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Zaarour Y, El Arroud F, Fernandez T, Cano JL, El Alami R, El Mrabet O, Benani A, Faik A, Griguer H. Microwave Antenna Sensing for Glucose Monitoring in a Vein Model Mimicking Human Physiology. BIOSENSORS 2025; 15:282. [PMID: 40422021 DOI: 10.3390/bios15050282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2025] [Revised: 03/06/2025] [Accepted: 03/09/2025] [Indexed: 05/28/2025]
Abstract
Non-invasive glucose monitoring has become a critical area of research for diabetes management, offering a less intrusive and more patient-friendly alternative to traditional methods such as finger-prick tests. This study presents a novel approach using a semi-solid tissue-mimicking phantom designed to replicate the dielectric properties of human skin and blood vessels. The phantom was simplified to focus solely on the skin layer, with embedded channels representing veins to achieve realistic glucose monitoring conditions. These channels were filled with D-(+)-Glucose solutions at varying concentrations (60 mg/dL to 200 mg/dL) to simulate physiological changes in blood glucose levels. A miniature patch antenna optimized to operate at 14 GHz with a penetration depth of approximately 1.5 mm was designed and fabricated. The antenna was tested in direct contact with the skin phantom, allowing for precise measurements of the changes in glucose concentration without interference from deeper tissue layers. Simulations and experiments demonstrated the antenna's sensitivity to variations in glucose concentration, as evidenced by measurable shifts in the dielectric properties of the phantom. Importantly, the system enabled stationary measurements by injecting glucose solutions into the same blood vessels, eliminating the need to reposition the sensor while ensuring reliable and repeatable results. This work highlights the importance of shallow penetration depth in targeting close vessels for noninvasive glucose monitoring, and emphasizes the potential of microwave-based sensing systems as a practical solution for continuous glucose management.
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Affiliation(s)
- Youness Zaarour
- Microwave Energy Sensing (MES), DICE-Digital Innovation Center of Excellence, University of Mohammed VI Polytechnic, Benguerir 43152, Morocco
| | - Fatimazahrae El Arroud
- Microwave Energy Sensing (MES), DICE-Digital Innovation Center of Excellence, University of Mohammed VI Polytechnic, Benguerir 43152, Morocco
| | - Tomas Fernandez
- Departamento de Ingeniería de Comunicaciones, Universidad de Cantabria, 39005 Santander, Spain
| | - Juan Luis Cano
- Departamento de Ingeniería de Comunicaciones, Universidad de Cantabria, 39005 Santander, Spain
| | - Rafiq El Alami
- Microwave Energy Sensing (MES), DICE-Digital Innovation Center of Excellence, University of Mohammed VI Polytechnic, Benguerir 43152, Morocco
| | - Otman El Mrabet
- Intelligent System Design Laboratory (ISD), Faculty of Science, Abdelmalek Essaadi University, Tetuan 93000, Morocco
| | - Abdelouheb Benani
- Oncovirology Laboratory, Institut Pasteur du Maroc, 1, Place Louis Pasteur, Casablanca 20360, Morocco
| | - Abdessamad Faik
- Laboratory for Inorganic Materiels for Sustainable Energy Technologies (LIMSET), University of Mohammed VI Polytechnic, Benguerir 43152, Morocco
| | - Hafid Griguer
- Microwave Energy Sensing (MES), DICE-Digital Innovation Center of Excellence, University of Mohammed VI Polytechnic, Benguerir 43152, Morocco
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2
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Endsley C, Ali S, Salhadar K, Woodward A, Garland S, Santelli J, Salimabad MZ, Ren L, Yokoo T, Rosado-Mendez IM, Fetzer DT, de Gracia Lux C. Lipid Microparticle-Based Phantoms Modeling Hepatic Steatosis for the Validation of Quantitative Imaging Techniques. SMALL METHODS 2025:e2500043. [PMID: 40277165 DOI: 10.1002/smtd.202500043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Revised: 03/30/2025] [Indexed: 04/26/2025]
Abstract
Metabolic dysfunction-associated steatotic liver disease (MASLD) typically presents as "macrovesicular steatosis", where each hepatocyte contains a large fat vacuole (30-50 µm), indicating a more indolent form. In about 20% of cases, "microvesicular steatosis" occurs, with smaller vacuoles (1-15 µm) linked to steatohepatitis, cirrhosis progression, and increased risk of liver cancer. Emerging quantitative ultrasound (QUS) liver fat quantification (QUS-LFQ) tools measure various acoustic properties, but few methods compare techniques and imaging modalities, and the impact of fat vacuole size remains unclear. This study introduces a methodology to create ultrasound (US) phantoms that replicate fat vesicle size in MASLD. While imaging phantoms validate quantitative tools, no model currently links QUS-LFQ measurements to steatosis severity. Existing homogeneous phantoms assessing properties like attenuation, backscatter, and speed of sound overlook the microstructure of steatosis, despite the known effect of particle size on acoustic interactions. Here, agar-based phantoms simulate fat accumulation in steatotic hepatocytes using stable peanut oil droplets as analogs for lipid vacuoles. Microscopy and sizing confirm stability at 4 °C, 23 °C, and 50 °C. Both microscopy and US imaging confirm uniform distribution, with QUS-LFQ measurements reflecting fat content. These phantoms hold promise for validating quantitative imaging methods, particularly for US-based MASLD screening tools.
