CT scan and 3D reconstruction

On the day of surgery, preoperative localization was conducted by an interventional radiologist and a surgeon in the radiology department. To ensure patient immobility during the procedure, a reusable immobilizer was utilized. The physician affixed a positioning tracker to the patient’s chest wall within the intended region. Subsequently, an initial CT scan was acquired and loaded into the robotic computer interface. The CT data underwent reconstruction to generate a comprehensive 3D model encompassing pulmonary nodules, vessels, bronchi, bone structures, and skin, aiding in navigation planning (Figure 2). All CT data were saved in Digital Imaging and Communications in Medicine (DICOM) format and subsequently transferred to the Hisense computer-assisted surgery system (Hisense, Qingdao, China).

CT scan and 3D reconstruction of the lung. (A) Placement of the positioning tracker on the patient’s chest wall; (B) planning of the needle trajectory based on the initial CT scan; (C) use of the fiducial tracker as the reference for precise positioning; (D) 3D reconstruction of the thoracic structure; (E) 3D verification of the puncture site. The white arrow indicates the puncture site; the black arrow indicates the target nodule; and the red arrow indicates the target site. CT, computed tomography; 3D, three-dimensional.