7. The Intervention Planning

 

7.3. Virtual Resection

 

  1. The volumes of the liver, tumors and territories are (1) displayed in the list.
  2. The virtual planning is disposed in "Strategies" which are saved in the list. (2). Thus, you have got the possibility to test and save different therapy versions (resection surfaces) for the intervention.
  3. Please map out a new strategy for each therapy version (3).
  4. You may also get back to the assessment of the vascular anatomy. (4)

 

  1. Afterwards you can add a resection surface to the strategy ("Add Resection") (1).

 

  1. Draw the position of the plane into the 2D layers (1) (draw the lines by pushing the left mouse button and moving the mouse). Draw in the course of the resection lines in some layers. It is not necessary to do so in every layer, each 10th layer would be sufficient. It is recommmended to draw the position of the lines in layers with critical points, e.g., near vessels in several successive layers.
  2. It is possible to delete the line of a layer again by pushing the button "Undo Line" (2).
  3. The present resection can be cancelled with "Cancel Resection" (3). This command deletes all resection lines.
  4. When the resection lines are drawn, you can generate a surface from these lines ("Generate Plane") (4).

 

  1. Please define the part of the liver to be resectioned (by mouse click) (1). Thereupon, the volumes of the resection are calculated automatically.

 

  1. The volumes of the resected and the remaining part of the liver are displayed (1).
  2. You can change the resection surface subsequently by "pulling" the lines. Afterwards, the volumes need to be recalculated. Therefore, push the button "Refresh Volumes" (2).
  3. To delete the marker and to place a new one, please choose "<< Reset Marker" (3).
  4. You can cancel the present resection (4).
  5. Go to the next step if you are satisfied with the result (5).

 

 

In this step, your planning result is presented on a 3D model of the liver, the tumor and the vascular systems of the patient. The following options, which are displayed in the area under the viewer, are available for the interaction with the 3D model (Attention: for all interactions with the 3D model, the "hand" tool of the viewer must be chosen):

  • Rotation: press the left mouse button and move the mouse, or rotation in horizontal or vertical direction through the wheels "RotX" or "RotY" at the edge of the viewer
  • Shifting: pressed left mouse button and pressed control key and movement of the mouse
  • Zoom: press the left mouse button, the control key and the shift key simultaneously and move the mouse
  • Selection of an object: click on an object with the left mouse button

Verify your planning by means of this model.

  1. For a modification of your resection surface, first of all, choose the arrow tool (1) of the viewer. (Hint: The plane can only be distorted beyond the displayed structures. (Thus, it is recommended to hide the liver capsule at this step.)
  2. Now you can distort the plane in the 3D view. (2).
  3. After modification of the plane, the partial volumes of the liver should be recalculated (3).
  4. Save your transection if you are satisfied with the planning (6).
  5. If you would like to modify the transection plane in 2D, go back to the previous step (4).

 

Modification of the resection surface:

  1. For a modification of your resection surface, first of all, choose the arrow tool (1) of the viewer. Afterwards you can deform the plane in the 3D view ("touch and pull" the plane, see images above).

 

  1. When the resection is saved, a list with all strategies is displayed. Now you have got the possibility to add a further resection surface to the strategy (1) (therefore, the strategy must be selected), a further therapy option in a new strategy (2) to test or to delete the selected strategy (3) .
  2. Saved resections can be edited (4) or deleted (3) if they have been selected in the list.

 

To reach the next step—the analysis of your planning—push the button "next step >>" (1) .

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