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Affiliation(s)
- Connor Endsley
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Shariq Ali
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Karim Salhadar
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Adam Woodward
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Shea Garland
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Julien Santelli
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Mehdi Zeighami Salimabad
- Departments of Medical Physics and Radiology, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Liqiang Ren
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Takeshi Yokoo
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Ivan M Rosado-Mendez
- Departments of Medical Physics and Radiology, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - David T Fetzer
- Department of Radiology, Collaborative for Advanced Clinical Techniques in UltraSound (CACTUS) Lab, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Caroline de Gracia Lux
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
- Department of Biomedical Engineering, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
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3
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Qiu H, Nazarenus J, Egeler B, Thode T, Osman F, Osmonov D, Bahr J, Kaps S, Siebert FA, Koch R, Lützen U, Adelung R, Siebert L. Hydrogel System with Independent Tailoring of Mechanics, CT, and US Contrasts for Affordable Medical Phantoms. ACS MATERIALS LETTERS 2024; 6:4847-4853. [PMID: 39391745 PMCID: PMC11463687 DOI: 10.1021/acsmaterialslett.4c01660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 09/16/2024] [Accepted: 09/16/2024] [Indexed: 10/12/2024]
Abstract
Medical phantoms mimic aspects of procedures like computed tomography (CT), ultrasound (US) imaging, and surgical practices. However, the materials for current commercial phantoms are expensive and the fabrication with these is complex and lacks versatility. Therefore, existing material solutions are not suitable for creating patient-specific phantoms. We present a novel and cost-effective material system (utilizing ubiquitous sodium alginate hydrogel and coconut fat) with independently and accurately tailorable CT, US, and mechanical properties. By varying the concentration of alginate, cross-linker, and coconut fat, the radiological parameters and the elastic modulus were adjusted independently in a wide range. The independence was demonstrated by creating phantoms with features hidden in US, while visible in CT imaging and vice versa. This system is particularly beneficial in resource-scarce areas since the materials are cheap (<$ 1 USD/kg) and easy to obtain, offering realistic and versatile phantoms to practice surgeries and ultimately enhance patient care.
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Affiliation(s)
- Haoyi Qiu
- Functional
Nanomaterials, Department of Materials Science, Kiel University, 24143 Kiel, Germany
| | - Jakob Nazarenus
- Multimedia
Information Processing, Institute for Computer Science, Kiel University, 24118 Kiel, Germany
| | - Bernhard Egeler
- Department
of Nuclear Medicine, University Hospital
Schleswig-Holstein, Campus
Kiel, 24105 Kiel, Germany
| | - Tom Thode
- Functional
Nanomaterials, Department of Materials Science, Kiel University, 24143 Kiel, Germany
| | - Firdaws Osman
- Functional
Nanomaterials, Department of Materials Science, Kiel University, 24143 Kiel, Germany
| | - Daniar Osmonov
- Department
of Urology, University Hospital Schleswig-Holstein, Campus Lübeck, 23538 Lübeck, Germany
| | - Jörg Bahr
- Functional
Nanomaterials, Department of Materials Science, Kiel University, 24143 Kiel, Germany
| | - Sören Kaps
- Functional
Nanomaterials, Department of Materials Science, Kiel University, 24143 Kiel, Germany
| | - Frank-Andre Siebert
- Department
of Radiation Oncology, University Hospital
Schleswig-Holstein, Campus
Kiel, 24105 Kiel, Germany
| | - Reinhard Koch
- Multimedia
Information Processing, Institute for Computer Science, Kiel University, 24118 Kiel, Germany
| | - Ulf Lützen
- Department
of Nuclear Medicine, University Hospital
Schleswig-Holstein, Campus
Kiel, 24105 Kiel, Germany
| | - Rainer Adelung
- Functional
Nanomaterials, Department of Materials Science, Kiel University, 24143 Kiel, Germany
- Kiel Nano,
Surface and Interface Science (KiNSIS), Kiel University, 24118 Kiel, Germany
| | - Leonard Siebert
- Functional
Nanomaterials, Department of Materials Science, Kiel University, 24143 Kiel, Germany
- Kiel Nano,
Surface and Interface Science (KiNSIS), Kiel University, 24118 Kiel, Germany
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Voskamp T, Khisa WW, Oosting RM, Wiggers T, Dankelman J. A training phantom for a vesicovaginal fistula repair with the transvaginal approach. Curr Probl Surg 2024; 61:101550. [PMID: 39098338 DOI: 10.1016/j.cpsurg.2024.101550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/12/2024] [Accepted: 06/24/2024] [Indexed: 08/06/2024]
Affiliation(s)
- Tink Voskamp
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | | | - Roos M Oosting
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | | | - Jenny Dankelman
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands.
