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Ali A, Morris JM, Decker SJ, Huang YH, Wake N, Rybicki FJ, Ballard DH. Clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: neurosurgical and otolaryngologic conditions. 3D Print Med 2023; 9:33. [PMID: 38008795 PMCID: PMC10680204 DOI: 10.1186/s41205-023-00192-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/03/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Medical three dimensional (3D) printing is performed for neurosurgical and otolaryngologic conditions, but without evidence-based guidance on clinical appropriateness. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness recommendations for neurologic 3D printing conditions. METHODS A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with neurologic and otolaryngologic conditions. Each study was vetted by the authors and strength of evidence was assessed according to published guidelines. RESULTS Evidence-based recommendations for when 3D printing is appropriate are provided for diseases of the calvaria and skull base, brain tumors and cerebrovascular disease. Recommendations are provided in accordance with strength of evidence of publications corresponding to each neurologic condition combined with expert opinion from members of the 3D printing SIG. CONCLUSIONS This consensus guidance document, created by the members of the 3D printing SIG, provides a reference for clinical standards of 3D printing for neurologic conditions.
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Affiliation(s)
- Arafat Ali
- Department of Radiology, Henry Ford Health, Detroit, MI, USA
| | | | - Summer J Decker
- Division of Imaging Research and Applied Anatomy, Department of Radiology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Yu-Hui Huang
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Nicole Wake
- Department of Research and Scientific Affairs, GE HealthCare, New York, NY, USA
- Center for Advanced Imaging Innovation and Research, Department of Radiology, NYU Langone Health, New York, NY, USA
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.
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Yan X, Zhu Y, Fang L, Ding P, Fang S, Zhou J, Wang J. Enhancing medical education in respiratory diseases: efficacy of a 3D printing, problem-based, and case-based learning approach. BMC MEDICAL EDUCATION 2023; 23:512. [PMID: 37461009 DOI: 10.1186/s12909-023-04508-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES The present study aims to investigate the efficacy of utilizing three-dimensional (3D) printing technology in concert with Problem-Based Learning (PBL) and Case-Based Learning (CBL) pedagogical approaches in educating senior undergraduate clinical medical students on respiratory diseases. METHODS A cohort of 422 fourth-year clinical medicical students of from Anhui Medical University, pursuing a five-year program, were arbitrarily segregated into two distinct groups. The experimental group was subjected to a combined pedagogical approach, which included 3D printing technology, PBL and CBL (referred to as DPC). Conversely, the control group was exposed to conventional teaching methodologies for respiratory disease education. The effectiveness of the teaching methods was subsequently appraised using both theoretical test scores and custom questionnaires. RESULTS Post-quiz scores indicated a statistically significant improvement in the DPC group as compared to the traditional group (P < 0.01). Self-evaluation and satisfaction questionnaires revealed that the DPC group's self-assessment scores outperformed the traditional group in several aspects, including clinical thinking ability, learning initiative, self-study ability, anatomical knowledge mastery, confidence in learning, ability to analyze and solve problems, comprehension of the knowledge, help to clinical thinking and level of satisfaction on the teaching methods (P < 0.01). However, within the unsatisfied DPC sub-group, none of these self-assessment aspects, except for comprehension of the knowledge, impacted the learning efficacy (P > 0.05). CONCLUSION The deployment of the DPC pedagogical approach may confer unique experiential learning opportunities for students, potentially enhancing theoretical test scores and promoting self-evaluation and satisfaction in the context of respiratory disease education. Hence, it may be instrumental in augmenting the overall teaching efficacy.
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Affiliation(s)
- Xuebo Yan
- Department of Geriatric Respiratory and Critical Care, Institute of Respiratory Disease, Provincial Key Laboratory of Molecular Medicine for Geriatric disease, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Yingying Zhu
- Department of Geriatric Respiratory and Critical Care, Institute of Respiratory Disease, Provincial Key Laboratory of Molecular Medicine for Geriatric disease, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Lei Fang
- Department of Geriatric Respiratory and Critical Care, Institute of Respiratory Disease, Provincial Key Laboratory of Molecular Medicine for Geriatric disease, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Peishan Ding
- Department of Geriatric Respiratory and Critical Care, Institute of Respiratory Disease, Provincial Key Laboratory of Molecular Medicine for Geriatric disease, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China
| | - Shu Fang
- School of Biomedical Engineering, Anhui Medical University, 81 Meishan Road, Hefei, 230023, Anhui, China
| | - Jinhua Zhou
- School of Biomedical Engineering, Anhui Medical University, 81 Meishan Road, Hefei, 230023, Anhui, China
| | - Jiong Wang
- Department of Geriatric Respiratory and Critical Care, Institute of Respiratory Disease, Provincial Key Laboratory of Molecular Medicine for Geriatric disease, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, Anhui, China.
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Cai B, Duan S, Yi J, Huang W, Bay BH, Li C, Chen C. Training surgical skills on hip arthroscopy by simulation: a survey on surgeon's perspectives. Int J Comput Assist Radiol Surg 2022; 17:1813-1821. [PMID: 35831550 PMCID: PMC9468038 DOI: 10.1007/s11548-022-02708-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 06/21/2022] [Indexed: 11/15/2022]
Abstract
Purpose The purpose of this study is to investigate the importance of general and specific surgical skills for hip arthroscopy from the perspective of surgeons in China. Concurrently, we intend to identify the preferred type of simulation that would facilitate competency of surgical trainees in performing arthroscopy and reinforce their preparation for carrying out the actual surgical procedure. Methods An online survey comprising 42 questions was developed by experts in hip arthroscopy and sent to 3 online communities whose members are arthroscopic surgeons in China. The responses collected were based on a 5-point Likert scale, with an open-ended comment section. Data were analyzed using one-way AVOVA and post hoc Tukey’s test. Results A total of 159 valid responses from 66 junior specialist surgeons, 68 consultant surgeons, and 25 senior consultant surgeons (from 130 institutions in 27 out of 34 provincial administrative districts in China) were collected. Cognitive ability was identified as the overall most important attribute for hip arthroscopic trainees to possess, while skills relevant to the treatment of femoroacetabular impingement (FAI) were considered as the most important specific skills by the surgeons surveyed. In addition, simulation using cadaveric specimens was considered the most favorable method for surgeons to practice their surgical skills. Conclusion In designing a training program for hip arthroscopy, it is essential to incorporate features that evaluate cognitive skills. It would be helpful for trainees to specifically practice skills that are often used in the treatment of some very common diseases of the hip joint, such as FAI. Using high-fidelity physical models for simulation to train skills of hip arthroscopy could be an ideal alternative and effective way to overcome problems arising from the lack of accessibility to cadaveric specimens. Supplementary Information The online version contains supplementary material available at 10.1007/s11548-022-02708-x.
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Affiliation(s)
- Bohong Cai
- Department of Industrial and Product Design, School of Design, Sichuan Fine Arts Institute, Chongqing, China
| | - Shengfeng Duan
- Department of Industrial and Product Design, School of Design, Sichuan Fine Arts Institute, Chongqing, China
| | - Jiahui Yi
- Department of Industrial and Product Design, School of Design, Sichuan Fine Arts Institute, Chongqing, China
| | - Wei Huang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Boon Huat Bay
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Chunbao Li
- Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, 100048, China.
| | - Cheng Chen
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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4
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Bertolini M, Rossoni M, Colombo G. Operative Workflow from CT to 3D Printing of the Heart: Opportunities and Challenges. Bioengineering (Basel) 2021; 8:bioengineering8100130. [PMID: 34677203 PMCID: PMC8533410 DOI: 10.3390/bioengineering8100130] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 01/25/2023] Open
Abstract
Medical images do not provide a natural visualization of 3D anatomical structures, while 3D digital models are able to solve this problem. Interesting applications based on these models can be found in the cardiovascular field. The generation of a good-quality anatomical model of the heart is one of the most complex tasks in this context. Its 3D representation has the potential to provide detailed spatial information concerning the heart’s structure, also offering the opportunity for further investigations if combined with additive manufacturing. When investigated, the adaption of printed models turned out to be beneficial in complex surgical procedure planning, for training, education and medical communication. In this paper, we will illustrate the difficulties that may be encountered in the workflow from a stack of Computed Tomography (CT) to the hand-held printed heart model. An important goal will consist in the realization of a heart model that can take into account real wall thickness variability. Stereolithography printing technology will be exploited with a commercial rigid resin. A flexible material will be tested too, but results will not be so satisfactory. As a preliminary validation of this kind of approach, print accuracy will be evaluated by directly comparing 3D scanner acquisitions to the original Standard Tessellation Language (STL) files.
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Abstract
An implants' effectiveness depends upon the form of biomaterial used in its manufacture. A suitable material for implants should be biocompatible, sterile, mechanically stable and simple to shape. 3D printing technologies have been breaking new ground in the medical and medical industries in order to build patient-specific devices embedded in bioactive drugs, cells and proteins. Widespread use in medical 3D printing is a broad range of biomaterials including metals, ceramics, polymers and composites. Continuous work and developments in biomaterials used in 3D printing have contributed to significant growth of 3D printing applications in the production of personalised joints, prostheses, medication delivery system and 3D tissue engineering and regenerative medicine scaffolds. The present analysis focuses on the biomaterials used for therapeutic applications in different 3D printing technologies. Many specific forms of medical 3D printing technology are explored in depth, including fused deposition modelling, extrusion-based bioprinting, inkjet and poly-jet printing processes, their therapeutic uses, various types of biomaterial used today and the major shortcoming , are being studied in depth.
