MP41-19: Phase I NCT03738488. Feasible 3D printed models of renal cell carcinoma with venous thrombus extension for surgical planning and simulation.

Ines Rivero Belenchon*, Carmen Belen Congregado Ruiz, Gorka Gomez Ciriza, Seville, Spain, Victoria Gomez Dos Santos, Madrid, Spain, Cristina Asensio, Seville, Spain, Cristina Gonzalez Gordaliza, Madrid, Spain, Ignacio Osman Garcia, Jose Manuel Conde Sanchez, Seville, Spain, Francisco Javier Burgos Revilla, Madrid, Spain, Rafael Antonio Medina Lopez, Seville, Spain

Introduction: Renal Cell Cancer (RCC) accounts for 3-5% of all adults malignancies, and up to 10% are presented with venous thrombus extension (VTE). This worsens prognosis and represents a therapeutic challenge. 3D biomodels are printed copies of patients´ radiological images with visual and tactile components that enhance understanding of anatomy and may improve surgical planning, communication and training. This is a Multicenter Clinical Trial (NCT03738488), which aims to assess the efficacy and efficiency of surgery planning with 3D in RCC with VTE. The objective of the phase I is to obtain a feasible, affordable, accurate and suitable for surgical simulation 3D model.

Methods: A CT image in early arterial and nephrogenic phase was obtained. ITK-snap ® and VirSSPA Software ® were used for segmentation. The resulting 3D mesh was processed with MeshMixer ®. Multiple models were printed using different 3D printers and materials. We evaluated: material, scale, thickness, accuracy, suitability for surgery, cost and printing time. 6 urologists completed a satisfaction questionnaire

Results: 4 models were discarded (table 1). The selected one was printed with BQ Witbox FDM printer in polyurethane filament with a 0.8mm thickness and 100% scale. All anatomical structures could be correctly identified with a good accuracy compared to the CT ( < 5mm deviation) and the surgery could be performed on it. Model cost was 15€ and whole processing and printing time 48h.

100% of urologists thought that the obtained 3D model could be useful for surgery planning and simulation.

3D

Model adequacy (yes / no)

Cost (€)

Printing time (h)

Discarded (yes/no)

Reason for discard

Printer

Material

Material

Scale

Thickness

Accuracy

Surgery performance

1

BQ Witbox

Rigid PLA

No

No

Yes

No

No

15

48

Yes

Material

2

BQ Witbox

Flexible PU

Yes

No

Yes

No

Yes

15

48

Yes

Structures identification

3

BQ Witbox

Flexible PU

Yes

Yes

No

Yes

Yes

15

48

Yes

Thickness

4

Stratasys

Polyjet

Agilus flexible

No

Yes

No

No

No

180

72

Yes

precision

BQ Witbox

Flexible PU

5

BQ Witbox

Flexible PU

Yes

Yes

Yes

Yes

Yes

15

48

No

-

Conclusions: - A feasible and affordable 3D printed model of RCC with VTE was obtained.
- It was accurate compared to the CT and suitable for surgery simulation.
- Urologists thought it could be useful for surgery planning and simulation.

Source of Funding: Funded by Pfizer