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Elisei RC, Graur F, Melzer A, Moldovan SC, Tiu C, Popa C, Mois E, Pisla D, Vaida C, Ștefănescu H, Coțe A, Al-Hajjar N. Liver Phantoms Cast in 3D-Printed Mold for Image-Guided Procedures. Diagnostics (Basel) 2024; 14:1521. [PMID: 39061658 PMCID: PMC11276290 DOI: 10.3390/diagnostics14141521] [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: 05/03/2024] [Revised: 07/03/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION Image-guided invasive procedures on the liver require a steep learning curve to acquire the necessary skills. The best and safest way to achieve these skills is through hands-on courses that include simulations and phantoms of different complications, without any risks for patients. There are many liver phantoms on the market made of various materials; however, there are few multimodal liver phantoms, and only two are cast in a 3D-printed mold. METHODS We created a virtual liver and 3D-printed mold by segmenting a CT scan. The InVesalius and Autodesk Fusion 360 software packages were used for segmentation and 3D modeling. Using this modular mold, we cast and tested silicone- and gelatin-based liver phantoms with tumor and vascular formations inside. We tested the gelatin liver phantoms for several procedures, including ultrasound diagnosis, elastography, fibroscan, ultrasound-guided biopsy, ultrasound-guided drainage, ultrasound-guided radio-frequency ablation, CT scan diagnosis, CT-ultrasound fusion, CT-guided biopsy, and MRI diagnosis. The phantoms were also used in hands-on ultrasound courses at four international congresses. RESULTS We evaluated the feedback of 33 doctors regarding their experiences in using and learning on liver phantoms to validate our model for training in ultrasound procedures. CONCLUSIONS We validated our liver phantom solution, demonstrating its positive impact on the education of young doctors who can safely learn new procedures thus improving the outcomes of patients with different liver pathologies.
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Affiliation(s)
- Radu Claudiu Elisei
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (C.P.); (E.M.); (H.Ș.); (N.A.-H.)
- Emergency County Hospital, 420016 Bistrita, Romania;
| | - Florin Graur
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (C.P.); (E.M.); (H.Ș.); (N.A.-H.)
- Regional Institute of Gastroenterology and Hepathology “Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
| | - Andreas Melzer
- ICCAS Institute of Computer Assisted Surgery, University Leipzig, 04103 Leipzig, Germany;
- IMSAT Institute for Medical Science and Technology, University Dundee, Dundee DD1 9SY, UK
| | | | - Calin Tiu
- Municipal Hospital, 105600 Campina, Romania;
| | - Calin Popa
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (C.P.); (E.M.); (H.Ș.); (N.A.-H.)
- Regional Institute of Gastroenterology and Hepathology “Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
| | - Emil Mois
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (C.P.); (E.M.); (H.Ș.); (N.A.-H.)
- Regional Institute of Gastroenterology and Hepathology “Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
| | - Doina Pisla
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
| | - Calin Vaida
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
| | - Horia Ștefănescu
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (C.P.); (E.M.); (H.Ș.); (N.A.-H.)
- Regional Institute of Gastroenterology and Hepathology “Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
| | - Adrian Coțe
- Emergency County Hospital, 410159 Oradea, Romania;
| | - Nadim Al-Hajjar
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (C.P.); (E.M.); (H.Ș.); (N.A.-H.)