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Affiliation(s)
- Abhay Mishra
- Department of Mechanical Engineering, DIT University, Dehradun, India
| | - Vivek Srivastava
- Department of Mechanical Engineering, DIT University, Dehradun, India
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6
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Waqas M, Mokin M, Lim J, Vakharia K, Springer ME, Meess KM, Ducharme RW, Ionita CN, Nagesh SVS, Gutierrez LC, Snyder KV, Davies JM, Levy EI, Siddiqui AH. Design and Physical Properties of 3-Dimensional Printed Models Used for Neurointervention: A Systematic Review of the Literature. Neurosurgery 2021; 87:E445-E453. [PMID: 32392300 DOI: 10.1093/neuros/nyaa134] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 03/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) printing has revolutionized training, education, and device testing. Understanding the design and physical properties of 3D-printed models is important. OBJECTIVE To systematically review the design, physical properties, accuracy, and experimental outcomes of 3D-printed vascular models used in neurointervention. METHODS We conducted a systematic review of the literature between January 1, 2000 and September 30, 2018. Public/Publisher MEDLINE (PubMed), Web of Science, Compendex, Cochrane, and Inspec databases were searched using Medical Subject Heading terms for design and physical attributes of 3D-printed models for neurointervention. Information on design and physical properties like compliance, lubricity, flow system, accuracy, and outcome measures were collected. RESULTS A total of 23 articles were included. Nine studies described 3D-printed models for stroke intervention. Tango Plus (Stratasys) was the most common material used to develop these models. Four studies described a population-representative geometry model. All other studies reported patient-specific vascular geometry. Eight studies reported complete reconstruction of the circle of Willis, anterior, and posterior circulation. Four studies reported a model with extracranial vasculature. One prototype study reported compliance and lubricity. Reported circulation systems included manual flushing, programmable pistons, peristaltic, and pulsatile pumps. Outcomes included thrombolysis in cerebral infarction, post-thrombectomy flow restoration, surgical performance, and qualitative feedback. CONCLUSION Variations exist in the material, design, and extent of reconstruction of vasculature of 3D-printed models. There is a need for objective characterization of 3D-printed vascular models. We propose the development of population representative 3D-printed models for skill improvement or device testing.
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Affiliation(s)
- Muhammad Waqas
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
| | - Maxim Mokin
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, Florida
| | - Jaims Lim
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
| | - Kunal Vakharia
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
| | | | | | | | - Ciprian N Ionita
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York
| | - Swetadri Vasan Setlur Nagesh
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.,Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York
| | - Liza C Gutierrez
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York
| | - Kenneth V Snyder
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York
| | - Jason M Davies
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.,Jacobs Institute, Buffalo, New York.,Department of Bioinformatics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Elad I Levy
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.,Jacobs Institute, Buffalo, New York.,Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York
| | - Adnan H Siddiqui
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.,Department of Neurosurgery, Gates Vascular Institute at Kaleida Health, Buffalo, New York.,Jacobs Institute, Buffalo, New York.,Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, New York.,Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
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7
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Kaschwich M, Dell A, Matysiak F, Bouchagiar J, Bayer A, Scharfschwerdt M, Ernst F, Kleemann M, Horn M. Development of an ultrasound-capable phantom with patient-specific 3D-printed vascular anatomy to simulate peripheral endovascular interventions. Ann Anat 2020; 232:151563. [DOI: 10.1016/j.aanat.2020.151563] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/19/2022]
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8
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Elsayed M, Kadom N, Ghobadi C, Strauss B, Al Dandan O, Aggarwal A, Anzai Y, Griffith B, Lazarow F, Straus CM, Safdar NM. Virtual and augmented reality: potential applications in radiology. Acta Radiol 2020; 61:1258-1265. [PMID: 31928346 DOI: 10.1177/0284185119897362] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The modern-day radiologist must be adept at image interpretation, and the one who most successfully leverages new technologies may provide the highest value to patients, clinicians, and trainees. Applications of virtual reality (VR) and augmented reality (AR) have the potential to revolutionize how imaging information is applied in clinical practice and how radiologists practice. This review provides an overview of VR and AR, highlights current applications, future developments, and limitations hindering adoption.
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Affiliation(s)
- Mohammad Elsayed
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Comeron Ghobadi
- Department of Radiology, The University of Chicago Pritzker School of Medicine, IL, USA
| | - Benjamin Strauss
- Department of Radiology, The University of Chicago Pritzker School of Medicine, IL, USA
| | - Omran Al Dandan
- Department of Radiology, Imam Abdulrahman Bin Faisal University College of Medicine, Dammam, Eastern Province, Saudi Arabia
| | - Abhimanyu Aggarwal
- Department of Radiology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Yoshimi Anzai
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Brent Griffith
- Department of Radiology, Henry Ford Health System, Detroit, MI, USA
| | - Frances Lazarow
- Department of Radiology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Christopher M Straus
- Department of Radiology, The University of Chicago Pritzker School of Medicine, IL, USA
| | - Nabile M Safdar
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Chueh JY, Kang DH, Kim BM, Gounis MJ. Role of Balloon Guide Catheter in Modern Endovascular Thrombectomy. J Korean Neurosurg Soc 2019; 63:14-25. [PMID: 31591997 PMCID: PMC6952736 DOI: 10.3340/jkns.2019.0114] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 06/21/2019] [Indexed: 01/09/2023] Open
Abstract
Proximal flow control achieved with a balloon guide catheter (BGC) during endovascular treatment of acute ischemic stroke is reviewed in this article. In clinical practice, BGCs offer a multi-faceted approach for clot retrieval by creating proximal flow arrest, reducing embolic burden, and shortening procedure time. Evaluation of frontline thrombectomy procedures with BGCs revealed advantages of combined use over the conventional guide catheter (CGC), notably in the significant reduction of distal emboli to both the affected and previously unaffected territories. Recently, new measures of early and complete reperfusion at first thrombectomy pass have been identified as independent predictors of improved outcomes, which were consistently demonstrated with use of BGC as a safe and effective option to minimize number of passes during intervention. Prior randomized controlled trials reported the positive correlation between BGC-treated patients and a lower risk of mortality as well as shortened procedure time. While BGC use is more common in stent retriever-mediated mechanical thrombectomy, preliminary data has shown the potential benefit of device application during contact aspiration thrombectomy to achieve successful recanalization. However, the question of which major endovascular strategy reigns superior as a frontline remains to be answered. Along with clinical case assessments, BGC performance during in-vitro simulation was analyzed to further understand mechanisms for optimization of thrombectomy technique.
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Affiliation(s)
- Ju-Yu Chueh
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, MA, USA
| | - Dong-Hun Kang
- Department of Neurosurgery and Radiology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Byung Moon Kim
- Department of Radiology, Severance Stroke Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Matthew J Gounis
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, MA, USA
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10
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Alonzo M, AnilKumar S, Roman B, Tasnim N, Joddar B. 3D Bioprinting of cardiac tissue and cardiac stem cell therapy. Transl Res 2019; 211:64-83. [PMID: 31078513 PMCID: PMC6702075 DOI: 10.1016/j.trsl.2019.04.004] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 04/01/2019] [Accepted: 04/03/2019] [Indexed: 12/17/2022]
Abstract
Cardiovascular tissue engineering endeavors to repair or regenerate damaged or ineffective blood vessels, heart valves, and cardiac muscle. Current strategies that aim to accomplish such a feat include the differentiation of multipotent or pluripotent stem cells on appropriately designed biomaterial scaffolds that promote the development of mature and functional cardiac tissue. The advent of additive manufacturing 3D bioprinting technology further advances the field by allowing heterogenous cell types, biomaterials, and signaling factors to be deposited in precisely organized geometries similar to those found in their native counterparts. Bioprinting techniques to fabricate cardiac tissue in vitro include extrusion, inkjet, laser-assisted, and stereolithography with bioinks that are either synthetic or naturally-derived. The article further discusses the current practices for postfabrication conditioning of 3D engineered constructs for effective tissue development and stability, then concludes with prospective points of interest for engineering cardiac tissues in vitro. Cardiovascular three-dimensional bioprinting has the potential to be translated into the clinical setting and can further serve to model and understand biological principles that are at the root of cardiovascular disease in the laboratory.
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Affiliation(s)
- Matthew Alonzo
- Inspired Materials & Stem-Cell Based Tissue Engineering Laboratory (IMSTEL), Department of Metallurgical, Materials and Biomedical Engineering, University of Texas at El Paso, El Paso, Texas
| | - Shweta AnilKumar
- Inspired Materials & Stem-Cell Based Tissue Engineering Laboratory (IMSTEL), Department of Metallurgical, Materials and Biomedical Engineering, University of Texas at El Paso, El Paso, Texas
| | - Brian Roman
- Inspired Materials & Stem-Cell Based Tissue Engineering Laboratory (IMSTEL), Department of Metallurgical, Materials and Biomedical Engineering, University of Texas at El Paso, El Paso, Texas
| | - Nishat Tasnim
- Inspired Materials & Stem-Cell Based Tissue Engineering Laboratory (IMSTEL), Department of Metallurgical, Materials and Biomedical Engineering, University of Texas at El Paso, El Paso, Texas
| | - Binata Joddar
- Inspired Materials & Stem-Cell Based Tissue Engineering Laboratory (IMSTEL), Department of Metallurgical, Materials and Biomedical Engineering, University of Texas at El Paso, El Paso, Texas; Border Biomedical Research Center, University of Texas at El Paso, El Paso, Texas.
