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Sandy Srinivas, MD
Sandy Srinivas, MD
Posted: Tuesday, August 30, 2022
Joseph D. Shirk, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues evaluated the utility of creating three-dimensional (3D) virtual reality (VR) models through data collected from multiparametric MRI. They sought to learn whether these models would assist in achieving the desired goals of prostate cancer surgery: controlling and/or removing the cancer while maintaining urinary continence and sexual function of the patient. The findings of their randomized controlled trial were published in The Journal of Urology. “Notably, surgeons were often more aggressive with nerve sparing after viewing the 3D VR models,” the investigators wrote, giving them the ability to “precisely select the right operative pathway regarding margins” and avoid nerve damage.
The multiparametric MRI technique is used to provide a detailed structure of the patient-specific prostate cancer and involved anatomy. However, it requires an extensive background knowledge and extra training. Ideally, the surgeons would be able to combine the information given from the multiparametric MRI and the 3D VR models to create a surgical approach that will save the nerves in the surrounding area.
The clinical trial included 92 patients undergoing robotic-assisted laparoscopic radical prostatectomy. One group’s surgeons performed surgery having access to standard MRI scans and prostate biopsy results alone. The other group’s surgeons performed surgery with access to 3D VR models in addition to the MRI and biopsy results.
According to the study authors, patients whose surgery involved 3D VR models were more likely to have complete removal of their prostate cancer and significantly lower levels of prostate-specific antigen after surgery (about 9% to 31% in the non-VR group)—an indicator of good cancer control. Urinary continence and sexual function were similar between the two groups; thus, the use of 3D VR models did not seem to sacrifice the functional portion of the desired postoperative effects. A total of 92% of surgeries involved a nerve-sparing approach in the VR group versus 78% in the control group.
Disclosure: For full disclosures of the study authors, visit auajournals.org.
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