- Regional Institute of Gastroenterology and Hepathology “Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
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Elisei RC, Graur F, Szold A, Melzer A, Moldovan SC, Motrescu M, Moiş E, Popa C, Pîsla D, Vaida C, Tudor T, Coţe A, Al-Hajjar N. Gelatin-Based Liver Phantoms for Training Purposes: A Cookbook Approach. J Clin Med 2024; 13:3440. [PMID: 38929969 PMCID: PMC11204368 DOI: 10.3390/jcm13123440] [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: 05/08/2024] [Revised: 06/04/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Patients with liver pathology benefit from image-guided interventions. Training for interventional procedures is recommended to be performed on liver phantoms until a basic proficiency is reached. In the last 40 years, several attempts have been made to develop materials to mimic the imaging characteristics of the human liver in order to create liver phantoms. There is still a lack of accessible, reproducible and cost-effective soft liver phantoms for image-guided procedure training. Methods: Starting from a CT-scan DICOM file, we created a 3D-printed liver mold using InVesalius (Centro de Tecnologia da informação Renato Archer CTI, InVesalius 3 open-source software, Campinas, Brazil) for segmentation, Autodesk Fusion 360 with Netfabb (Autodesk software company, Fusion 360 2.0.19426 with Autodesk Netfabb Premium 2023.0 64-Bit Edition, San Francisco, CA, USA) for 3D modeling and Stratasys Fortus 380 mc 3D printer (Stratasys 3D printing company, Fortus 380 mc 3D printer, Minneapolis, MN, USA). Using the 3D-printed mold, we created 14 gelatin-based liver phantoms with 14 different recipes, using water, cast sugar and dehydrated gelatin, 32% fat bovine milk cream with intravenous lipid solution and technical alcohol in different amounts. We tested all these phantoms as well as ex vivo pig liver and human normal, fatty and cirrhotic liver by measuring the elasticity, shear wave speed, ultrasound attenuation, CT-scan density, MRI signal intensity and fracture force. We assessed the results of the testing performed, as well as the optical appearance on ultrasound, CT and MRI, in order to find the best recipe for gelatin-based phantoms for image-guided procedure training. Results: After the assessment of all phantom recipes, we selected as the best recipe for transparent phantoms one with 14 g of gelatin/100 mL water and for opaque phantom, the recipes with 25% cream. Conclusions: These liver gelatin-based phantom recipes are an inexpensive, reproducible and accessible alternative for training in image-guided and diagnostic procedures and will meet most requirements for valuable training.
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Affiliation(s)
- Radu Claudiu Elisei
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (E.M.); (C.P.); (N.A.-H.)
- Emergency Clinical County Hospital, 420016 Bistrita, Romania; (S.C.M.); (M.M.); (T.T.)
| | - Florin Graur
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (E.M.); (C.P.); (N.A.-H.)
- Regional Institute of Gastroenterology and Hepathology “Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
| | - Amir Szold
- Assia Medical, Assuta Medical Center, Tel Aviv 6971028, Israel;
| | - Andreas Melzer
- ICCAS Insitute of Computer Assisted Surgery, University Leipzig, 04109 Leipzig, Germany;
- IMSAT Insitute for Medical Science and Technology, University Dundee, Dundee DD1 4HN, UK
| | - Sever Cãlin Moldovan
- Emergency Clinical County Hospital, 420016 Bistrita, Romania; (S.C.M.); (M.M.); (T.T.)
| | - Mihai Motrescu
- Emergency Clinical County Hospital, 420016 Bistrita, Romania; (S.C.M.); (M.M.); (T.T.)
| | - Emil Moiş
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (E.M.); (C.P.); (N.A.-H.)
- Regional Institute of Gastroenterology and Hepathology “Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
| | - Cãlin Popa
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (E.M.); (C.P.); (N.A.-H.)
- Regional Institute of Gastroenterology and Hepathology “Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
| | - Doina Pîsla
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
| | - Cãlin Vaida
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
| | - Tiberiu Tudor
- Emergency Clinical County Hospital, 420016 Bistrita, Romania; (S.C.M.); (M.M.); (T.T.)
| | - Adrian Coţe
- Emergency County Hospital, 410159 Oradea, Romania;
| | - Nadim Al-Hajjar
- Department of Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, Romania; (R.C.E.); (E.M.); (C.P.); (N.A.-H.)
- Regional Institute of Gastroenterology and Hepathology “Dr. Octavian Fodor”, 400394 Cluj-Napoca, Romania
- CESTER Department, Faculty of Industrial Engineering, Robotics and Production Management, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.P.); (C.V.)