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Mobbs RJ, Parr WC, Choy WJ, McEvoy A, Walsh WR, Phan K. Anterior Lumbar Interbody Fusion Using a Personalized Approach: Is Custom the Future of Implants for Anterior Lumbar Interbody Fusion Surgery? World Neurosurg 2019; 124:452-458.e1. [PMID: 30633990 DOI: 10.1016/j.wneu.2018.12.144] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Spine surgery has the potential to benefit from the use of three-dimensional (3D) printing technology (additive manufacturing), particularly in cases of complex anatomic diseases. Custom devices have the potential to reduce operative times, reduce blood loss, provide immediate stability, and improve fusion rates. CASE DESCRIPTION A 34-year-old man presented with 3-year history of bilateral L5 radiculopathy caused by bilateral L5 pars defect, L5/S1 degenerative disc disease, and severe foraminal stenosis. Anterior lumbar interbody fusion surgery was determined to be the most efficacious method for distraction of the disc space to increase the foraminal volume and stabilization of the motion segment. Surgical decompression and reconstruction was performed in combination with a 3D printed custom interbody implant. Custom design features included corrective angulation to restore lumbar lordosis, preplanned screw holes in the 3D implant, and device end plate interface geometry designed to shape-match with the patient's end plate anatomy. CONCLUSIONS The use of patient-specific implants has reduced operative time significantly, which may offset costs of increased time spent preplanning the procedure. Surgical procedures can be preplanned using 3D models reconstructed from patient computed tomography and/or magnetic resonance imaging scans. Planning can be aided by 3D printed models of patient anatomy, which surgeons can use in training before performing complex procedures. When considering implants and prostheses, the use of 3D printing allows a superior anatomic fit for the patient compared with generic devices, with the potential to improve restoration of nonpathologic anatomy.
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12
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Chepelev L, Wake N, Ryan J, Althobaity W, Gupta A, Arribas E, Santiago L, Ballard DH, Wang KC, Weadock W, Ionita CN, Mitsouras D, Morris J, Matsumoto J, Christensen A, Liacouras P, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios. 3D Print Med 2018; 4:11. [PMID: 30649688 PMCID: PMC6251945 DOI: 10.1186/s41205-018-0030-y] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/19/2018] [Indexed: 02/08/2023] Open
Abstract
Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.
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Affiliation(s)
- Leonid Chepelev
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Nicole Wake
- Center for Advanced Imaging Innovation and Research (CAI2R), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY USA
- Sackler Institute of Graduate Biomedical Sciences, NYU School of Medicine, New York, NY USA
| | | | - Waleed Althobaity
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Ashish Gupta
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Elsa Arribas
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lumarie Santiago
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO USA
| | - Kenneth C Wang
- Baltimore VA Medical Center, University of Maryland Medical Center, Baltimore, MD USA
| | - William Weadock
- Department of Radiology and Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI USA
| | - Ciprian N Ionita
- Department of Neurosurgery, State University of New York Buffalo, Buffalo, NY USA
| | - Dimitrios Mitsouras
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | | | | | - Andy Christensen
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Peter Liacouras
- 3D Medical Applications Center, Walter Reed National Military Medical Center, Washington, DC, USA
| | - Frank J Rybicki
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
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Abstract
Surgeons typically rely on their past training and experiences as well as visual aids from medical imaging techniques such as magnetic resonance imaging (MRI) or computed tomography (CT) for the planning of surgical processes. Often, due to the anatomical complexity of the surgery site, two dimensional or virtual images are not sufficient to successfully convey the structural details. For such scenarios, a 3D printed model of the patient's anatomy enables personalized preoperative planning. This paper reviews critical aspects of 3D printing for preoperative planning and surgical training, starting with an overview of the process-flow and 3D printing techniques, followed by their applications spanning across multiple organ systems in the human body. State of the art in these technologies are described along with a discussion of current limitations and future opportunities.
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Lv X, Chen H, Liu G, Shen S, Wu Q, Hu C, Li J, Dong E, Xu RX. Design of a portable phantom device to simulate tissue oxygenation and blood perfusion. APPLIED OPTICS 2018; 57:3938-3946. [PMID: 29791363 DOI: 10.1364/ao.57.003938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/19/2018] [Indexed: 06/08/2023]
Abstract
We propose a portable phantom system for calibration and validation of medical optical devices in a clinical setting. The phantom system comprises a perfusion module and an exchangeable tissue-simulating phantom that simulates tissue oxygenation and blood perfusion. The perfusion module consists of a peristaltic pump, two liquid storage units, and two pressure suppressors. The tissue-simulating phantom is fabricated by a three-dimensional (3D) printing process with microchannels embedded to simulate blood vessels. Optical scattering and absorption properties of biologic tissue are simulated by mixing graphite powder and titanium dioxide powder with clear photoreactive resin at specific ratios. Tissue oxygen saturation (StO2) and blood perfusion are simulated by circulating the mixture of blood and intralipid at different oxygenation levels and flow rates. A house-made multimodal imaging system that combines multispectral imaging and laser speckle imaging are used for non-invasive detection of phantom oxygenation and perfusion, and the measurements are compared with those of a commercial Moor device as well as numerical simulation. By acquiring multimodal imaging data from one phantom and applying the calibration factors in different settings, we demonstrate the technical feasibility to calibrate optical devices for consistent measurements. By simulating retina tissue vasculature and acquiring functional images at different tissue oxygenation and blood perfusion levels, we demonstrate the clinical potential to simulate tissue anomalies. Our experiments imply the clinical potential of a portable, low-cost, and traceable phantom standard to calibrate and validate medical optical devices for improved performance.
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Lichtenberger JP, Tatum PS, Gada S, Wyn M, Ho VB, Liacouras P. Using 3D Printing (Additive Manufacturing) to Produce Low-Cost Simulation Models for Medical Training. Mil Med 2018; 183:73-77. [DOI: 10.1093/milmed/usx142] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 12/29/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- John P Lichtenberger
- Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
- Department of Radiology, 3D Medical Applications Center, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600
| | - Peter S Tatum
- Rowan School of Osteopathic Medicine, 42 East Laurel Road, Stratford, NJ 08084
| | - Satyen Gada
- Department of Simulation, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600
| | - Mark Wyn
- Department of Simulation, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600
| | - Vincent B Ho
- Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814
- Department of Radiology, 3D Medical Applications Center, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600
| | - Peter Liacouras
- Department of Radiology, 3D Medical Applications Center, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600
- Department of Radiology and Radiological Services, USUHS & Naval Postgraduate Dental School, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600
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Konieczna L, Belka M, Okońska M, Pyszka M, Bączek T. New 3D-printed sorbent for extraction of steroids from human plasma preceding LC-MS analysis. J Chromatogr A 2018. [PMID: 29523348 DOI: 10.1016/j.chroma.2018.02.040] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In recent years, there has been an increasing worldwide interest in the use of alternative sample preparation methods that are proceeded by separation techniques. Fused deposition modeling (FDM) is a 3D printing technique that is based the consecutive layering of softened/melted thermoplastic materials. In this study, a group of natural steroids and sexual hormones - namely, aldosterone, cortisol, β-estradiol, testosterone, dihydrotestosterone, and synthetic methyltestosterone and betamethasone - were separated and determined using an optimized high-performance liquid chromatography coupled to mass spectrometry (LC-MS) method in positive ionization mode. 3D-printed sorbents were selected as the pre-concentration technique because they are generally low cost, fast, and simple to make and automate. Furthermore, the use of 3D-printed sorbents helps to minimize potential errors due to their repeatability and reproducibility, and their ability to eliminate carry over by using one printed sorbent for a single extraction of steroids from biological matrices. The extraction procedure was optimized and the parameters influencing 3D-printed Layfomm 60® based sorbent and LC-MS were studied, including the type of extraction solvent used, sorption and desorption times, temperature, and the salting-out effect. To demonstrate this method's applicability for biological sample analysis, the SPME-LC-MS method was validated for its ability to simultaneously quantify endogenous steroids. This evaluation confirmed good linearity and an R2 that was between 0.9970 and 0.9990. The recovery rates for human plasma samples were 86.34-93.6% for the studied steroids with intra- and inter-day RSDs of 1.44-7.42% and 1.44-9.46%, respectively. To our knowledge, this study is the first time that 3D-printed sorbents have been used to extract trace amounts of endogenous low-molecular-weight compounds, such as steroids, from biological samples, such as plasma.
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Affiliation(s)
- Lucyna Konieczna
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland
| | - Mariusz Belka
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland
| | - Magdalena Okońska
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland
| | - Magdalena Pyszka
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland
| | - Tomasz Bączek
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, al. gen. J. Hallera 107, 80-416 Gdańsk, Poland.
