Neoplasms

All Conditions

Pelvic Neoplasms

Children with a pelvic or retroperitoneal tumor requiring an MRI or CT scan for a possible surgical intervention

Thomas BLANC, MD

Gael PLASTOW

Sabine SARNACKI, MD

This study's purpose is the comparison of the automatically segmented 3D model to the reference manual segmentation, based on the Dice precision index. It is implemented by making parents' patients, surgeons and surgical helpers answer specific questions comparing 3D images to usual 2D images of the patient's tumor.

The investigator will inform the child and his parents during the pre-surgical consultation, and will collect their non-opposition to be included in the study at the latest on the day of the MRI examination or CT scan. Patients requiring emergency imaging will not be included.

Pelvic tumors will benefit from MRI imaging and renal tumors from MRI and/or CT scan.

A CT scan will be carried out for retroperitoneal tumors other than renal tumors (mainly neuroblastomas).

All of the above examinations are carried out as part of the usual treatment, in the month preceding the surgery.

Pre-operatively After the imaging has been carried out, the 2D images will be presented to the patient and his family before surgery as it is done routinely. The 3D image will be showed afterwards. The family will have the opportunity to ask questions which the surgeon will answer as usually done.

The specific questionnaire will be completed by the patient and his family at the end of the consultation and given to the research team.

Once the patient is included and the examinations have been carried out, the operating surgeons and their assistants (help No. 1 and 2) will look at the 2D images, followed by the 3D images secondly a few days before surgery. They will complete the specific questionnaire and give it to the research team.

Once the patient is included and the imaging examinations have been carried out, surgeons external to the service will be contacted by the research team to organize a remote review session. The 2D images will be presented to them first, followed by the 3D images on the visualization software, via a remote communication system with screen sharing. They will complete the specific questionnaire independently and a copy of the questionnaires will then be sent to the research team by email and the originals sent by post.

Intraoperatively:

The 3D model of the patient will be displayed in the operating room, and/or integrated into the robot's display console (for robot-assisted surgeries) during the surgical procedure. At the end of the surgery, the operating surgeon and his assistants will complete (independently) a questionnaire on the consistency of the 2D and 3D images with the anatomy identified during the procedure and on the help or not provided by the 3D model.

Contribution of 3D Modeling in Surgical Management of Pediatric Retroperitoneal and Pelvic Tumors

Non-interventional Study on the Contribution of 3D Modelling in Surgical Management of Pediatric Retroperitoneal and Pelvic Tumors Compared to 2D Imaging

Comparison of the automatically segmented 3D model to the reference manual segmentation

Distance comparison between the reference segmentation and the one obtained by the algorithm

Recognition of anatomical structures comparison from 2D imaging and 3D imaging by surgeons preoperatively

Contribution of 3D modeling comparison to 2D imaging in pre-operative planning

Added value evaluation of 3D modelling compared to 2D imaging for surgeons pre-operatively

Surgeons' support evaluation for integrating 3D modelling into routine pre-operative planning

Evaluation of the contribution of 2D imaging for families in understanding the information (pathology and surgery) delivered by the surgeon to parents pre-operatively

Evaluation of the contribution of 3D modelling for families in understanding the information (pathology and surgery) delivered by the surgeon to parents pre-operatively

Added value evaluation of 3D modelling compared to 2D imaging for families pre-operatively

Contribution of 3D modelling evaluation compared to 2D imaging for surgeons during surgery

Consistency evaluation of the 3D imaging with anatomy observed intraoperatively

Surgeons' support evaluation for integrating 3D modeling into their current practice

Imagine Institute

Assistance Publique - Hôpitaux de Paris

Diseases and Abnormalities at or Before Birth

Congenital Abnormalities

This study is part of the launch of a multidisciplinary project called IMAG2, for image-guided minimally invasive surgery. It involves collaboration between the radiology and surgery teams at Necker Hospital and the Image Processing and Interpretation (TII) team at the LTCI at Télécom ParisTech.

To make a decision, surgeons need access to a 3D model reflecting the anatomy of the specific patient and its pathological variations. Patient-specific 3D reconstruction provides a significant improvement, leading to a precise assessment of the malformation or tumour and its relationship with surrounding organs, nerves and vessels. It allows the surgeon to simulate a pre-operative procedure, which is a definite advantage in terms of safe, effective and curative surgery, particularly in oncology. MRI has been chosen as the basic imaging technique because of its non-irradiating nature and the current lack of 3D MRI reconstruction technology.

The study aims to provide an aid to diagnosis and surgical planning by developing dedicated methods and algorithms for segmenting not only the tumour but also the main anatomical components surrounding the tumour from 3D MRI imaging data. The imaging will be performed on a 3 Tesla MRI. The data will be that required for diagnosis and surgical planning, acquired on a routine clinical basis with an expected benefit for patients.

Computational Anatomy in Surgery for Childhood Tumours and Malformations

Nerve network in areas of interest (pelvis) using tractography analysis with 3 Tesla MRI by automation of 3D imaging using images produced by General Electrics' 3 Tesla MRI. This automation will be carried out using software developed by Telecom Paristech.

Study title	NCT ID	Conditions	Eligibility	Organization
Contribution of 3D Modeling in Surgical Management of Pediatric Retroperitoneal and Pelvic Tumors	NCT06418243	Pelvic Tumor Retroperitoneal...	3 Months - 17 Years	Assistance Publique - Hôpitaux de Paris
Contribution of 3D Modeling in Surgical Management of Pediatric Retroperitoneal and Pelvic Tumors	NCT06418243	Pelvic Tumor Retroperitoneal...	3 Months - 17 Years	Assistance Publique - Hôpitaux de Paris
Computational Anatomy in Surgery for Childhood Tumours and Malformations	NCT06224985	Malformation Tumor Paediatric Surg... 3D Imaging	5 Months - 17 Years	Imagine Institute

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