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Seitzinger M, Gnatzy F, Kern S, Steinhausen R, Klammer J, Schlosser T, Blank V, Karlas T. Development, evaluation, and overview of standardized training phantoms for abdominal ultrasound-guided interventions. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2024; 45:176-183. [PMID: 38350630 DOI: 10.1055/a-2242-7074] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
PURPOSE Ultrasound (US) represents the primary approach for abdominal diagnosis and is regularly used to guide diagnostic and therapeutic interventions (INVUS). Due to possible serious INVUS complications, structured training concepts are required. Phantoms can facilitate teaching, but their use is currently restricted by complex manufacturing and short durability of the materials. Hence, the aim of this study was the development and evaluation of an optimized abdominal INVUS phantom. MATERIALS AND METHODS Phantom requirements were defined in a structured research process: Skin-like surface texture, homogeneous matrix with realistic tissue properties, implementation of lesions and abscess cavities in different sizes and depths as well as a modular production process allowing for customized layouts. The phantom prototypes were evaluated in certified ultrasound courses. RESULTS In accordance with the defined specifications, a new type of matrix was developed and cast in multiple layers including different target materials. The phantom structure is based on features of liver anatomy and includes solid focal lesions, vessels, and abscess formations. For a realistic biopsy procedure, ultrasound-proof material was additionally included to imitate bone. The evaluation was performed by US novices (n=40) and experienced participants (n=41). The majority (73/81) confirmed realistic visualization of the lesions. The 3D impression was rated as "very good" in 64% of cases (52/81) and good in 31% (25/81). Overall, 86% (70/81) of the participants certified high clinical relevance of the phantom. CONCLUSION The presented INVUS phantom concept allows standardized and realistic training for interventions.
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Affiliation(s)
- Max Seitzinger
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre, Leipzig, Germany
| | - Franziska Gnatzy
- Department of Medicine II, St. Elisabeth Hospital, Leipzig, Germany
| | - Sabine Kern
- Forschungszentrum Ultraschall gGmbH, Research Center Ultrasound, Halle (Saale), Germany
| | - Ralf Steinhausen
- Forschungszentrum Ultraschall gGmbH, Research Center Ultrasound, Halle (Saale), Germany
| | - Jana Klammer
- Forschungszentrum Ultraschall gGmbH, Research Center Ultrasound, Halle (Saale), Germany
| | - Tobias Schlosser
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre, Leipzig, Germany
| | - Valentin Blank
- Division of Interdisciplinary Ultrasound; Department of Internal Medicine I (Gastroenterology, Pneumology), University Hospital Halle, Halle, Germany
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre, Leipzig, Germany
| | - Thomas Karlas
- Division of Gastroenterology, Department of Medicine II, Leipzig University Medical Centre, Leipzig, Germany
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Lemine AS, Ahmad Z, Al-Thani NJ, Hasan A, Bhadra J. Mechanical properties of human hepatic tissues to develop liver-mimicking phantoms for medical applications. Biomech Model Mechanobiol 2024; 23:373-396. [PMID: 38072897 PMCID: PMC10963485 DOI: 10.1007/s10237-023-01785-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/17/2023] [Indexed: 03/26/2024]
Abstract
Using liver phantoms for mimicking human tissue in clinical training, disease diagnosis, and treatment planning is a common practice. The fabrication material of the liver phantom should exhibit mechanical properties similar to those of the real liver organ in the human body. This tissue-equivalent material is essential for qualitative and quantitative investigation of the liver mechanisms in producing nutrients, excretion of waste metabolites, and tissue deformity at mechanical stimulus. This paper reviews the mechanical properties of human hepatic tissues to develop liver-mimicking phantoms. These properties include viscosity, elasticity, acoustic impedance, sound speed, and attenuation. The advantages and disadvantages of the most common fabrication materials for developing liver tissue-mimicking phantoms are also highlighted. Such phantoms will give a better insight into the real tissue damage during the disease progression and preservation for transplantation. The liver tissue-mimicking phantom will raise the quality assurance of patient diagnostic and treatment precision and offer a definitive clinical trial data collection.