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Hamedani BA, Melvin A, Vaheesan K, Gadani S, Pereira K, Hall AF. Three-dimensional printing CT-derived objects with controllable radiopacity. J Appl Clin Med Phys 2018; 19:317-328. [PMID: 29411529 PMCID: PMC5849815 DOI: 10.1002/acm2.12278] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 12/14/2017] [Accepted: 12/19/2017] [Indexed: 12/27/2022] Open
Abstract
Purpose The goal of this work was to develop phantoms for the optimization of pre‐operative computed tomography (CT) scans of the prostate artery, which are used for embolization planning. Methods Acrylonitrile butadiene styrene (ABS) pellets were doped with barium sulfate and extruded into filaments suitable for 3D printing on a fused deposition modeling (FDM) printer. Cylinder phantoms were created to evaluate radiopacity as a function of doping percentage. Small‐diameter tree phantoms were created to assess their composition and dimensional accuracy. A half‐pelvis phantom was created using clinical CT images, to assess the printer's control over cortical bone thickness and cancellous bone attenuation. CT‐derived prostate artery phantoms were created to simulate complex, contrast‐filled arteries. Results A linear relationship (R = 0.998) was observed between barium sulfate added (0%–10% by weight), and radiopacity (−31 to 1454 Hounsfield Units [HU]). Micro‐CT scans showed even distribution of the particles, with air pockets comprising 0.36% by volume. The small vessels were found to be oversized by a consistent amount of 0.08 mm. Micro‐CT scans revealed that the phantoms' interiors were completely filled in. The maximum HU values of cortical bone in the phantom were lower than that of the filament, a result of CT image reconstruction. Creation of cancellous bone regions with lower HU values, using the printer's infill parameter, was successful. Direct volume renderings of the pelvis and prostate artery were similar to the clinical CT, with the exception that the surfaces of the phantom objects were not as smooth. Conclusions It is possible to reliably create FDM 3D printer filaments with predictable radiopacity in a wide range of attenuation values, which can be used to print dimensionally accurate radiopaque objects derived from CT data. Phantoms of this type can be quickly and inexpensively developed to assess and optimize CT protocols for specific clinical applications.
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Affiliation(s)
- Borhan Alhosseini Hamedani
- Department of Mechanical Engineering, College of Engineering, Michigan State University, 428 S. Shaw Lane, East Lansing, MI, 48824, USA
| | - Alexa Melvin
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, 1 N. Grand Blvd., St. Louis, MO, 63103, USA
| | - Kirubahara Vaheesan
- Department of Radiology - Interventional Radiology, Saint Louis University School of Medicine, 3635 Vista Blvd., St. Louis, MO, 63110, USA
| | - Sameer Gadani
- Department of Radiology - Interventional Radiology, Saint Louis University School of Medicine, 3635 Vista Blvd., St. Louis, MO, 63110, USA
| | - Keith Pereira
- Department of Radiology - Interventional Radiology, Saint Louis University School of Medicine, 3635 Vista Blvd., St. Louis, MO, 63110, USA
| | - Andrew F Hall
- Department of Biomedical Engineering, Parks College of Engineering, Aviation and Technology, Saint Louis University, 1 N. Grand Blvd., St. Louis, MO, 63103, USA
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Mobbs RJ, Choy WJ, Wilson P, McEvoy A, Phan K, Parr WCH. L5 En-Bloc Vertebrectomy with Customized Reconstructive Implant: Comparison of Patient-Specific Versus Off-the-Shelf Implant. World Neurosurg 2018; 112:94-100. [PMID: 29366999 DOI: 10.1016/j.wneu.2018.01.078] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Spine surgery has the potential to benefit from additive manufacturing/3-dimensional printing (3DP) technology with complex anatomical pathologies requiring reconstruction, with the potential to customize surgery to reduce operative times, reduce blood loss, provide immediate stability, and potentially improve fusion rates. We report a unique case of intraoperative trial placement of a custom patient-specific implant (PSI) versus the final implantation of a customizable off-the-shelf (OTS) implant. Data collected for comparison included time to implant, ease of implantation, firmness of press-fit, and fixation options after implantation. CASE DESCRIPTION A 64-year-old man presented with low back pain. Computed tomography and magnetic resonance imaging revealed a solitary lesion in the L5 vertebral body, confirmed by positron emission tomography scan. Removal of the L5 vertebral body was performed, and reconstruction was achieved with an expandable cage. The time of implant insertion was minimal with the PSI (90 seconds) versus the OTS (>40 minutes). Immediate press-fit and "firmness" of implantation was clearly superior with the PSI, although this was an intraoperative subjective assessment. Other benefits include integral fixation that is predetermined with the PSI, reduced time and blood loss, and ease of bone grafting with a PSI. CONCLUSIONS Use of 3DP has been able to reduce operative time significantly. Surgeons can train before performing complex procedures, which enhances their presurgical planning, with the goal to maximize patient outcomes. When considering implants and prostheses, the use of 3DP allows a superior anatomical fit for the patient, with the potential to improve restoration of anatomy.
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Affiliation(s)
- Ralph J Mobbs
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia; NeuroSpine Surgery Research Group (NSURG), Sydney, Australia; Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia.
| | - Wen Jie Choy
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia
| | - Peter Wilson
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia; Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia
| | | | - Kevin Phan
- Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia; NeuroSpine Surgery Research Group (NSURG), Sydney, Australia; Department of Neurosurgery, Prince of Wales Hospital, Sydney, Australia; Faculty of Medicine, University of Sydney, Sydney, Australia
| | - William C H Parr
- 3DMorphic, UNSW, Sydney, Australia; SORL, Surgical & Orthopaedic Research Labs, UNSW, Sydney, Australia
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Reconstruction of Thoracic Spine Using a Personalized 3D-Printed Vertebral Body in Adolescent with T9 Primary Bone Tumor. World Neurosurg 2017; 105:1032.e13-1032.e17. [DOI: 10.1016/j.wneu.2017.05.133] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 05/23/2017] [Indexed: 01/09/2023]
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Three-Dimensional Printing of Hollow Portal Vein Stenosis Models: A Feasibility Study. J Vasc Interv Radiol 2017; 27:1755-1758. [PMID: 27926413 DOI: 10.1016/j.jvir.2016.05.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 05/18/2016] [Accepted: 05/19/2016] [Indexed: 12/14/2022] Open
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Alrasheed AS, Nguyen LHP, Mongeau L, Funnell WRJ, Tewfik MA. Development and validation of a 3D-printed model of the ostiomeatal complex and frontal sinus for endoscopic sinus surgery training. Int Forum Allergy Rhinol 2017; 7:837-841. [PMID: 28614638 DOI: 10.1002/alr.21960] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 04/10/2017] [Accepted: 04/25/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Endoscopic sinus surgery poses unique training challenges due to complex and variable anatomy, and the risk of major complications. We sought to create and provide validity evidence for a novel 3D-printed simulator of the nose and paranasal sinuses. METHODS Sinonasal computed tomography (CT) images of a patient were imported into 3D visualization software. Segmentation of bony and soft tissue structures was then performed. The model was printed using simulated bone and soft tissue materials. Rhinologists and otolaryngology residents completed 6 prespecified tasks including maxillary antrostomy and frontal recess dissection on the simulator. Participants evaluated the model using survey ratings based on a 5-point Likert scale. The average time to complete each task was calculated. Descriptive analysis was used to evaluate ratings, and thematic analysis was done for qualitative questions. RESULTS A total of 20 participants (10 rhinologists and 10 otolaryngology residents) tested the model and answered the survey. Overall the participants felt that the simulator would be useful as a training/educational tool (4.6/5), and that it should be integrated as part of the rhinology training curriculum (4.5/5). The following responses were obtained: visual appearance 4.25/5; realism of materials 3.8/5; and surgical experience 3.9/5. The average time to complete each task was lower for the rhinologist group than for the residents. CONCLUSION We describe the development and validation of a novel 3D-printed model for the training of endoscopic sinus surgery skills. Although participants found the simulator to be a useful training and educational tool, further model development could improve the outcome.
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Affiliation(s)
- Abdulaziz S Alrasheed
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montréal, QC, Canada
| | - Lily H P Nguyen
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montréal, QC, Canada
| | - Luc Mongeau
- Department of Mechanical Engineering, McGill University, Montréal, QC, Canada
| | - W Robert J Funnell
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montréal, QC, Canada.,Department of BioMedical Engineering, McGill University, Montréal, QC, Canada
| | - Marc A Tewfik
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montréal, QC, Canada
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Unterhofer C, Wipplinger C, Verius M, Recheis W, Thomé C, Ortler M. Reconstruction of large cranial defects with poly-methyl-methacrylate (PMMA) using a rapid prototyping model and a new technique for intraoperative implant modeling. Neurol Neurochir Pol 2017; 51:214-220. [DOI: 10.1016/j.pjnns.2017.02.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Revised: 02/06/2017] [Accepted: 02/23/2017] [Indexed: 10/20/2022]
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Creating vascular models by postprocessing computed tomography angiography images: a guide for anatomical education. Surg Radiol Anat 2017; 39:905-910. [PMID: 28168520 DOI: 10.1007/s00276-017-1822-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 01/16/2017] [Indexed: 01/17/2023]
Abstract
BACKGROUND A new application of teaching anatomy includes the use of computed tomography angiography (CTA) images to create clinically relevant three-dimensional (3D) printed models. The purpose of this article is to review recent innovations on the process and the application of 3D printed models as a tool for using under and post-graduate medical education. METHODS Images of aortic arch pattern received by CTA were converted into 3D images using the Google SketchUp free software and were saved in stereolithography format. Using a 3D printer (Makerbot), a model mode polylactic acid material was printed. RESULTS A two-vessel left aortic arch was identified consisting of the brachiocephalic trunk and left subclavian artery. The life-like 3D models were rotated 360° in all axes in hand. CONCLUSIONS The early adopters in education and clinical practices have embraced the medical imaging-guided 3D printed anatomical models for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between the anatomical structures. Printed vascular models are used to assist in preoperative planning, develop intraoperative guidance tools, and to teach patients surgical trainees in surgical practice.
