Patient-specific virtual simulation - a state of the art approach to teach renal tumor localization

To test a novel visuospatial testing platform improve trainee ability to convert two-dimensional (2D) to three-dimensional (3D) space.

Medical students were recruited from Baylor College of Medicine and McGovern Medical School (Houston, TX). We 3D reconstructed three partial nephrectomy cases using a novel, rapid and highly accurate edge-detection algorithm. Patient-specific reconstructions were imported into the dV-Trainer (Mimics Technologies, Seattle, WA) and used to generate custom 3D printed physical models. Tumor location was altered digitally to generate nine physical models for each case, one with the correct tumor location and eight with sham locations. Subjects were randomized 1:1 into the dV-Trainer (intervention) and No-dV-Trainer (control) groups. Each subject completed the following steps: (1) visualization of computed-tomographic images, (2) visualization of the reconstructed kidney and tumor in the dV-Trainer (intervention group only), and (3) selection of the correct tumor location on the 3D printed models (primary outcome). Normalized distances from the correct tumor location were quantified and compared between groups.

100 subjects were randomized for this study. dV-Trainer use significantly improved subjects ability to localize tumor position (Tumor Localization Score: 0.24 vs. 0.38, p<0.001). However, subjects in the No-dV-Trainer group more accurately assigned R.E.N.A.L.

Even brief exposure to interactive patient-specific renal tumor models improves a novice's ability to localize tumor location. Virtual reality simulation prior to surgery could benefit trainees learning to localize renal masses for minimally invasive partial nephrectomy.

Urology. 2018 Jun 27 [Epub ahead of print]

Arun Rai, Jason M Scovell, Ang Xu, Adithya Balasubramanian, Ryan Siller, Taylor Kohn, Young Moon, Naveen Yadav, Richard E Link

Scott Department of Urology., Scott Department of Urology; Translational Biology and Molecular Medicine., Scott Department of Urology; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA.. Electronic address: .

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