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Abdollahi S, Mowlavi AA, Yazdi MHH, Ceberg S, Aznar MC, Tabrizi FV, Salek R, Guckenberger M, Tanadini-Lang S. Dynamic anthropomorphic thorax phantom for quality assurance of motion management in radiotherapy. Phys Imaging Radiat Oncol 2024; 30:100587. [PMID: 38818304 PMCID: PMC11137593 DOI: 10.1016/j.phro.2024.100587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 06/01/2024] Open
Abstract
Background and purpose Motion management techniques are important to spare the healthy tissue adequately. However, they are complex and need dedicated quality assurance. The aim of this study was to create a dynamic phantom designed for quality assurance and to replicate a patient's size, anatomy, and tissue density. Materials and methods A computed tomography (CT) scan of a cancer patient was used to create molds for the lungs, heart, ribs, and vertebral column via additive manufacturing. A pump system and software were developed to simulate respiratory dynamics. The extent of respiratory motion was quantified using a 4DCT scan. End-to-end tests were conducted to evaluate two motion management techniques for lung stereotactic body radiotherapy (SBRT). Results The chest wall moved between 4 mm and 13 mm anteriorly and 2 mm to 7 mm laterally during the breathing. The diaphragm exhibited superior-inferior movement ranging from 5 mm to 16 mm in the left lung and 10 mm to 36 mm in the right lung. The left lung tumor displaced ± 7 mm superior-inferiorly and anterior-posteriorly. The CT numbers were for lung: -716 ± 108 HU (phantom) and -713 ± 70 HU (patient); bone: 460 ± 20 HU (phantom) and 458 ± 206 HU (patient); soft tissue: 92 ± 9 HU (phantom) and 60 ± 25 HU (patient). The end-to-end testing showed an excellent agreement between the measured and the calculated dose for ion chamber and film dosimetry. Conclusions The phantom is recommended for quality assurance, evaluating the institution's specific planning and motion management strategies either through end-to-end testing or as an external audit phantom.
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Affiliation(s)
- Sara Abdollahi
- Department of Physics, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran
- Department of Radiation Oncology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Ali Asghar Mowlavi
- Department of Physics, Hakim Sabzevari University, Sabzevar, Iran
- Département de physique, Université de Montréal, Montréal, Québec, Canada
| | | | - Sofie Ceberg
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Marianne Camille Aznar
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | | | - Roham Salek
- Department of Radiation Oncology, Mashhad University of Medical Science, Mashhad, Iran
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, 8091 Zurich, Switzerland
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Liu H, Gong Y, Zhang K, Ke S, Wang Y, Wang J, Wang H. Recent Advances in Decellularized Matrix-Derived Materials for Bioink and 3D Bioprinting. Gels 2023; 9:gels9030195. [PMID: 36975644 PMCID: PMC10048399 DOI: 10.3390/gels9030195] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
As an emerging 3D printing technology, 3D bioprinting has shown great potential in tissue engineering and regenerative medicine. Decellularized extracellular matrices (dECM) have recently made significant research strides and have been used to create unique tissue-specific bioink that can mimic biomimetic microenvironments. Combining dECMs with 3D bioprinting may provide a new strategy to prepare biomimetic hydrogels for bioinks and hold the potential to construct tissue analogs in vitro, similar to native tissues. Currently, the dECM has been proven to be one of the fastest growing bioactive printing materials and plays an essential role in cell-based 3D bioprinting. This review introduces the methods of preparing and identifying dECMs and the characteristic requirements of bioink for use in 3D bioprinting. The most recent advances in dECM-derived bioactive printing materials are then thoroughly reviewed by examining their application in the bioprinting of different tissues, such as bone, cartilage, muscle, the heart, the nervous system, and other tissues. Finally, the potential of bioactive printing materials generated from dECM is discussed.