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Vukicevic M, Mosadegh B, Min JK, Little SH. Cardiac 3D Printing and its Future Directions. JACC Cardiovasc Imaging 2017; 10:171-184. [PMID: 28183437 PMCID: PMC5664227 DOI: 10.1016/j.jcmg.2016.12.001] [Citation(s) in RCA: 284] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/21/2016] [Accepted: 12/22/2016] [Indexed: 12/15/2022]
Abstract
Three-dimensional (3D) printing is at the crossroads of printer and materials engineering, noninvasive diagnostic imaging, computer-aided design, and structural heart intervention. Cardiovascular applications of this technology development include the use of patient-specific 3D models for medical teaching, exploration of valve and vessel function, surgical and catheter-based procedural planning, and early work in designing and refining the latest innovations in percutaneous structural devices. In this review, we discuss the methods and materials being used for 3D printing today. We discuss the basic principles of clinical image segmentation, including coregistration of multiple imaging datasets to create an anatomic model of interest. With applications in congenital heart disease, coronary artery disease, and surgical and catheter-based structural disease, 3D printing is a new tool that is challenging how we image, plan, and carry out cardiovascular interventions.
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Affiliation(s)
- Marija Vukicevic
- Department of Cardiology, Weill Cornell Medicine, Houston Methodist Research Institute, Houston, Texas
| | - Bobak Mosadegh
- Department of Radiology and Medicine, Weill Cornell Medicine, New-York Presbyterian, New York, New York
| | - James K Min
- Department of Radiology and Medicine, Weill Cornell Medicine, New-York Presbyterian, New York, New York
| | - Stephen H Little
- Department of Cardiology, Weill Cornell Medicine, Houston Methodist Research Institute, Houston, Texas.
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Itagaki MW. Using 3D printed models for planning and guidance during endovascular intervention: a technical advance. Diagn Interv Radiol 2016; 21:338-41. [PMID: 26027767 DOI: 10.5152/dir.2015.14469] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Three-dimensional (3D) printing applications in medicine have been limited due to high cost and technical difficulty of creating 3D printed objects. It is not known whether patient-specific, hollow, small-caliber vascular models can be manufactured with 3D printing, and used for small vessel endoluminal testing of devices. Manufacture of anatomically accurate, patient-specific, small-caliber arterial models was attempted using data from a patient's CT scan, free open-source software, and low-cost Internet 3D printing services. Prior to endovascular treatment of a patient with multiple splenic artery aneurysms, a 3D printed model was used preoperatively to test catheter equipment and practice the procedure. A second model was used intraoperatively as a reference. Full-scale plastic models were successfully produced. Testing determined the optimal puncture site for catheter positioning. A guide catheter, base catheter, and microcatheter combination selected during testing was used intraoperatively with success, and the need for repeat angiograms to optimize image orientation was minimized. A difficult and unconventional procedure was successful in treating the aneurysms while preserving splenic function. We conclude that creation of small-caliber vascular models with 3D printing is possible. Free software and low-cost printing services make creation of these models affordable and practical. Models are useful in preoperative planning and intraoperative guidance.
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Affiliation(s)
- Michael W Itagaki
- Department of Interventional Radiology, Swedish Medical Center, Seattle, Washington, USA.
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Govsa F, Yagdi T, Ozer MA, Eraslan C, Alagoz AK. Building 3D anatomical model of coiling of the internal carotid artery derived from CT angiographic data. Eur Arch Otorhinolaryngol 2016; 274:1097-1102. [PMID: 27785571 DOI: 10.1007/s00405-016-4355-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 10/19/2016] [Indexed: 12/26/2022]
Abstract
The purpose of this study is to recreate live patient arterial anomalies using new recent application of three-dimensional (3D) printed anatomical models. Another purpose of building such models is to evaluate the effectiveness of angiographic data. With the help of the DICOM files from computed tomographic angiography (CT-A), we were able to build a printed model of variant course of the internal carotid artery (ICA). Images of coiling of the ICA taken by CT-A, were then converted into 3D images using Google SketchUp free software, and the images were saved in stereolithography format. Imaging helped us conduct the examination in details with reference to geometrical features of ICA, degree of curve, its extension, location and presence of loop. Challenging vascular anatomy was exposed with models of adverse curve of carotid anatomy, including highly angulated necks, conical necks, short necks, tortuous carotid arteries, and narrowed carotid lumens. It assisted us to comprehend spatial anatomy configuration of life-like models. 3D model can be very effective in cases when anatomical difficulties are detected through the CT-A, and therefore, a tactile approach is demanded preoperatively. 3D life-like models serve as an essential office-based tool in vascular surgery as they assist surgeons in preoperative planning, develop intraoperative guidance, teach both the patients and the surgical trainees, and simulate to show patient-specific procedures in medical field.
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Affiliation(s)
- Figen Govsa
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey.
| | - Tahir Yagdi
- Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Mehmet Asim Ozer
- Department of Anatomy, Faculty of Medicine, Ege University, 35100, Izmir, Turkey
| | - Cenk Eraslan
- Department of Radiology, Faculty of Medicine, Ege University, Izmir, Turkey
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3D Printed Models of Cleft Palate Pathology for Surgical Education. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e1029. [PMID: 27757345 PMCID: PMC5055011 DOI: 10.1097/gox.0000000000001029] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/13/2016] [Indexed: 12/14/2022]
Abstract
To explore the potential viability and limitations of 3D printed models of children with cleft palate deformity. BACKGROUND The advantages of 3D printed replicas of normal anatomical specimens have previously been described. The creation of 3D prints displaying patient-specific anatomical pathology for surgical planning and interventions is an emerging field. Here we explored the possibility of taking rare pediatric radiographic data sets to create 3D prints for surgical education. METHODS Magnetic resonance imaging data of 2 children (8 and 14 months) were segmented, colored, and anonymized, and stereolothographic files were prepared for 3D printing on either multicolor plastic or powder 3D printers and multimaterial 3D printers. RESULTS Two models were deemed of sufficient quality and anatomical accuracy to print unamended. One data set was further manipulated digitally to artificially extend the length of the cleft. Thus, 3 models were printed: 1 incomplete soft-palate deformity, 1 incomplete anterior palate deformity, and 1 complete cleft palate. All had cleft lip deformity. The single-material 3D prints are of sufficient quality to accurately identify the nature and extent of the deformities. Multimaterial prints were subsequently created, which could be valuable in surgical training. CONCLUSION Improvements in the quality and resolution of radiographic imaging combined with the advent of multicolor multiproperty printer technology will make it feasible in the near future to print 3D replicas in materials that mimic the mechanical properties and color of live human tissue making them potentially suitable for surgical training.
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Sedlacik J, Frölich A, Spallek J, Forkert ND, Faizy TD, Werner F, Knopp T, Krause D, Fiehler J, Buhk JH. Magnetic Particle Imaging for High Temporal Resolution Assessment of Aneurysm Hemodynamics. PLoS One 2016; 11:e0160097. [PMID: 27494610 PMCID: PMC4975468 DOI: 10.1371/journal.pone.0160097] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 07/07/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose The purpose of this work was to demonstrate the capability of magnetic particle imaging (MPI) to assess the hemodynamics in a realistic 3D aneurysm model obtained by additive manufacturing. MPI was compared with magnetic resonance imaging (MRI) and dynamic digital subtraction angiography (DSA). Materials and Methods The aneurysm model was of saccular morphology (7 mm dome height, 5 mm cross-section, 3–4 mm neck, 3.5 mm parent artery diameter) and connected to a peristaltic pump delivering a physiological flow (250 mL/min) and pulsation rate (70/min). High-resolution (4 h long) 4D phase contrast flow quantification (4D pc-fq) MRI was used to directly assess the hemodynamics of the model. Dynamic MPI, MRI, and DSA were performed with contrast agent injections (3 mL volume in 3 s) through a proximally placed catheter. Results and Discussion 4D pc-fq measurements showed distinct pulsatile flow velocities (20–80 cm/s) as well as lower flow velocities and a vortex inside the aneurysm. All three dynamic methods (MPI, MRI, and DSA) also showed a clear pulsation pattern as well as delayed contrast agent dynamics within the aneurysm, which is most likely caused by the vortex within the aneurysm. Due to the high temporal resolution of MPI and DSA, it was possible to track the contrast agent bolus through the model and to estimate the average flow velocity (about 60 cm/s), which is in accordance with the 4D pc-fq measurements. Conclusions The ionizing radiation free, 4D high resolution MPI method is a very promising tool for imaging and characterization of hemodynamics in human. It carries the possibility of overcoming certain disadvantages of other modalities like considerably lower temporal resolution of dynamic MRI and limited 2D characteristics of DSA. Furthermore, additive manufacturing is the key for translating powerful pre-clinical techniques into the clinic.
