Abstract
AB089. Improving decision-making in traumatic brain injury patients via 3D volumetric analysis of epidural haematoma
Timotius Wira Yudha1,2, Roland Sidabutar1,2, Farid Yudoyono1,2
1Department of Neurosurgery, Padjadjaran University, Bandung, Indonesia;
2Department of Neurosurgery, Hasan Sadikin General Hospital, Bandung, Indonesia
Correspondence to: Timotius Wira Yudha, MBBS. Department of Neurosurgery, Padjadjaran University, Jalan Pasteur No. 38, Bandung 40161, Indonesia; Department of Neurosurgery, Hasan Sadikin General Hospital, Bandung, Indonesia. Email: wiratimothy.scientific@gmail.com.
Background: Epidural haematoma (EDH) is a common finding in many traumatic brain injury scenarios, which necessitates surgical evacuation if the volume equals 30 cm3. The Tada formula, despite its convenience, have been observed to inaccurately depict haemorrhage volume, which can lead to inappropriate decision-making. Objective: (I) to determine if there are statistical differences between EDH volumes as calculated using three-dimensional (3D) software versus Tada’s formula; and (II) whether this difference leads to differences in treatment options.
Methods: Computed tomography (CT)-scan of 15 traumatic brain injury (TBI) patients with EDH in January–February 2024 were obtained, and the volumetric analysis was performed using the (I) 3D Slicer software; and the (II) Tada formula for each scan. In addition, characteristics such as patient demographics and region were noted. We performed a paired t-test to scrutinise whether there were any differences between the volumes obtained via the two methods.
Results: There was a significant difference (P≤0.05) between the EDH volumes as calculated via 3D software and the Tada formula. We also noted that some patients who should have been treated surgically were not operated on, and vice versa. The process of 3D segmentation only takes an average of 8.2 minutes per patient; which is comparable to using the Tada formula. The inaccuracy of the Tada formula could be attributed to the irregular volume of the bleeding foci, contrary to the prototypical biconvex shape.
Conclusions: 3D segmentation should be routinely employed in EDH and other TBI-related haemorrhage cases when available, to aid in decision-making. Extensive development is needed to explore the utility of 3D software in emergency neurosurgery.
Keywords: Epidural haematoma (EDH); three-dimensional (3D) reconstruction; volumetric analysis
Acknowledgments
The authors thank the Radiology Department of Hasan Sadikin General Hospital for the acquisition of the DICOM images.
Funding: None.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab089/coif). The authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and is currently being applied for approval by the Hasan Sadikin Hospital Ethical Committee. Written informed consent was obtained from the patients.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
Cite this abstract as: Yudha TW, Sidabutar R, Yudoyono F. AB089. Improving decision-making in traumatic brain injury patients via 3D volumetric analysis of epidural haematoma. Chin Clin Oncol 2024;13(Suppl 1):AB089. doi: 10.21037/cco-24-ab089