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Affiliation(s)
- Huaying Liu
- College of Life Sciences and Bioengineering, School of Physical Science and Engineering, Beijing Jiaotong University, Beijing 100091, China
| | - Yuxuan Gong
- College of Life Sciences and Bioengineering, School of Physical Science and Engineering, Beijing Jiaotong University, Beijing 100091, China
| | - Kaihui Zhang
- College of Life Sciences and Bioengineering, School of Physical Science and Engineering, Beijing Jiaotong University, Beijing 100091, China
- College of Life Sciences, Inner Mongolia University, Hohhot 010070, China
| | - Shen Ke
- College of Life Sciences and Bioengineering, School of Physical Science and Engineering, Beijing Jiaotong University, Beijing 100091, China
| | - Yue Wang
- National Institutes for Food and Drug Control, Beijing 102629, China
| | - Jing Wang
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, China
- Correspondence: (J.W.); (H.W.)
| | - Haibin Wang
- College of Life Sciences and Bioengineering, School of Physical Science and Engineering, Beijing Jiaotong University, Beijing 100091, China
- Correspondence: (J.W.); (H.W.)
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Laidlaw J, Earl N, Shavdia N, Davis R, Mayer S, Karaman D, Richtsmeier D, Rodesch PA, Bazalova-Carter M. Design and CT imaging of casper, an anthropomorphic breathing thorax phantom. Biomed Phys Eng Express 2023; 9. [PMID: 36724499 DOI: 10.1088/2057-1976/acb7f7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/01/2023] [Indexed: 02/03/2023]
Abstract
The goal of this work was to build an anthropomorphic thorax phantom capable of breathing motion with materials mimicking human tissues in x-ray imaging applications. The thorax phantom, named Casper, was composed of resin (body), foam (lungs), glow polyactic acid (bones) and natural polyactic acid (tumours placed in the lungs). X-ray attenuation properties of all materials prior to manufacturing were evaluated by means of photon-counting computed tomography (CT) imaging on a table-top system. Breathing motion was achieved by a scotch-yoke mechanism with diaphragm motion frequencies of 10-20 rpm and displacements of 1 to 2 cm. Casper was manufactured by means of 3D printing of moulds and ribs and assembled in a complex process. The final phantom was then scanned using a clinical CT scanner to evaluate material CT numbers and the extent of tumour motion. Casper CT numbers were close to human CT numbers for soft tissue (46 HU), ribs (125 HU), lungs (-840 HU) and tumours (-45 HU). For a 2 cm diaphragm displacement the largest tumour displacement was 0.7 cm. The five tumour volumes were accurately assessed in the static CT images with a mean absolute error of 4.3%. Tumour sizes were either underestimated for smaller tumours or overestimated for larger tumours in dynamic CT images due to motion blurring with a mean absolute difference from true volumes of 10.3%. More Casper information including a motion movie and manufacturing data can be downloaded from http://web.uvic.ca/~bazalova/Casper/.
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Affiliation(s)
- Josie Laidlaw
- Department of Mechanical Engineering, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Nicolas Earl
- Department of Mechanical Engineering, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Nihal Shavdia
- Department of Mechanical Engineering, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Rayna Davis
- Department of Mechanical Engineering, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Sarah Mayer
- Department of Mechanical Engineering, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Dmitri Karaman
- Axolotl Bioscience, Victoria, British Columbia V8W 2Y2, Canada
| | - Devon Richtsmeier
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Pierre-Antoine Rodesch
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
| | - Magdalena Bazalova-Carter
- Department of Physics and Astronomy, University of Victoria, Victoria, British Columbia V8P 5C2, Canada
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Motovilova E, Aronowitz E, Vincent J, Shin J, Tan ET, Robb F, Taracila V, Sneag DB, Dyke JP, Winkler SA. Silicone-based materials with tailored MR relaxation characteristics for use in reduced coil visibility and in tissue-mimicking phantom design. Med Phys 2023. [PMID: 36737839 DOI: 10.1002/mp.16255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/24/2022] [Accepted: 01/15/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The development of materials with tailored signal intensity in MR imaging is critically important both for the reduction of signal from non-tissue hardware, as well as for the construction of tissue-mimicking phantoms. Silicone-based phantoms are becoming more popular due to their structural stability, stretchability, longer shelf