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Affiliation(s)
- Jan Sedlacik
- Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Andreas Frölich
- Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johanna Spallek
- Department of Product Development and Mechanical Engineering Design, Hamburg University of Technology, Hamburg, Germany
| | - Nils D. Forkert
- Department of Radiology and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Tobias D. Faizy
- Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Werner
- Section for Biomedical Imaging, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute for Biomedical Imaging, Hamburg University of Technology, Hamburg, Germany
| | - Tobias Knopp
- Section for Biomedical Imaging, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute for Biomedical Imaging, Hamburg University of Technology, Hamburg, Germany
| | - Dieter Krause
- Department of Product Development and Mechanical Engineering Design, Hamburg University of Technology, Hamburg, Germany
| | - Jens Fiehler
- Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan-Hendrik Buhk
- Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Tam MD, Latham TR, Lewis M, Khanna K, Zaman A, Parker M, Grunwald IQ. A Pilot Study Assessing the Impact of 3-D Printed Models of Aortic Aneurysms on Management Decisions in EVAR Planning. Vasc Endovascular Surg 2016; 50:4-9. [DOI: 10.1177/1538574415623651] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Endovascular repair of aortic aneurysms with difficult anatomy is challenging. There is no consensus for planning such procedures. Methods: Six cases of aortic aneurysms with challenging anatomical features, such as short, angulated, and conical necks and tortuous iliacs were harvested. The computed tomography (CT) scans were anonymized. Lifesize 3-dimensional (3-D) printed models were created of the lumen. Endovascular operators were asked to review the CT angiography (CTA), make a management plan, and give an indication of their confidence. They were then presented with the equivalent model and asked to review their decision. Their attitudes to such models were briefly surveyed. Results: A total of 28 endovascular operators reviewed 144 cases. After review of the physical model, the management plan changed in 29 (20.1%) of 144 cases. Initial plan after CTA review was endovascular 73.6%, open repair 22.9%, and second opinion 3.5%. After model review, this became endovascular 67.4%, open repair 19.4%, and second opinion 4.8%. Although the general trend was toward more open procedures, off-label techniques reduced from 19.4% to 15.2% following model review. When the management plan did not change, level of confidence did increase in 37 (43.5%) of 85 cases. The majority of operators stated that they would find models useful for planning in some procedures. For 1 case, the change in the percentage of participants being sure in the management plan was statistically significant ( P = .031). Conclusion: The 3-D printed models may be potentially useful in planning cases with EVAR. It is a paradigm that warrants further investigation.
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Affiliation(s)
- Matthew D. Tam
- Department of Radiology, Southend University Hopsital NHS Foundation Trust, Southend, United Kingdom
| | - Tom R. Latham
- Department of Radiology, Southend University Hopsital NHS Foundation Trust, Southend, United Kingdom
| | - Mark Lewis
- Department of Radiology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom
| | - Kunal Khanna
- Department of Radiology, St. Bartholomew’s and the Royal London NHS Foundation Trust, London, United Kingdom
| | - Ali Zaman
- Department of Radiology, Southend University Hopsital NHS Foundation Trust, Southend, United Kingdom
| | - Mike Parker
- Neuroscience and Vascular Simulation Unit, Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Iris Q. Grunwald
- Department of Radiology, Southend University Hopsital NHS Foundation Trust, Southend, United Kingdom
- Neuroscience and Vascular Simulation Unit, Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, United Kingdom
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Frölich AMJ, Spallek J, Brehmer L, Buhk JH, Krause D, Fiehler J, Kemmling A. 3D Printing of Intracranial Aneurysms Using Fused Deposition Modeling Offers Highly Accurate Replications. AJNR Am J Neuroradiol 2016; 37:120-4. [PMID: 26294648 DOI: 10.3174/ajnr.a4486] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 06/17/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE As part of a multicenter cooperation (Aneurysm-Like Synthetic bodies for Testing Endovascular devices in 3D Reality) with focus on implementation of additive manufacturing in neuroradiologic practice, we systematically assessed the technical feasibility and accuracy of several additive manufacturing techniques. We evaluated the method of fused deposition modeling for the production of aneurysm models replicating patient-specific anatomy. MATERIALS AND METHODS 3D rotational angiographic data from 10 aneurysms were processed to obtain volumetric models suitable for fused deposition modeling. A hollow aneurysm model with connectors for silicone tubes was fabricated by using acrylonitrile butadiene styrene. Support material was dissolved, and surfaces were finished by using NanoSeal. The resulting models were filled with iodinated contrast media. 3D rotational angiography of the models was acquired, and aneurysm geometry was compared with the original patient data. RESULTS Reproduction of hollow aneurysm models was technically feasible in 8 of 10 cases, with aneurysm sizes ranging from 41 to 2928 mm(3) (aneurysm diameter, 3-19 mm). A high level of anatomic accuracy was observed, with a mean Dice index of 93.6% ± 2.4%. Obstructions were encountered in vessel segments of <1 mm. CONCLUSIONS Fused deposition modeling is a promising technique, which allows rapid and precise replication of cerebral aneurysms. The porosity of the models can be overcome by surface finishing. Models produced with fused deposition modeling may serve as educational and research tools and could be used to individualize treatment planning.
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Affiliation(s)
- A M J Frölich
- From the Department of Diagnostic and Interventional Neuroradiology (A.M.J.F., L.B., J.-H.B., J.F., A.K.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Spallek
- Technical University Hamburg-Harburg (D.K., J.S.), Institute of Product Development and Mechanical Engineering Design, Hamburg, Germany
| | - L Brehmer
- From the Department of Diagnostic and Interventional Neuroradiology (A.M.J.F., L.B., J.-H.B., J.F., A.K.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J-H Buhk
- From the Department of Diagnostic and Interventional Neuroradiology (A.M.J.F., L.B., J.-H.B., J.F., A.K.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Krause
- Technical University Hamburg-Harburg (D.K., J.S.), Institute of Product Development and Mechanical Engineering Design, Hamburg, Germany
| | - J Fiehler
- From the Department of Diagnostic and Interventional Neuroradiology (A.M.J.F., L.B., J.-H.B., J.F., A.K.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Kemmling
- From the Department of Diagnostic and Interventional Neuroradiology (A.M.J.F., L.B., J.-H.B., J.F., A.K.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Hoffman A, Nitecki S, Karram T, Leiderman M, Kogan I, Yudkovsky G, Ofer A. Enlarged and Colored Enhanced 3D Printing of Renal Artery Aneurysms for Improved Imaging and Treatment Planning. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/wjcd.2016.61001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cao P, Duhamel Y, Olympe G, Ramond B, Langevin F. A new production method of elastic silicone carotid phantom based on MRI acquisition using rapid prototyping technique. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2013:5331-4. [PMID: 24110940 DOI: 10.1109/embc.2013.6610753] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In vitro experimental simulations of blood fluid in carotid artery require ideal phantoms that are as precise as possible. The purpose of this work is to demonstrate a method for carotid phantom fabrication by rapid prototyping technique (RP). By using 3D reconstructed projection of the 3D time-of-flight (TOF) Magnetic Resonance Imaging (MRI) sequence, a 12.5 cm multi-dimensional spatial structure of a carotid artery has been set up. Y-shaped and patient specific models have been generated respectively using silicone elastomer, which has a high resilience and a good tensile strength. The final patient specific model has internal carotid artery (ICA) with a highly spiraling siphon and an external carotid artery (ECA). Elastic properties of carotid walls have also been evaluated by Young's elastic modulus test and dynamic behaviors in optical and echography simulation experiments.
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Tam MD, Latham T, Brown JRI, Jakeways M. Use of a 3D printed hollow aortic model to assist EVAR planning in a case with complex neck anatomy: potential of 3D printing to improve patient outcome. J Endovasc Ther 2015; 21:760-2. [PMID: 25290807 DOI: 10.1583/14-4810l.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Matthew D Tam
- Departments of 1Radiology and 3Surgery, Southend University Hospital NHS Foundation Trust, Westcliff on Sea, UK 2Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK,
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DOUTEL E, CARNEIRO J, OLIVEIRA MSN, CAMPOS JBLM, MIRANDA JM. FABRICATION OF 3D MILI-SCALE CHANNELS FOR HEMODYNAMIC STUDIES. J MECH MED BIOL 2015. [DOI: 10.1142/s0219519415500049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
3D mili-scale channel representing simplified anatomical models of blood vessels were constructed in polidimethylsiloxane (PDMS). The objective was to obtain a sequential method to fabricate transparent PDMS models from a mold produced by rapid prototyping. For this purpose, two types of casting methods were compared, a known lost-wax casting method and a casting method using sucrose. The channels fabricated by both casting methods were analyzed by Optical Microscopy, Scanning Electron Microscopy (SEM), and Energy Dispersive X-ray Spectroscopy (EDS). The lost-wax method is not ideal since the channels become contaminated during the removal process. The models produced with the lost-sucrose casting method exhibit much better optical characteristics. These models are transparent with no visible contamination, since the removing process is done by dissolution at room temperature rather than melting. They allow for good optical access for flow visualization and measurement of the velocity field by micro-Particle Image Velocimetry (μPIV). The channels fabricated by the lost-sucrose casting method were shown to be suitable for future hemodynamic studies using optical techniques.
