{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T09:09:42Z","timestamp":1782205782695,"version":"3.54.5"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J CARS"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Understanding patient-specific liver anatomy is crucial for patient safety and achieving complete treatment of all tumors during surgery. This study evaluates the impact of the use of patient-specific 3D liver models and surgical navigation on procedural complexity in open liver surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with colorectal liver metastases scheduled for open liver surgery were included between June 2022 and October 2023 at the Netherlands Cancer Institute. Patient-specific 3D liver models could be used upon request during the surgical procedure. Subsequently, surgeons could request additional surgical navigation by landmark registration using an electromagnetically tracked ultrasound transducer. Postoperatively, surgeons assessed the impact of the use of the model and navigation on procedural complexity on a scale from 1 to 10.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>35 patients were included in this study, with a median number of 8 (ranging from 3 to 25) tumors. 3D models were utilized in all procedures. Additional navigation was requested in 21\/35 of patients to improve intraoperative planning and tumor localization. The mean procedural complexity score with navigation was 4.3 (95% CI [3.7, 5.0]), compared to 7.8 (95% CI [6.6, 9.0]) with the 3D model alone. Both visualization methods improved lesion localization and provided better anatomical insight.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>3D models and surgical navigation significantly reduce the complexity of open liver surgery, especially in patients with bilobar disease. These tools enhance intraoperative decision-making and may lead to better surgical outcomes. The stepwise implementation of the visualization techniques in this study underscores the added benefit of surgical navigation beyond 3D modeling alone, supporting its potential for broader clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11548-025-03455-5","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T11:01:31Z","timestamp":1751367691000},"page":"2213-2218","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The impact of 3-dimensional models and surgical navigation for open liver surgery"],"prefix":"10.1007","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1448-8328","authenticated-orcid":false,"given":"Karin A.","family":"Olthof","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Fusaglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne G.","family":"den Hartog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels F. M.","family":"Kok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo J. M.","family":"Ruers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koert F. D.","family":"Kuhlmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"3455_CR1","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.1002\/BJS.9213","volume":"100","author":"DA Bischof","year":"2013","unstructured":"Bischof DA, Clary BM, Maithel SK, Pawlik TM (2013) Surgical management of disappearing colorectal liver metastases. Br J Surg 100:1414\u20131420. https:\/\/doi.org\/10.1002\/BJS.9213","journal-title":"Br J Surg"},{"key":"3455_CR2","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1007\/S11605-010-1348-Y","volume":"14","author":"MG van Vledder","year":"2010","unstructured":"van Vledder MG, de Jong MC, Pawlik TM, Schulick RD, Diaz LA, Choti MA (2010) Disappearing colorectal liver metastases after chemotherapy: should we be concerned? J Gastrointest Surg 14:1691\u20131700. https:\/\/doi.org\/10.1007\/S11605-010-1348-Y","journal-title":"J Gastrointest Surg"},{"key":"3455_CR3","doi-asserted-by":"publisher","first-page":"1798","DOI":"10.1016\/j.ejso.2016.05.005","volume":"42","author":"K Kuhlmann","year":"2016","unstructured":"Kuhlmann K, van Hilst J, Fisher S, Poston G (2016) Management of disappearing colorectal liver metastases. Eur J Surg Oncol 42:1798\u20131805. https:\/\/doi.org\/10.1016\/j.ejso.2016.05.005","journal-title":"Eur