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Affiliation(s)
- Aicha S Lemine
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar
- Qatar University Young Scientists Center (QUYSC), Qatar University, 2713, Doha, Qatar
| | - Zubair Ahmad
- Qatar University Young Scientists Center (QUYSC), Qatar University, 2713, Doha, Qatar
- Center for Advanced Materials (CAM), Qatar University, PO Box 2713, Doha, Qatar
| | - Noora J Al-Thani
- Qatar University Young Scientists Center (QUYSC), Qatar University, 2713, Doha, Qatar
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, 2713, Doha, Qatar
| | - Jolly Bhadra
- Qatar University Young Scientists Center (QUYSC), Qatar University, 2713, Doha, Qatar.
- Center for Advanced Materials (CAM), Qatar University, PO Box 2713, Doha, Qatar.
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Rahmah M, Al-Ashwal RH, Salim MIM, Lam YT, Hau YW. Anatomically realistic aortic dissection simulator as a potential training tool for point-of-care ultrasound. J Ultrason 2024; 24:1-9. [PMID: 38343785 PMCID: PMC10850942 DOI: 10.15557/jou.2024.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/23/2023] [Indexed: 04/26/2024] Open
Abstract
Aim Simulators for aortic dissection diagnosis are limited by complex anatomy influencing the accuracy of point-of-care ultrasound for diagnosing aortic dissection. Therefore, this study aimed to create a healthy ascending aorta and class DeBakey, type II aortic dissection simulator as a potential point-of-care ultrasound training model. Material and methods 3D mould simulators were created based on computed tomography images of one healthy and one DeBakey type II aortic dissection patient. In the next step, two polyvinyl alcohol-based and two silicone-based simulators were synthesised. Results The results of the scanning electron microscope assessment showed an aortic dissection simulator's surface with disorganised surface texture and higher root mean square (RMS or Rq) value than the healthy model of polyvinyl alcohol (RqAD = 20.28 > RqAAo = 10.26) and silicone (RqAD = 33.8 > RqAAo = 23.07). The ultrasound assessment of diameter aortic dissection showed higher than the healthy ascending aorta in polyvinyl alcohol (dAD = 28.2 mm > dAAo = 20.2 mm) and Si (dAD = 31.0 mm > dAAo = 22.4 mm), while the wall thickness of aortic dissection showed thinner than the healthy aorta in polyvinyl alcohol, which is comparable with the actual aorta measurement. The intimal flap of aortic dissection was able to replicate and showed a false lumen in the ultrasound images. The flap was measured quantitatively, indicating that the intimal flap was hyperechoic. Conclusions The simulators were able to replicate the surface morphology and echogenicity of the intimal flap, which is a linear hyperechoic area representing the separation of the aorta wall.
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Affiliation(s)
- Mutiah Rahmah
- Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Skudai, Malaysia
| | - Rania Hussien Al-Ashwal
- Advanced Diagnostic and Progressive Human Care research Group, Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Skudai, Malaysia
| | - Maheza Irna Mohamad Salim
- Advanced Diagnostic and Progressive Human Care research Group, Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Skudai, Malaysia
| | - Yan Tung Lam
- Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Skudai, Malaysia
| | - Yuan Wen Hau
- IJN-UTM Cardiovascular Engineering Centre, Department of Biomedical Engineering and Health Sciences, Faculty of Electrical Engineering, Universiti Teknologi Malaysia, Skudai, Malaysia
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10
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Schoenborn S, Pirola S, Woodruff MA, Allenby MC. Fluid-Structure Interaction Within Models of Patient-Specific Arteries: Computational Simulations and Experimental Validations. IEEE Rev Biomed Eng 2024; 17:280-296. [PMID: 36260570 DOI: 10.1109/rbme.2022.3215678] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality worldwide and its incidence is rising due to an aging population. The development and progression of CVD is directly linked to adverse vascular hemodynamics and biomechanics, whose in-vivo measurement remains challenging but can be simulated numerically and experimentally. The ability to evaluate these parameters in patient-specific CVD cases is crucial to better predict future disease progression, risk of adverse events, and treatment efficacy. While significant progress has been made toward patient-specific hemodynamic simulations, blood vessels are often assumed to be rigid, which does not consider the compliant mechanical properties of vessels whose malfunction is implicated in disease. In an effort to simulate the biomechanics of flexible vessels, fluid-structure interaction (FSI) simulations have emerged as promising tools for the characterization of hemodynamics within patient-specific cardiovascular anatomies. Since FSI simulations combine the blood's fluid domain with the arterial structural domain, they pose novel challenges for their experimental validation. This paper reviews the scientific work related to FSI simulations for patient-specific arterial geometries and the current standard of FSI model validation including the use of compliant arterial phantoms, which offer novel potential for the experimental validation of FSI results.