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Affiliation(s)
- E. DOUTEL
- Centro de Estudos de Fenómenos de Transporte, Departamento de Engenharia Química, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - J. CARNEIRO
- Centro de Estudos de Fenómenos de Transporte, Departamento de Engenharia Química, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - M. S. N. OLIVEIRA
- Department of Mechanical and Aerospace Engineering, University of Strathclyde, Glasgow G1 1XJ, UK
| | - J. B. L. M. CAMPOS
- Centro de Estudos de Fenómenos de Transporte, Departamento de Engenharia Química, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - J. M. MIRANDA
- Centro de Estudos de Fenómenos de Transporte, Departamento de Engenharia Química, Faculdade de Engenharia da Universidade do Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
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Ghassemi P, Wang J, Melchiorri AJ, Ramella-Roman JC, Mathews SA, Coburn JC, Sorg BS, Chen Y, Joshua Pfefer T. Rapid prototyping of biomimetic vascular phantoms for hyperspectral reflectance imaging. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:121312. [PMID: 26662064 PMCID: PMC4881289 DOI: 10.1117/1.jbo.20.12.121312] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/20/2015] [Indexed: 05/03/2023]
Abstract
The emerging technique of rapid prototyping with three-dimensional (3-D) printers provides a simple yet revolutionary method for fabricating objects with arbitrary geometry. The use of 3-D printing for generating morphologically biomimetic tissue phantoms based on medical images represents a potentially major advance over existing phantom approaches. Toward the goal of image-defined phantoms, we converted a segmented fundus image of the human retina into a matrix format and edited it to achieve a geometry suitable for printing. Phantoms with vessel-simulating channels were then printed using a photoreactive resin providing biologically relevant turbidity, as determined by spectrophotometry. The morphology of printed vessels was validated by x-ray microcomputed tomography. Channels were filled with hemoglobin (Hb) solutions undergoing desaturation, and phantoms were imaged with a near-infrared hyperspectral reflectance imaging system. Additionally, a phantom was printed incorporating two disjoint vascular networks at different depths, each filled with Hb solutions at different saturation levels. Light propagation effects noted during these measurements—including the influence of vessel density and depth on Hb concentration and saturation estimates, and the effect of wavelength on vessel visualization depth—were evaluated. Overall, our findings indicated that 3-D-printed biomimetic phantoms hold significant potential as realistic and practical tools for elucidating light–tissue interactions and characterizing biophotonic system performance.
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Affiliation(s)
- Pejhman Ghassemi
- Food and Drug Administration, Center for Devices and Radiological Health, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
| | - Jianting Wang
- Food and Drug Administration, Center for Devices and Radiological Health, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
- University of Maryland, Fischell Department of Bioengineering, 3142 Jeong H. Kim Engineering Building, College Park, Maryland 20742, United States
| | - Anthony J. Melchiorri
- University of Maryland, Fischell Department of Bioengineering, 3142 Jeong H. Kim Engineering Building, College Park, Maryland 20742, United States
| | - Jessica C. Ramella-Roman
- Florida International University, Department of Biomedical Engineering and Herbert Wertheim College of Medicine, E6 2610, 10555 West Flagler Street, Miami, Florida 33174, United States
| | - Scott A. Mathews
- The Catholic University of America, Department of Electrical Engineering and Computer Science, 620 Michigan Avenue NE, Washington, District of Columbia 20064, United States
| | - James C. Coburn
- Food and Drug Administration, Center for Devices and Radiological Health, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
| | - Brian S. Sorg
- National Institutes of Health, National Cancer Institute, 9609 Medical Center Drive, Rockville, Maryland 20852, United States
| | - Yu Chen
- University of Maryland, Fischell Department of Bioengineering, 3142 Jeong H. Kim Engineering Building, College Park, Maryland 20742, United States
| | - T. Joshua Pfefer
- Food and Drug Administration, Center for Devices and Radiological Health, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993, United States
- Address all correspondence to: T. Joshua Pfefer, E-mail:
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Tam MDBS, Laycock SD, Brown JRI, Jakeways M. 3D printing of an aortic aneurysm to facilitate decision making and device selection for endovascular aneurysm repair in complex neck anatomy. J Endovasc Ther 2014; 20:863-7. [PMID: 24325705 DOI: 10.1583/13-4450mr.1] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To describe rapid prototyping or 3-dimensional (3D) printing of aneurysms with complex neck anatomy to facilitate endovascular aneurysm repair (EVAR). CASE REPORT A 75-year-old man had a 6.6-cm infrarenal aortic aneurysm that appeared on computed tomographic angiography to have a sharp neck angulation of ~90°. However, although the computed tomography (CT) data were analyzed using centerline of flow, the true neck length and relations of the ostial origins were difficult to determine. No multidisciplinary consensus could be reached as to which stent-graft to use owing to these borderline features of the neck anatomy. Based on past experience with rapid prototyping technology, a decision was taken to print a model of the aneurysm to aid in visualization of the neck anatomy. The CT data were segmented, processed, and converted into a stereolithographic format representing the lumen as a 3D volume, from which a full-sized replica was printed within 24 hours. The model demonstrated that the neck was adequate for stent-graft repair using the Aorfix device. CONCLUSION Rapid prototyping of aortic aneurysms is feasible and can aid decision making and device delivery. Further work is required to test the value of 3D replicas in planning procedures and their impact on procedure time, radiation dose, and procedure cost.
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Affiliation(s)
- Matthew D B S Tam
- 1 Department of Radiology, Southend University Hospital NHS Foundation Trust, Westcliff on Sea, UK. 2Postgraduate Medical Institute, Anglia Ruskin University, Chelmsford, UK
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Abstract
BACKGROUND Three-dimensional printing represents an evolving technology still in its infancy. Currently, individuals and small business entities have the ability to manufacture physical objects from digital renderings, computer-aided design, and open source files. Design modifications and improvements in extrusion methods have made this technology much more affordable. This article explores the potential uses of three-dimensional printing in plastic surgery. METHODS A review was performed detailing the known uses of three-dimensional printing in medicine. The potential applications of three-dimensional printing in plastic surgery are discussed. RESULTS Various applications for three-dimensional printing technology have emerged in medicine, including printing organs, printing body parts, bio-printing, and computer-aided tissue engineering. In plastic surgery, these tools offer various prospective applications for surgical planning, resident education, and the development of custom prosthetics. CONCLUSIONS Numerous applications exist in medicine, including the printing of devices, implants, tissue replacements, and even whole organs. Plastic surgeons may likely find this technology indispensable in surgical planning, education, and prosthetic device design and development in the near future.
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Gounis MJ, Wakhloo AK, Chueh JY. Preclinical Investigations for Thrombectomy Devices--Does it Translate to Humans? Stroke 2013; 44:S7-S10. [DOI: 10.1161/strokeaha.111.000692] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rengier F, Mehndiratta A, von Tengg-Kobligk H, Zechmann CM, Unterhinninghofen R, Kauczor HU, Giesel FL. 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg 2010; 5:335-41. [DOI: 10.1007/s11548-010-0476-x] [Citation(s) in RCA: 1066] [Impact Index Per Article: 76.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 04/21/2010] [Indexed: 11/28/2022]
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Abstract
INTRODUCTION The anatomy of the temporal bone (TB) can only be mastered by repeated surgical and anatomic dissections, and surgical teaching initiative had a major effect on outcomes. The aim of this study was to investigate the validity of an artificial TB model devoted to surgical training and education. MATERIALS AND METHODS A helical computed tomographic (CT) scan was used to acquire high-resolution data of cadaveric TB. Digital imaging and communications in medicine (DICOM) data were converted into.stl files after data processing. Cadaveric TBs were prototyped using stereolithography. The validation of the prototype needed several steps. First of all, we have studied on CT scan the positional relationship between the facial nerve and other structures of the cadaveric TBs and prototyped bones. Otoendoscopy of the middle ear and the internal acoustic canal and visualization of anatomic landmarks during TB drilling of the cadaveric TBs and prototyped bones were also performed. RESULTS Seven normal CT scans of cadaveric TB were selected to make prototyped bone using stereolithography. Measurements of volume and distance showed no significant difference between prototypes and cadaver TBs. Classic mastoid surgical procedures were performed in the Anatomy Department: exposing sigmoid sinus, facial nerve, labyrinth, dura mater, jugular bulb, and internal carotid artery. Two simulations of implantable middle ear prosthesis were made successfully. CONCLUSION These prototypes made using stereolithography seem to be a good anatomic model for surgical training. This model could also be interesting for surgical planning in congenital ear anomalies before middle ear prosthesis implantation.
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Chueh JY, Wakhloo AK, Gounis MJ. Neurovascular modeling: small-batch manufacturing of silicone vascular replicas. AJNR Am J Neuroradiol 2009; 30:1159-64. [PMID: 19321626 DOI: 10.3174/ajnr.a1543] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Realistic, population based cerebrovascular replicas are required for the development of neuroendovascular devices. The objective of this work was to develop an efficient methodology for manufacturing realistic cerebrovascular replicas. MATERIALS AND METHODS Brain MR angiography data from 20 patients were acquired. The centerline of the vasculature was calculated, and geometric parameters were measured to describe quantitatively the internal carotid artery (ICA) siphon. A representative model was created on the basis of the quantitative measurements. Using this virtual model, we designed a mold with core-shell structure and converted it into a physical object by fused-deposit manufacturing. Vascular replicas were created by injection molding of different silicones. Mechanical properties, including the stiffness and luminal coefficient of friction, were measured. RESULTS The average diameter, length, and curvature of the ICA siphon were 4.15 +/- 0.09 mm, 22.60 +/- 0.79 mm, and 0.34 +/- 0.02 mm(-1) (average +/- standard error of the mean), respectively. From these image datasets, we created a median virtual model, which was transformed into a physical replica by an efficient batch-manufacturing process. The coefficient of friction of the luminal surface of the replica was reduced by up to 55% by using liquid silicone rubber coatings. The modulus ranged from 0.67 to 1.15 MPa compared with 0.42 MPa from human postmortem studies, depending on the material used to make the replica. CONCLUSIONS Population-representative, smooth, and true-to-scale silicone arterial replicas with uniform wall thickness were successfully built for in vitro neurointerventional device-testing by using a batch-manufacturing process.