J Surg Oncol"},{"key":"3455_CR4","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/J.HPB.2020.10.005","volume":"23","author":"LG Melstrom","year":"2021","unstructured":"Melstrom LG, Warner SG, Wong P, Sun V, Raoof M, Singh G, Chavin KD, Fong Y, Adam R, Hugh TJ (2021) Management of disappearing colorectal liver metastases: an international survey. HPB 23:506\u2013511. https:\/\/doi.org\/10.1016\/J.HPB.2020.10.005","journal-title":"HPB"},{"issue":"5","key":"3455_CR5","doi-asserted-by":"publisher","first-page":"1016","DOI":"10.1016\/J.EJSO.2023.01.011","volume":"49","author":"KF Kuhlmann","year":"2023","unstructured":"Kuhlmann KF, Tufo A, Kok NF, Gordon-Weeks A, Pston G, Diaz Nieto R, Jones R, Fenwick SW, Malik HZ (2023) Disappearing colorectal liver metastases in the era of state-of-the-art triple-modality diagnostic imaging. Eur J Surg Oncol 49(5):1016\u20131022. https:\/\/doi.org\/10.1016\/J.EJSO.2023.01.011","journal-title":"Eur J Surg Oncol"},{"key":"3455_CR6","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1007\/S00423-021-02127-7","volume":"406","author":"C Boedecker","year":"2021","unstructured":"Boedecker C, Huettl F, Saalfeld P, Paschold M, Kneist W, Baumgart J, Preim BHC, Lang H, Huber T (2021) Using virtual 3D-models in surgical planning: workflow of an immersive virtual reality application in liver surgery. Langenbeck\u2019s Arch Surg 406:911\u2013915. https:\/\/doi.org\/10.1007\/S00423-021-02127-7","journal-title":"Langenbeck\u2019s Arch Surg"},{"key":"3455_CR7","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/J.JAMCOLLSURG.2014.09.023","volume":"220","author":"CH Fang","year":"2015","unstructured":"Fang CH, Tao HS, Yang J, Fang Z, Cai W, Liu J, Fan YF (2015) Impact of three-dimensional reconstruction technique in the operation planning of centrally located hepatocellular carcinoma. J Am Coll Surg 220:28\u201337. https:\/\/doi.org\/10.1016\/J.JAMCOLLSURG.2014.09.023","journal-title":"J Am Coll Surg"},{"key":"3455_CR8","doi-asserted-by":"publisher","first-page":"298","DOI":"10.35772\/GHM.2020.01045","volume":"2","author":"A Miyata","year":"2020","unstructured":"Miyata A, Arita J, Kawaguchi Y, Hasegawa K, Kokudo N (2020) Simulation and navigation liver surgery: an update after 2,000 virtual hepatectomies. Glob Heal Med 2:298. https:\/\/doi.org\/10.35772\/GHM.2020.01045","journal-title":"Glob Heal Med"},{"key":"3455_CR9","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1001\/ARCHSURG.140.7.629","volume":"140","author":"H Lang","year":"2005","unstructured":"Lang H, Radtke A, Hindennach M, Schroeder T, Fr\u00fchauf N, Malag\u00f3 M, Bourquain H, Peitgen HO, Oldhafer KJ, Broelsch CE (2005) Impact of virtual tumor resection and computer-assisted risk analysis on operation planning and intraoperative strategy in major hepatic resection. Arch Surg 140:629\u2013638. https:\/\/doi.org\/10.1001\/ARCHSURG.140.7.629","journal-title":"Arch Surg"},{"key":"3455_CR10","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1007\/s11548-022-02659-3","volume":"17","author":"JN Smit","year":"2022","unstructured":"Smit JN, Kuhlmann KFD, Ivashchenko OV, Thomson BR, Lang\u00f8 T, Kok NFM, Fusgalia M, Ruers TJM (2022) Ultrasound-based navigation for open liver surgery using active liver tracking. IJCARS 17:1765\u20131773. https:\/\/doi.org\/10.1007\/s11548-022-02659-3","journal-title":"IJCARS"},{"key":"3455_CR11","doi-asserted-by":"publisher","first-page":"znae110","DOI":"10.1093\/BJS\/ZNAE110","volume":"111","author":"KA Olthof","year":"2024","unstructured":"Olthof KA, Smit JN, Fusaglia M, Kok NFM, Ruers TJM, Kuhlmann KFD (2024) A surgical navigation system to aid the ablation of vanished colorectal liver metastases. Br J Surg 111:znae110. https:\/\/doi.org\/10.1093\/BJS\/ZNAE110","journal-title":"Br J Surg"},{"key":"3455_CR12","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/J.MRI.2019.12.008","volume":"68","author":"OV Ivashchenko","year":"2020","unstructured":"Ivashchenko OV, Rijkhorst EJ, ter Beek LC, Hoetjes N, Pouw B, Nijkamp J, Kuhlmann KFD, Ruers TJM (2020) A workflow for automated segmentation of the liver surface, hepatic vasculature and biliary tree