The value of DWI-based fractal dimension in evaluating the clinical efficacy of 3D printing technology for gliomas after surgery
Objective:To evaluate whether personalized 3D printing technology can improve the clinical outcomes of surgically treated glioma patients using diffusion weighted imaging(DWI)-based FD.Materials and Methods:We retrospectively analyzed 136 cases of patients with pathologically confirmed gliomas in our hospital from January 2018 to January 2023,of which 32 cases were in the experimental group,in which the personalized 3D printing technology was used preoperatively;the remaining patients were in the control group,in which conventional craniotomy was performed.The boundaries around the operated area were manually outlined on DWI maps one week after surgery,and the FD was measured after drawing binary maps.Using the median FD to group the control group,we compared whether there was a difference in surgical condition,pain level,neurological deficit,prognosis,and ability to perform daily life between patients with high and low FD in the control group;and explored whether the personalized 3D printing technology affected the FD of the edematous trauma and whether it would further improve the clinical outcome of the patients.Results:The degree of pain(t=-13.228,P<0.001)and the degree of nerve defect(t=-2.627,P=0.008)in the high FD group were higher than those in the low FD group,and the activities of daily living(t=4.821,P<0.001)and prognosis(t=-3.058,P=0.003)were worse than those in the low FD group.The results of receiver operating characteristic(ROC)curve showed that FD could effectively distinguish the above four scores of patients.The use of personalized 3D printing technology before operation can reduce the FD of patients with edema zone,reduce the degree of nerve defect and improve the ability of daily living,but it has no obvious effect on improving the prognosis and pain in the operation area.Conclusions:Personalized 3D printing technology can effectively reduce the FD of the oedema band in the surgical area of patients and reduce nerve damage,which is worthy of clinical application.
gliomadiffusion-weighted imagingmagnetic resonance imagingfractal dimension3D printing technologyprecision medicine