life, and ease of handling, as well as for their application in dynamic imaging of physiology in motion. Moreover, silicone can be also used for the design of stretchable receive radio-frequency (RF) coils. PURPOSE Fabrication of materials with tailored signal intensity for MRI requires knowledge of precise T1 and T2 relaxation times of the materials used. In order to increase the range of possible relaxation times, silicone materials can be doped with gadolinium (Gd). In this work, we aim to systematically evaluate relaxation properties of Gd-doped silicone material at a broad range of Gd concentrations and at three clinically relevant magnetic field strengths (1.5 T, 3 T, and 7 T). We apply the findings for rendering silicone substrates of stretchable receive RF coils less visible in MRI. Moreover, we demonstrate early stage proof-of-concept applicability in tissue-mimicking phantom development. MATERIALS AND METHODS Ten samples of pure and Gd-doped Ecoflex silicone polymer samples were prepared with various Gd volume ratios ranging from 1:5000 to 1:10, and studied using 1.5 T and 3 T clinical and 7 T preclinical scanners. T1 and T2 relaxation times of each sample were derived by fitting the data to Bloch signal intensity equations. A receive coil made from Gd-doped Ecoflex silicone polymer was fabricated and evaluated in vitro at 3 T. RESULTS With the addition of a Gd-based contrast agent, it is possible to significantly change T2 relaxation times of Ecoflex silicone polymer (from 213 ms to 20 ms at 1.5 T; from 135 ms to 17 ms at 3 T; and from 111.4 ms to 17.2 ms at 7 T). T1 relaxation time is less affected by the introduction of the contrast agent (changes from 608 ms to 579 ms; from 802.5 ms to 713 ms at 3 T; from 1276 ms to 979 ms at 7 T). First results also indicate that liver, pancreas, and white matter tissues can potentially be closely mimicked using this phantom preparation technique. Gd-doping reduces the appearance of the silicone-based coil substrate during the MR scan by up to 81%. CONCLUSIONS Gd-based contrast agents can be effectively used to create Ecoflex silicone polymer-based phantoms with tailored T2 relaxation properties. The relative low cost, ease of preparation, stretchability, mechanical stability, and long shelf life of Ecoflex silicone polymer all make it a good candidate for "MR invisible" coil development and bears promise for tissue-mimicking phantom development applicability.
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Affiliation(s)
- Elizaveta Motovilova
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA.,Department of Radiology, Hospital for Special Surgery, New York, New York, USA
| | - Eric Aronowitz
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | | | - James Shin
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Ek Tsoon Tan
- Department of Radiology, Hospital for Special Surgery, New York, New York, USA
| | | | | | - Darryl B Sneag
- Department of Radiology, Hospital for Special Surgery, New York, New York, USA
| | - Jonathan P Dyke
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
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Arteaga-Marrero N, Villa E, Llanos González AB, Gómez Gil ME, Fernández OA, Ruiz-Alzola J, González-Fernández J. Low-Cost Pseudo-Anthropomorphic PVA-C and Cellulose Lung Phantom for Ultrasound-Guided Interventions. Gels 2023; 9:gels9020074. [PMID: 36826245 PMCID: PMC9957311 DOI: 10.3390/gels9020074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
A low-cost custom-made pseudo-anthropomorphic lung phantom, offering a model for ultrasound-guided interventions, is presented. The phantom is a rectangular solidstructure fabricated with polyvinyl alcohol cryogel (PVA-C) and cellulose to mimic the healthy parenchyma. The pathologies of interest were embedded as inclusions containing gaseous, liquid, or solid materials. The ribs were 3D-printed using polyethylene terephthalate, and the pleura was made of a bidimensional reticle based on PVA-C. The healthy and pathological tissues were mimicked to display acoustic and echoic properties similar to that of soft tissues. Theflexible fabrication process facilitated the modification of the physical and acoustic properties of the phantom. The phantom's manufacture offers flexibility regarding the number, shape, location, and composition of the inclusions and the insertion of ribs and pleura. In-plane and out-of-plane needle insertions, fine needle aspiration, and core needle biopsy were performed under ultrasound image guidance. The mimicked tissues displayed a resistance and recoil effect typically encountered in a real scenario for a pneumothorax, abscesses, and neoplasms. The presented phantom accurately replicated thoracic tissues (lung, ribs, and pleura) and associated pathologies providing a useful tool for training ultrasound-guided procedures.