anatomy from multiphase MR images. Magn Reson Imaging 68:53\u201365. https:\/\/doi.org\/10.1016\/J.MRI.2019.12.008","journal-title":"Magn Reson Imaging"},{"key":"3455_CR13","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1159\/000513335","volume":"61","author":"OV Ivashchenko","year":"2021","unstructured":"Ivashchenko OV, Smit JN, Nijkamp J, Ter Beek L, Rijkhorst E, Kok NFM, Kuhlmann KFD, Ruers TJM (2021) Clinical implementation of in-house developed MR-based patient-specific 3D models of liver anatomy. Eur Surg Res 61:143\u2013152. https:\/\/doi.org\/10.1159\/000513335","journal-title":"Eur Surg Res"},{"key":"3455_CR14","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1016\/J.MRI.2012.05.001","volume":"30","author":"A Fedorov","year":"2012","unstructured":"Fedorov A, Beichel R, Kalpathy-Cramer J, Finet J, Fillion-Robin J, Pujol S, Bauer C, Jennings D, Fennessy F, Sonka M, Buatti J, Aylward S, Miller JV, Pieper S, Kikinis R (2012) 3D Slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging 30:1323\u20131341. https:\/\/doi.org\/10.1016\/J.MRI.2012.05.001","journal-title":"Magn Reson Imaging"},{"issue":"3","key":"3455_CR15","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1016\/J.HPB.2017.08.035","volume":"20","author":"TP Kingham","year":"2018","unstructured":"Kingham TP, Pak LM, Simpson AL, Leung U, Doussot A, D\u2019Angelica M, DeMatteo RP, Allen PJ, Jarnagin WR (2018) 3D image guidance assisted identification of colorectal cancer liver metastases not seen on intraoperative ultrasound: results from a prospective trial. HPB (Oxford) 20(3):260\u2013267. https:\/\/doi.org\/10.1016\/J.HPB.2017.08.035","journal-title":"HPB (Oxford)"},{"key":"3455_CR16","doi-asserted-by":"publisher","first-page":"4315","DOI":"10.1007\/S00464-017-5458-4","volume":"31","author":"P Tinguely","year":"2017","unstructured":"Tinguely P, Fusaglia M, Freedman J, Weber S, Candinas D, Nilsson H (2017) Laparoscopic image-based navigation for microwave ablation of liver tumors-a multi-center study. Surg Endosc 31:4315\u20134324. https:\/\/doi.org\/10.1007\/S00464-017-5458-4","journal-title":"Surg Endosc"},{"key":"3455_CR17","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1007\/S00268-015-3229-8","volume":"40","author":"D Ntourakis","year":"2016","unstructured":"Ntourakis D, Memeo R, Soler L, Marescaux J, Mutter D, Pessaux P (2016) Augmented reality guidance for the resection of missing colorectal liver metastases: an initial experience. World J Surg 40:419\u2013426. https:\/\/doi.org\/10.1007\/S00268-015-3229-8","journal-title":"World J Surg"},{"key":"3455_CR18","doi-asserted-by":"publisher","first-page":"645","DOI":"10.3390\/LIFE12050645","volume":"12","author":"HC Groen","year":"2022","unstructured":"Groen HC, Den Hartog AG, Heerink WJ, Kuhlmann KFD, Kok NFM, van Veen R, Hiep M, Snaebjornsson P, Grotenhuis BA, Beets GL, Aalbers AGJ, Ruers TJM (2022) Use of image-guided surgical navigation during resection of locally recurrent rectal cancer. Life 12:645. https:\/\/doi.org\/10.3390\/LIFE12050645","journal-title":"Life"}],"container-title":["International Journal of Computer Assisted Radiology and Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11548-025-03455-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11548-025-03455-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11548-025-03455-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T06:47:37Z","timestamp":1761806857000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11548-025-03455-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":18,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["3455"],"URL":"https:\/\/doi.org\/10.1007\/s11548-025-03455-5","relation":{},"ISSN":["1861-6429"],"issn-type":[{"value":"1861-6429","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]},"assertion":[{"value":"17 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors (KO, MF, AH, NK, TR, KK) declare no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in this study involving human participants were conducted in accordance with the ethical standards of the institutional and national research committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}