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11
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Groves LA, Keita M, Talla S, Kikinis R, Fichtinger G, Mousavi P, Camara M. A Review of Low-Cost Ultrasound Compatible Phantoms. IEEE Trans Biomed Eng 2023; 70:3436-3448. [PMID: 37339047 DOI: 10.1109/tbme.2023.3288071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Ultrasound-compatible phantoms are used to develop novel US-based systems and train simulated medical interventions. The price difference between lab-made and commercially available ultrasound-compatible phantoms lead to the publication of many papers categorized as low-cost in the literature. The aim of this review was to improve the phantom selection process by summarizing the pertinent literature. We compiled papers on US-compatible spine, prostate, vascular, breast, kidney, and li ver phantoms. We reviewed papers for cost and accessibility, providing an overview of the materials, construction time, shelf life, needle insertion limits, and manufacturing and evaluation methods. This information was summarized by anatomy. The clinical application associated with each phantom was also reported for those interested in a particular intervention. Techniques and common practices for building low-cost phantoms were provided. Overall, this article aims to summarize a breadth of ultrasound-compatible phantom research to enable informed phantom methods selection.
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12
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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: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [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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13
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Zhao Z, Ma Y, Mushtaq A, Radhakrishnan V, Hu Y, Ren H, Song W, Tse ZTH. Engineering functional and anthropomorphic models for surgical training in interventional radiology: A state-of-the-art review. Proc Inst Mech Eng H 2023; 237:3-17. [PMID: 36377860 PMCID: PMC9841824 DOI: 10.1177/09544119221135086] [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] [Indexed: 11/17/2022]
Abstract
Training medical students in surgical procedures and evaluating their performance are both necessary steps to ensure the safety and efficacy of surgeries. Traditionally, trainees practiced on live patients, cadavers or animals under the supervision of skilled physicians, but realistic anatomical phantom models have provided a low-cost alternative because of the advance of material technology that mimics multi-layer tissue structures. This setup provides safer and more efficient training. Many research prototypes of phantom models allow rapid in-house prototyping for specific geometries and tissue properties. The gel-based method and 3D printing-based method are two major methods for developing phantom prototypes. This study excluded virtual reality based technologies and focused on physical phantoms, total 189 works published between 2015 and 2020 on anatomical phantom prototypes made for interventional radiology were reviewed in terms of their functions and applications. The phantom prototypes were first categorized based on fabrication methods and then subcategorized based on the organ or body part they simulated; the paper is organized accordingly. Engineering specifications and applications were analyzed and summarized for each study. Finally, current challenges in the development of phantom models and directions for future work were discussed.
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Affiliation(s)
- Zhuo Zhao
- School of Electrical and Computer Engineering, University of Georgia, Athens, GA, USA
| | - Yangmyung Ma
- Hull York Medical School, University of York, Heslington, York, UK
| | - Adeel Mushtaq
- Hull York Medical School, University of York, Heslington, York, UK
| | - Vignesh Radhakrishnan
- School of Engineering and Materials Science, Queen Mary University of London, London
| | - Yihua Hu
- School of Engineering and Materials Science, Queen Mary University of London, London
| | - Hongliang Ren
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China,Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Wenzhan Song
- Department of Computer Science, University of Georgia, Athens, GA, USA
| | - Zion Tsz Ho Tse
- School of Engineering and Materials Science, Queen Mary University of London, London,Zion Tsz Ho Tse, School of Engineering and Materials Science, Queen Mary University of London, Room 229 Mile End Road, London E1 4NS, United Kingdom.
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14
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Arm R, Shahidi A, Clarke C, Alabraba E. Synthesis and characterisation of a cancerous liver for presurgical planning and training applications. BMJ Open Gastroenterol 2022; 9:e000909. [PMID: 35853677 PMCID: PMC9301799 DOI: 10.1136/bmjgast-2022-000909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Oncology surgeons use animals and cadavers in training because of a lack of alternatives. The aim of this work was to develop a design methodology to create synthetic liver models familiar to surgeons, and to help plan, teach and rehearse patient-specific cancerous liver resection surgery. DESIGN Synthetic gels were selected and processed to recreate accurate anthropomorphic qualities. Organic and synthetic materials were mechanically tested with the same equipment and standards to determine physical properties like hardness, elastic modulus and viscoelasticity. Collected data were compared with published data on the human liver. Patient-specific CT data were segmented and reconstructed and additive manufactured models were made of the liver vasculature, parenchyma and lesion. Using toolmaking and dissolvable scaffolds, models were transformed into tactile duplicates that could mimic liver tissue behaviour. RESULTS Porcine liver tissue hardness was found to be 23 H00 (±0.1) and synthetic liver was 10 H00 (±2.3), while human parenchyma was reported as 15.06 H00 (±2.64). Average elastic Young's modulus of human liver was reported as 0.012 MPa, and synthetic liver was 0.012 MPa, but warmed porcine parenchyma was 0.28 MPa. The final liver model demonstrated a time-dependant viscoelastic response to cyclic loading. CONCLUSION Synthetic liver was better than porcine liver at recreating the mechanical properties of living human liver. Warmed porcine liver was more brittle, less extensible and stiffer than both human and synthetic tissues. Qualitative surgical assessment of the model by a consultant liver surgeon showed vasculature was explorable and that bimanual palpation, organ delivery, transposition and organ slumping were analogous to human liver behaviour.