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Affiliation(s)
- Natalia Arteaga-Marrero
- Grupo Tecnología Médica IACTEC, Instituto de Astrofísica de Canarias (IAC), 38205 San Cristóbal de La Laguna, Spain
| | - Enrique Villa
- Grupo Tecnología Médica IACTEC, Instituto de Astrofísica de Canarias (IAC), 38205 San Cristóbal de La Laguna, Spain
- Correspondence:
| | - Ana Belén Llanos González
- Departamento de Neumología, Complejo Universitario de Canarias (HUC), 38320 San Cristóbal de La Laguna, Spain
| | - Marta Elena Gómez Gil
- Departameto de Radiología, Complejo Universitario de Canarias (HUC), 38320 San Cristóbal de La Laguna, Spain
| | - Orlando Acosta Fernández
- Departamento de Neumología, Complejo Universitario de Canarias (HUC), 38320 San Cristóbal de La Laguna, Spain
| | - Juan Ruiz-Alzola
- Grupo Tecnología Médica IACTEC, Instituto de Astrofísica de Canarias (IAC), 38205 San Cristóbal de La Laguna, Spain
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS), Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Departamento de Señales y Comunicaciones, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Javier González-Fernández
- Departamento de Ingeniería Biomédica, Instituto Tecnológico de Canarias (ITC), 38009 Santa Cruz de Tenerife, Spain
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6
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3D Printing Surgical Phantoms and their Role in the Visualization of Medical Procedures. ANNALS OF 3D PRINTED MEDICINE 2022. [DOI: 10.1016/j.stlm.2022.100057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Han MC, Kim J, Hong CS, Chang KH, Han SC, Park K, Kim DW, Kim H, Chang JS, Kim J, Kye S, Park RH, Chung Y, Kim JS. Performance Evaluation of Deformable Image Registration Algorithms Using Computed Tomography of Multiple Lung Metastases. Technol Cancer Res Treat 2022; 21:15330338221078464. [PMID: 35167403 PMCID: PMC9099354 DOI: 10.1177/15330338221078464] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose: Various deformable image registration (DIR) methods have
been used to evaluate organ deformations in 4-dimensional computed tomography
(4D CT) images scanned during the respiratory motions of a patient. This study
assesses the performance of 10 DIR algorithms using 4D CT images of 5 patients
with fiducial markers (FMs) implanted during the postoperative radiosurgery of
multiple lung metastases. Methods: To evaluate DIR algorithms, 4D
CT images of 5 patients were used, and ground-truths of FMs and tumors were
generated by physicians based on their medical expertise. The positions of FMs
and tumors in each 4D CT phase image were determined using 10 DIR algorithms,
and the deformed results were compared with ground-truth data.
Results: The target registration errors (TREs) between the FM
positions estimated by optical flow algorithms and the ground-truth ranged from
1.82 ± 1.05 to 1.98 ± 1.17 mm, which is within the uncertainty of the
ground-truth position. Two algorithm groups, namely, optical flow and demons,
were used to estimate tumor positions with TREs ranging from 1.29 ± 1.21 to
1.78 ± 1.75 mm. With respect to the deformed position for tumors, for the 2 DIR
algorithm groups, the maximum differences of the deformed positions for gross
tumor volume tracking were approximately 4.55 to 7.55 times higher than the mean
differences. Errors caused by the aforementioned difference in the Hounsfield
unit values were also observed. Conclusions: We quantitatively
evaluated 10 DIR algorithms using 4D CT images of 5 patients and compared the
results with ground-truth data. The optical flow algorithms showed reasonable
FM-tracking results in patient 4D CT images. The iterative optical flow method
delivered the best performance in this study. With respect to the tumor volume,
the optical flow and demons algorithms delivered the best performance.
