Three-dimensional modelling as a novel interactive tool for preoperative planning for complex perianal fistulas in Crohn's disease |
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Authors: | Sebastián Jeri-McFarlane Álvaro García-Granero Aina Ochogavía-Seguí Gianluca Pellino Anaí Oseira-Reigosa Alejandro Gil-Catalan Leandro Brogi Daniel Ginard-Vicens Margarita Gamundi-Cuesta Francisco Xavier Gonzalez-Argente |
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Affiliation: | 1. Colorectal Unit, General and Digestive Surgery Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain;2. Colorectal Surgery Unit, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona UAB, Barcelona, Spain;3. Simulation and 3D Reconstruction Area, Hospital Universitario Son Espases, Palma de Mallorca, Spain;4. Gastroenterology Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain |
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Abstract: | Aim The aim of this study is to demonstrate the added value of three-dimensional (3D) reconstruction models and artificial intelligence for preoperative planning in complex perianal Crohn's disease. MRI is the gold standard for diagnosis of complex perianal fistulas and abscess due to its high sensitivity, but it lacks high specificity values. This creates the need for better diagnostic models such as 3D image processing and reconstruction (3D-IPR) with artificial intelligence (AI) algorithms. Method This is a prospective study evaluating the utility of 3D reconstruction models from MRI in four patients with perineal Crohn's disease (pCD). Results Four pCD patients had 3D reconstruction models made from pelvic MRI. This provided a more visual representation of perianal disease and made possible location of the internal fistula orifice, seton placement in fistula tracts and abscess drainage. Conclusion Three-dimensional reconstruction in CD-associated complex perianal fistulas can facilitate disease interpretation, anatomy and surgical strategy, potentially improving preoperative planning as well as intraoperative assistance. This could probably result in better surgical outcomes to control perianal sepsis and reduce the number of surgical procedures required in these patients. |
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Keywords: | artificial intelligence Crohn disease rectal fistula three-dimensional imaging |
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