Patient Specific Anatomy: From Concept to Clinical Routine

Medical imaging (CT-scan or MRI) allows to see patient anatomy and pathologies from gray level slices. But how to efficiently detect an anatomical variation in the image from these slices? The solution lies in image processing programs that provide a 3D reconstruction of patient anatomy. In order to truly take advantage of this personalized 3D anatomy, preoperative planning or simulation software has to be added so as to test the surgical strategy before surgery with no risk for the patient. Among the available solutions only one is currently 100% covered in France by an increasing number of private health insurances: The Visible Patient solution, which is an online medical image analysis laboratory. We will illustrate in thoracic, digestive, urologic and pediatric surgery the interest of this solution providing personalized 3D anatomy in clinical routine. In each case we will present the limits of usual medical image analysis due to an average anatomical definition and limited human perception. 3D modelling is provided by an online service that has the advantage of being usable anywhere in France without any specific infrastructure and being covered by a growing number of private health insurances, making it possible to use in clinical routine. We will then compare the result obtained from a normal anatomical analysis with the result obtained from the 3D modelling and associated preoperative planning. These examples illustrate the great benefit of using patient-specific 3D modelling and preoperative virtual planning in comparison with the usual anatomical definition using only medical image slices. These examples also confirm that this new patient-specific anatomy corrects many mistakes created by the current standard definition, increased by physician interpretation that can vary from one person to another