About the 3D planning Special Interest Group
The 3D Planning Special Interest Group (SIG) brings together experts in the TMVR field with an interest in 3D Planning technology for pre-procedural patient CT planning. The goal of the meeting is to share views on the assets, use and impact of the 3D Planning technology and to explore how the field can benefit and adopt the technology.
Exchange findings with experts in the structural heart field
Become part of the 3D Planning community
Help shape the future of transcatheter interventions
What is 3D Planning?
If you think about pre-procedural CT planning, you can identify two aspects – visualization and analysis (measurements). 3D Planning is a technology that starts from accurate 3D models (STL) to enable visualization and analysis fully in 3D. This is in core a different technology then the established planners use. There a visualization is offered in 3D (volume rendering) but the analysis of the planning remains on 2D CT slices.
As we know that structural heart encounters complex 3D problems, think about which information might be missed when being limited to 2D CT slices. You can compare it to a traditional map vs the GPS. The GPS automatically takes all options and factors into account when finding the best route. With a traditional map this will not only take you a long time, you can never be sure that you haven’t missed any option.
Volume rendering vs accurate 3D models
You can think of volume rendering as a ghost. You can see it, but you can’t grab or manipulate it to do an analysis. In that analogy accurate 3D models are real tangible models. You can manipulate, dissect and measure them allowing you to execute you analysis fully in 3D.
This video illustrates the difference quite nicely. Although volume rendering gives the impression of working in 3D, measurements are taken on the 2D projection of the model. When using accurate 3D models, measurements snap to the model, which allows evaluation in all three dimensions.
Where are we now, where could we be?
3D Planning technology
The group’s view
Time to take action!
MUST-READS ON THE TOPIC
“Multi-detector computed tomography-derived, 3D, virtual and printed models contribute to adequate planning in terms of determining patient eligibility, procedure feasibility, and device sizing.”
“Time to complete neo-LVOT assessment in 2 device positions was found to be between 1 and 5 min, representing a time savings of at least 75% when compared with traditional methods. Skill level of the operator had no significant impact on assessment time.”
Wang et al., TCT-862 A More Reliable Method for Predicting Neo-LVOT Obstruction after TMVR
“Direct comparisons of the accuracy and reproducibility of neo-LVOT prediction using MDCT planimetry and semi-automated MDCT-derived 3D computational models showed significantly higher interrater agreement in the semi-automated method”
“[…] this ongoing study suggests that automation of mitral valve quantification is possible and its performance is in line with that of a manual approach, potentially contributing to more consistent pre–transcatheter mitral valve replacement planning.”
“CAD design and CT postprocessing are indispensable tools in predicting LVOT obstruction and necessary for anatomic screening in percutaneous TMVR.”
Wang et al., “Predicting LVOT Obstruction After TMVR.”
“Successful transcatheter mitral valve replacement (TMVR) depends on accurate sizing of the mitral annulus and avoidance of LVOT obstruction.”