3-D surface mesh model, which was imported into a 3-D viewer to acquire direct anatomical measurements. The thoracic cage and intra-thoracic organs were measured for data analysis. A methodology was successfully developed to convert a patient's thoracic CT scans into interactive 3-D models, permitting the collection of key anatomical measurements to assess intra-thoracic device fit feasibility. Extensive measurements of the reconstructed thoracic cavity were recorded in a database format and analyzed. This study demonstrated the feasibility of implementing a rapid preoperative screening method based on anatomical fit for the selection or rejection of patients who are candidates for an intra-thoracic mechanical device. This new method will allow for the virtual preoperative implantation of such devices within a patient's chest cavity.