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Affiliation(s)
- J Y Chueh
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA 01655, USA
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Wong EY, Thorne ML, Nikolov HN, Poepping TL, Holdsworth DW. Doppler ultrasound compatible plastic material for use in rigid flow models. ULTRASOUND IN MEDICINE & BIOLOGY 2008; 34:1846-1856. [PMID: 18343018 DOI: 10.1016/j.ultrasmedbio.2008.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Revised: 12/13/2007] [Accepted: 01/08/2008] [Indexed: 05/26/2023]
Abstract
A technique for the rapid but accurate fabrication of multiple flow phantoms with variations in vascular geometry would be desirable in the investigation of carotid atherosclerosis. This study demonstrates the feasibility and efficacy of implementing numerically controlled direct-machining of vascular geometries into Doppler ultrasound (DUS)-compatible plastic for the easy fabrication of DUS flow phantoms. Candidate plastics were tested for longitudinal speed of sound (SoS) and acoustic attenuation at the diagnostic frequency of 5 MHz. Teflon was found to have the most appropriate SoS (1376 +/- 40 m s(-1) compared with 1540 m s(-1) in soft tissue) and thus was selected to construct a carotid bifurcation flow model with moderate eccentric stenosis. The vessel geometry was machined directly into Teflon using a numerically controlled milling technique. Geometric accuracy of the phantom lumen was verified using nondestructive micro-computed tomography. Although Teflon displayed a higher attenuation coefficient than other tested materials, Doppler data acquired in the Teflon flow model indicated that sufficient signal power was delivered throughout the depth of the vessel and provided comparable velocity profiles to that obtained in the tissue-mimicking phantom. Our results indicate that Teflon provides the best combination of machinability and DUS compatibility, making it an appropriate choice for the fabrication of rigid DUS flow models using a direct-machining method.
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Affiliation(s)
- Emily Y Wong
- Robarts Research Institute, The University of Western Ontario, London, Ontario, Canada
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Abstract
As the appreciation of structural heart disease in children and adults has increased and as catheter-based closure procedures are now being performed in clinical practice, cardiovascular physicians have multiple compelling new reasons to better understand cardiac anatomic and spatial relationships. Current 2-dimensional imaging techniques remain limited both in their ability to represent the complex 3-dimensional relationships present in structural heart disease and in their capacity to adequately facilitate often complex corrective procedures. This review discusses the cardiovascular applications of rapid prototyping, a new technology that may not only play a significant role in the planning of catheter-based interventions but also may serve as a valuable educational tool to enhance the medical community’s understanding of the many forms of structural heart disease.
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Affiliation(s)
- Michael S. Kim
- From the University of Colorado at Denver, Aurora, Colo (M.S.K., A.R.H., R.A.Q., J.D.C.); and Philips Healthcare, Bothell, Wash (O.W.)
| | - Adam R. Hansgen
- From the University of Colorado at Denver, Aurora, Colo (M.S.K., A.R.H., R.A.Q., J.D.C.); and Philips Healthcare, Bothell, Wash (O.W.)
| | - Onno Wink
- From the University of Colorado at Denver, Aurora, Colo (M.S.K., A.R.H., R.A.Q., J.D.C.); and Philips Healthcare, Bothell, Wash (O.W.)
| | - Robert A. Quaife
- From the University of Colorado at Denver, Aurora, Colo (M.S.K., A.R.H., R.A.Q., J.D.C.); and Philips Healthcare, Bothell, Wash (O.W.)
| | - John D. Carroll
- From the University of Colorado at Denver, Aurora, Colo (M.S.K., A.R.H., R.A.Q., J.D.C.); and Philips Healthcare, Bothell, Wash (O.W.)
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Sulaiman A, Roty C, Serfaty JM, Attia C, Huet L, Douek P. In vitro, nonrigid model of aortic arch aneurysm. J Vasc Interv Radiol 2008; 19:919-24. [PMID: 18503908 DOI: 10.1016/j.jvir.2008.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Revised: 02/04/2008] [Accepted: 02/04/2008] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To develop and validate a controlled patient-derived process for producing an in vitro, nonrigid model of aortic arch aneurysm. MATERIALS AND METHODS A three-dimensional magnetic resonance (MR) angiogram derived from a patient with an aortic arch aneurysm was segmented by using a homemade software package, meshed and converted to Standard Tessellation Language (STL) file format. The authors transferred this format to a stereolithography machine to produce a replica of the entire aorta, including the arch aneurysm and supraaortic arteries, by pouring silicone rubber. RESULTS A sturdy, life-size, soft, transparent plastic cast, accurately reproducing both the internal and external anatomy of the aortic aneurysm, was produced in less than 1 week. Comparison between the STL file format of MR angiographic images of both the patient's aorta and model enabled validation of the reliability of the manufacturing process. CONCLUSIONS The combination of easy segmentation and conversion to the STL file format with stereolithography techniques enabled a realistic, life-size, silicone vascular phantom to be created from a live patient imaging dataset.
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Affiliation(s)
- Abdulrazzaq Sulaiman
- Department of Cardiovascular Radiology, Cardiovascular Hospital (Louis Pradel), CREATIS, UMR 5515, U630 INSERM, 69394 Lyon Cedex 03, France.
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Schievano S, Migliavacca F, Coats L, Khambadkone S, Carminati M, Wilson N, Deanfield JE, Bonhoeffer P, Taylor AM. Percutaneous Pulmonary Valve Implantation Based on Rapid Prototyping of Right Ventricular Outflow Tract and Pulmonary Trunk from MR Data. Radiology 2007; 242:490-7. [PMID: 17255420 DOI: 10.1148/radiol.2422051994] [Citation(s) in RCA: 176] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine if magnetic resonance (MR) imaging data can be used to create rigid models that are accurate representations of the right ventricular outflow tract (RVOT) and pulmonary trunk anatomy and if such models can be used to refine the selection of patients for percutaneous pulmonary valve implantation (PPVI). MATERIALS AND METHODS Institutional review board approval and informed patient consent were obtained. Twelve patients' MR data were analyzed and elaborated for input into a rapid prototyping (RP) system. RP models were successfully built and presented to two experienced cardiologists, who were retrospectively asked if they would have attempted PPVI. Their responses were compared with the documented decisions and outcomes of PPVI. RESULTS For four subjects, both cardiologists correctly determined, on the basis of MR image or three-dimensional (3D) RP model findings, that PPVI should not have been attempted. Two patients in whom PPVI was attempted were considered to be unsuitable for the procedure after balloon sizing, and in another two patients, implantation was unsuccessful because of device instability. For the four patients in whom PPVI was suitable and the four in whom it was unsuitable, observers 1 and 2 correctly determined suitability for PPVI in four and two patients, respectively, by using the MR images alone. Both observers correctly determined the suitability of five patients by using the 3D models alone. CONCLUSION Using 3D RP models resulted in more accurate selection of patients for PPVI than did using MR images.
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Affiliation(s)
- Silvia Schievano
- Cardiothoracic Unit, UCL Institute of Child Health & Great Ormond Street Hospital for Children, Great Ormond St, London WC1N 3JH, England
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Frauenfelder T, Lotfey M, Boehm T, Wildermuth S. Computational fluid dynamics: hemodynamic changes in abdominal aortic aneurysm after stent-graft implantation. Cardiovasc Intervent Radiol 2006; 29:613-23. [PMID: 16508795 DOI: 10.1007/s00270-005-0227-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to demonstrate quantitatively and qualitatively the hemodynamic changes in abdominal aortic aneurysms (AAA) after stent-graft placement based on multidetector CT angiography (MDCT-A) datasets using the possibilities of computational fluid dynamics (CFD). Eleven patients with AAA and one patient with left-side common iliac aneurysm undergoing MDCT-A before and after stent-graft implantation were included. Based on the CT datasets, three-dimensional grid-based models of AAA were built. The minimal size of tetrahedrons was determined for grid-independence simulation. The CFD program was validated by comparing the calculated flow with an experimentally generated flow in an identical, anatomically correct silicon model of an AAA. Based on the results, pulsatile flow was simulated. A laminar, incompressible flow-based inlet condition, zero traction-force outlet boundary, and a no-slip wall boundary condition was applied. The measured flow volume and visualized flow pattern, wall pressure, and wall shear stress before and after stent-graft implantation were compared. The experimentally and numerically generated streamlines are highly congruent. After stenting, the simulation shows a reduction of wall pressure and wall shear stress and a more equal flow through both external iliac arteries after stenting. The postimplantation flow pattern is characterized by a reduction of turbulences. New areas of high pressure and shear stress appear at the stent bifurcation and docking area. CFD is a versatile and noninvasive tool to demonstrate changes of flow rate and flow pattern caused by stent-graft implantation. The desired effect and possible complications of a stent-graft implantation can be visualized. CFD is a highly promising technique and improves our understanding of the local structural and fluid dynamic conditions for abdominal aortic stent placement.
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Affiliation(s)
- Thomas Frauenfelder
- Institute of Diagnostic Radiology, University Hospital of Zurich, Zurich, Switzerland.
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