Changes of Resection Goal After Using 3-Dimensional Printing Brain Tumor Model for Presurgical Planning

Abstract

Conventional 2D MRI-based neuronavigation systems can improve the maximal safe resection in brain tumor surgery but can be unintuitive. A 3D-printed brain tumor model allows for a more intuitive and stereoscopic understanding of brain tumors and adjacent neurovascular structures. This study aimed to identify the clinical efficacy of a 3D-printed brain tumor model in presurgical planning by focusing on differences in the extent of resection (EOR). Thirty-two neurosurgeons (14 faculty members, 11 fellows, 7 residents) randomly selected the two 3D-printed brain tumor models from the 10 manufactured models and performed presurgical planning following a standardized questionnaire. To compare the 2D MRI-based planning results with the 3D-printed model-based planning results, we analyzed the changing patterns and characteristics of the EOR. Of 64 randomly generated cases, the resection goal changed in 12 cases (18.8%). When the tumor was located intra-axially, the surgical posture required a prone position, and when the neurosurgeon was dexterous in surgery, there was a higher rate of EOR changes. 3D-printed models 2, 4, and 10, which all represented tumors in the posterior of the brain, had high rates of changing EOR. A 3D-printed brain tumor model could be utilized in presurgical planning to effectively determine the EOR.