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Affiliation(s)
- Min Cheol Han
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jihun Kim
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chae-Seon Hong
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - Su Chul Han
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kwangwoo Park
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Wook Kim
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hojin Kim
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jee Suk Chang
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jina Kim
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sunsuk Kye
- 65661Yonsei Cancer Center, Seoul, Republic of Korea
| | | | | | - Jin Sung Kim
- 37991Yonsei University College of Medicine, Seoul, Republic of Korea
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Tajik M, Akhlaqi MM, Gholami S. Advances in anthropomorphic thorax phantoms for radiotherapy: a review. Biomed Phys Eng Express 2021; 8. [PMID: 34736235 DOI: 10.1088/2057-1976/ac369c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 11/04/2021] [Indexed: 11/12/2022]
Abstract
A phantom is a highly specialized device, which mimic human body, or a part of it. There are three categories of phantoms: physical phantoms, physiological phantoms, and computational phantoms. The phantoms have been utilized in medical imaging and radiotherapy for numerous applications. In radiotherapy, the phantoms may be used for various applications such as quality assurance (QA), dosimetry, end-to-end testing, etc. In thoracic radiotherapy, unique QA problems including tumor motion, thorax deformation, and heterogeneities in the beam path have complicated the delivery of dose to both tumor and organ at risks (OARs). Also, respiratory motion is a major challenge in radiotherapy of thoracic malignancies, which can be resulted in the discrepancies between the planned and delivered doses to cancerous tissue. Hence, the overall treatment procedure needs to be verified. Anthropomorphic thorax phantoms, which are made of human tissue-mimicking materials, can be utilized to obtain the ground truth to validate these processes. Accordingly, research into new anthropomorphic thorax phantoms has accelerated. Therefore, the review is intended to summarize the current status of the commercially available and in-house-built anthropomorphic physical/physiological thorax phantoms in radiotherapy. The main focus is on anthropomorphic, deformable thorax motion phantoms. This review also discusses the applications of three-dimensional (3D) printing technology for the fabrication of thorax phantoms.
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Affiliation(s)
- Mahdieh Tajik
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Iran Tehran district 6 poursina st Tehran University of Medical Sciences, Tehran, 1416753955, Iran (the Islamic Republic of)
| | - Mohammad Mohsen Akhlaqi
- Shahid Beheshti University of Medical Sciences, Iran,Tehran,Shahid Bahonar roundabout, Darabad Avenue,Masih Daneshvari Hospital, Tehran, 19839-63113, Iran (the Islamic Republic of)
| | - Somayeh Gholami
- Radiotherapy, Tehran University of Medical Sciences, Bolvarekeshavarz AVN, Tehran, Iran, Tehran, 1416753955, Iran (the Islamic Republic of)
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Weatherall AD, Rogerson MD, Quayle MR, Cooper MG, McMenamin PG, Adams JW. A Novel 3-Dimensional Printing Fabrication Approach for the Production of Pediatric Airway Models. Anesth Analg 2020; 133:1251-1259. [PMID: 33181556 PMCID: PMC8505162 DOI: 10.1213/ane.0000000000005260] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Pediatric airway models currently available for use in education or simulation do not replicate anatomy or tissue responses to procedures. Emphasis on mass production with sturdy but homogeneous materials and low-fidelity casting techniques diminishes these models’ abilities to realistically represent the unique characteristics of the pediatric airway, particularly in the infant and younger age ranges. Newer fabrication technologies, including 3-dimensional (3D) printing and castable tissue-like silicones, open new approaches to the simulation of pediatric airways with greater anatomical fidelity and utility for procedure training.
