Multidisciplinary Series: Advancing Thoracic Surgery Care with 3DQ Imaging for Nuss Procedure
by Mary Sheridan Bilbao, PA-C, MPAS
February 28, 2025
In a recent case study series through the Stanford 3D and Quantitative Imaging (3DQ) Laboratory, a patient diagnosed with pectus excavatum and experiencing chest pain and breathing difficulties was referred to the Department of Radiology and the 3DQ Lab for advanced medical imaging. Pectus excavatum is a congenital chest wall deformity that causes a sunken chest.
The advanced images produced by the 3DQ Lab demonstrated the severe concave condition of the patient's chest wall and were provided to the Department of Cardiothoracic Surgery for further evaluation and to develop a plan for surgical intervention. To correct the condition, the patient underwent the Nuss procedure, a minimally invasive surgery designed to realign the breastbone and improve respiratory and cardiac function. While the exact cause of pectus excavatum remains unclear, it is believed to result from genetic and environmental factors. Mild cases may not require treatment, but severe cases can impact heart and lung function, necessitating surgical intervention.
Stanford offers a comprehensive, multidisciplinary Adult Chest Wall Surgery Program, which includes thoracic surgeons, physiotherapists, pulmonologists, pain specialists, social workers, and oncologists for tumor-related cases, to provide the most advanced diagnosis and treatment options for patients. The Stanford Adult Pectus Program is led by Leah Backhus, MD, MPH, Professor of Cardiothoracic Surgery (Thoracic Surgery), and features an expert team, including:
● Surgeons: Leah Backhus,MD and Mark Berry,MD
● Pediatric Surgery: Stephanie Chao, MD
● Nurse Practitioners: Angela Lee, NP & Alfredo DeJesus, NP
● Chest Radiology: Henry Guo, MD
● Cardiology: George Lui, MD
● Pulmonary Medicine: Michelle Cao, MD
The team employs advanced techniques such as 3D modeling and prosthetic reconstruction for complex chest wall repairs, ensuring high-quality care for patients with pectus excavatum and other chest wall conditions.
Through a multidisciplinary approach, the 3DQ Lab works in close collaboration with other departments, including cardiothoracic surgery, cardiovascular medicine, and radiology.
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The cross-departmental collaboration with the Stanford Department of Radiology includes Henry Guo, MD, PhD, Clinical Professor in Radiology, who oversees workflows, and Dominik Fleischmann, MD, Professor and Medical Director of the 3DQ Lab, who leads the lab’s efforts with the cardiothoracic surgery and multidisciplinary teams. Together, they refine and optimize these workflows.
All 3DQ Lab work is performed under the supervision and guidance of radiologists, who play a critical role in ensuring the highest quality imaging support for interventional procedures. Their expertise helps translate imaging data into actionable insights, aligning with the needs of clinicians, interventionalists, and surgeons.
This collaboration across departments and specialties, including cardiothoracic surgery, radiology, and cardiovascular imaging, ensures a comprehensive approach to advancing patient care through innovation and expertise.
Thank you to the extensive time and attention from the following :
