The three-dimensional reconstruction of the dilated renal pelvicalyceal system by non-enhanced computed tomography

• Published in: Vestnik urologii (Online) Vol. 9; no. 3; pp. 19 - 24
• Main Authors: Guliev, B. G., Komyakov, B. K., Talyshinskiy, A. E.
• Format: Journal Article
• Language: English; Russian
• Published: State Budget Educational Institute of Higher Professional Education, Rostov State Medical University, Ministry Health of Russian Federation 05-10-2021
• Subjects: 3d-reconstruction; kidney; non-enhanced ct; pelvicalyceal system
• ISSN: 2308-6424; 2308-6424
• DOI: 10.21886/2308-6424-2021-9-3-19-24

Introduction.
The three-dimensional reconstruction of the renal pelvicalyceal system (PCS) is possible when performing enhanced computed tomography (CT). However, the use of a contrast agent has its limitations associated with the presence of allergy and chronic kidney disease.
Purpose of the study.
To describe the method of semi-autonomous three-dimensional (3D) reconstruction of the PCS based on non-enhanced CT images of patients with upper urinary tract obstruction.
Materials and methods.
Five patients diagnosed with renal colic were recruited from April-May 2021. All patients underwent CT-urography after informed consent. Medical Imaging Interaction Toolkit program (MITK) expanded with explainable update were used for 3D-reconstruction of PCS via excretory and native phases. To assess the accuracy of the latter, both contrast and non-contrast models were compared regarding their surface area. Also, the PCS of one patient was used to reconstruct virtual endoscopic views based on enhanced and non-enhanced models. Five urologists estimated their similarity and potential use of non-enhanced models for the interventional planning via a Likert scale questionnaire. The resulting models were also analyzed by programmer-engineers to test their suitability for 3D-printing.
Results.
The average surface area of enhanced and non-enhanced models was 3291 mm
2
and 2879 mm
2
, respectively. Obtained models were suitable for their intraluminal reconstruction and potential 3D-printing. Analyzed properties of non-enhanced models were estimated at 4.5 out of 5.0.
Conclusion.
The described semi-autonomous reconstruction of the renal PCS based on non-enhanced CT images allows for a short time to reconstruct its 3D-view in patients with the upper urinary tract obstruction.