Clinical effcacy of customized 3D printing positioning guide plate assisted microsurgery for resection of supratentorial brain tumors

LIU Fa-jian; ZHANG Shun-xin; LIU Qi-dong; CAO De-qian; HUANG Ze-yun; WANG Yang; XU Ru-xiang; FENG Jin-zhou

doi:10.13798/j.issn.1009-153X.2024.04.008

Abstract：Objective To explore the reliability and safety of 3D printing technology based on multimodal CT and MRI images in facilitating microsurgical resection of supratentorial brain tumors.Methods The clinical data of 56 patients with supratentorial brain tumors underwent surgical resection from June 2021 to June 2022 were retrospectively analyzed.Of these 56 patients,27 patients underwnt surgery guided by neuronavigation system(neuronavigation group)and 29 guided by 3D printing positioning guide plate(3D printing group).The individualized customization process of 3D printing guide plates entailed:The original data in DICOM format of preoperative CT,MRI and other images were dispatched to the database of the medical 3D printing center for multimodal image fusion and three-dimensional modeling,thereby clearly delineating the adjacent relationship between the lesion and adjacent significant blood vessels and nerves.Based on the model,the surgical path was rationally planned,and subsequently,the positioning guide plate was designed by exploiting the relationship between the surgical path and specific areas of the cranial surface.Results The patients in both groups successfully completed the operations without surgical death.The positioning time in the 3D printing group was significantly shorter than that in the navigation group(P<0.05).However,there were no significant differences in lesion accuracy,total resection rate,and GOS score at the three-month follow-up between the two groups(P>0.05).Conclusions Multi-modal image fusion with 3D printing technology can generate personalized physical models of brain tumors and provide surgical positioning guidance,effectively facilitating supratentorial brain tumor resections.This approach may serve as a viable alternative to certain aspects of the neuronavigation system.