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Affiliation(s)
- Andrew D Weatherall
- From the Department of Anaesthesia, The Children's Hospital at Westmead, Sydney, Australia.,Discipline of Child and Adolescent Health, The University of Sydney, Australia
| | - Matthew D Rogerson
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | - Michelle R Quayle
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | - Michael G Cooper
- From the Department of Anaesthesia, The Children's Hospital at Westmead, Sydney, Australia
| | - Paul G McMenamin
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
| | - Justin W Adams
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Melbourne, Australia
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Öllers MC, Swinnen ACC, Verhaegen F. Acuros
®
dose verification of ultrasmall lung lesions with EBT‐XD film in a homogeneous and heterogeneous anthropomorphic phantom setup. Med Phys 2020; 47:5829-5837. [DOI: 10.1002/mp.14485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/27/2020] [Accepted: 09/07/2020] [Indexed: 02/01/2023] Open
Affiliation(s)
- Michel C. Öllers
- Department of Radiation Oncology (Maastro) GROW School for Oncology Maastricht University Medical Centre+ Maastricht The Netherlands
| | - Ans C. C. Swinnen
- Department of Radiation Oncology (Maastro) GROW School for Oncology Maastricht University Medical Centre+ Maastricht The Netherlands
| | - Frank Verhaegen
- Department of Radiation Oncology (Maastro) GROW School for Oncology Maastricht University Medical Centre+ Maastricht The Netherlands
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11
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Sramek M, Shi Y, Quintanilla E, Wu X, Ponukumati A, Pastel D, Halter R, Paydarfar J. Tumor phantom for training and research in transoral surgery. Laryngoscope Investig Otolaryngol 2020; 5:677-682. [PMID: 32864438 PMCID: PMC7444757 DOI: 10.1002/lio2.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 06/18/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE With the paradigm shift towards minimally invasive surgical techniques such as transoral laser microsurgery and transoral robotic surgery for resection of head and neck malignancies, there is a need to enhance the surgical training of these techniques as well as provide a platform for testing new approaches and technologies. The steeper learning curve associated with minimally invasive surgical techniques may be mitigated with the use of tumor phantoms (TP) placed in cadaver models. METHODS An injectable TP was developed using an agar-gelatin base, unsalted chicken stock, deionized water, food coloring for visual mimicry, and iohexol for radiographic mimicry. Four percentage glutaraldehyde was used as a cross-linking agent for solidification of the TP. The TP was then injected in various mucosal anatomic sites in four unfixed cadaver heads. Visual, radiographic, and tactile mimicry was assessed via endoscopy, CT scan, and tumor dissection and palpation, respectively. RESULTS Tumor phantom injection was successfully achieved in all four cadaver heads. Visually and tactilely, the TP demonstrated similar color change, induration, and firmness of a typical squamous cell carcinoma (SCCa). However, ulceration that is often seen with SCCa could not be replicated. CT mimicry was compared with nine patients with known SCCa. Tumor radiodensity in the nine patients was between 77 and 110 HU (mean 86.3 HU) whereas TP radiodensity was 59 and 127 HU (mean 93.7 HU), with no significant difference between groups (P = .21). CONCLUSION This inexpensive, easy to apply, and unique tumor phantom could be used both to train transoral techniques and as a tool to further investigate new approaches and technologies for transoral surgery. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Michael Sramek
- Geisel School of Medicine at DartmouthHanoverNew HampshireUSA
| | - Yuan Shi
- Thayer School of Engineering at DartmouthHanoverNew HampshireUSA
| | | | - Xiaotian Wu
- Thayer School of Engineering at DartmouthHanoverNew HampshireUSA
| | | | - David Pastel
- Geisel School of Medicine at DartmouthHanoverNew HampshireUSA
- Division of Neuroradiology, Department of RadiologyDartmouth‐Hitchcock Medical CenterLebanonNew HampshireUSA
| | - Ryan Halter
- Geisel School of Medicine at DartmouthHanoverNew HampshireUSA
- Thayer School of Engineering at DartmouthHanoverNew HampshireUSA
| | - Joseph Paydarfar
- Geisel School of Medicine at DartmouthHanoverNew HampshireUSA
- Thayer School of Engineering at DartmouthHanoverNew HampshireUSA
- Section of Otolaryngology, Department of SurgeryDartmouth‐Hitchcock Medical CenterLebanonNew HampshireUSA
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