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Affiliation(s)
- Richard Arm
- School of Art and Design, Nottingham Trent University City Campus, Nottingham, UK
| | - Arash Shahidi
- School of Art and Design, Nottingham Trent University City Campus, Nottingham, UK
| | - Christopher Clarke
- Department of Radiology, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Edward Alabraba
- Department of Hepatobiliary and Pancreatic Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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15
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Nilsson DPG, Holmgren M, Holmlund P, Wåhlin A, Eklund A, Dahlberg T, Wiklund K, Andersson M. Patient-specific brain arteries molded as a flexible phantom model using 3D printed water-soluble resin. Sci Rep 2022; 12:10172. [PMID: 35715506 PMCID: PMC9205921 DOI: 10.1038/s41598-022-14279-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/03/2022] [Indexed: 11/08/2022] Open
Abstract
Visualizing medical images from patients as physical 3D models (phantom models) have many roles in the medical field, from education to preclinical preparation and clinical research. However, current phantom models are generally generic, expensive, and time-consuming to fabricate. Thus, there is a need for a cost- and time-efficient pipeline from medical imaging to patient-specific phantom models. In this work, we present a method for creating complex 3D sacrificial molds using an off-the-shelf water-soluble resin and a low-cost desktop 3D printer. This enables us to recreate parts of the cerebral arterial tree as a full-scale phantom model ([Formula: see text] cm) in transparent silicone rubber (polydimethylsiloxane, PDMS) from computed tomography angiography images (CTA). We analyzed the model with magnetic resonance imaging (MRI) and compared it with the patient data. The results show good agreement and smooth surfaces for the arteries. We also evaluate our method by looking at its capability to reproduce 1 mm channels and sharp corners. We found that round shapes are well reproduced, whereas sharp features show some divergence. Our method can fabricate a patient-specific phantom model with less than 2 h of total labor time and at a low fabrication cost.
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Affiliation(s)
| | - Madelene Holmgren
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, 901 87, Umeå, Sweden
- Department of Clinical Science, Neurosciences, Umeå University, 901 87, Umeå, Sweden
| | - Petter Holmlund
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, 901 87, Umeå, Sweden
| | - Anders Wåhlin
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, 901 87, Umeå, Sweden
- Department of Applied Physics and Electronics, Umeå University, 901 87, Umeå, Sweden
- Umeå Center for Functional Brain Imaging (UFBI), Umeå University, 901 87, Umeå, Sweden
| | - Anders Eklund
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, 901 87, Umeå, Sweden
| | - Tobias Dahlberg
- Department of Physics, Umeå University, 901 87, Umeå, Sweden
| | - Krister Wiklund
- Department of Physics, Umeå University, 901 87, Umeå, Sweden
| | - Magnus Andersson
- Department of Physics, Umeå University, 901 87, Umeå, Sweden.
- Umeå Center for Microbial Research (UCMR), Umeå University, 901 87, Umeå, Sweden.
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16
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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: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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17
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Gautam UC, Pydi YS, Selladurai S, Das CJ, Thittai AK, Roy S, Datla NV. A Poly-vinyl Alcohol (PVA)-based phantom and training tool for use in simulated Transrectal Ultrasound (TRUS) guided prostate needle biopsy procedures. Med Eng Phys 2021; 96:46-52. [PMID: 34565552 DOI: 10.1016/j.medengphy.2021.08.008] [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: 08/13/2020] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
Trans-rectal ultrasound-guided needle biopsy is a well-established diagnosis technique for prostate cancer. To enhance the needle manoeuvring skills under ultrasound (US) guidance, it is preferable to train medical practitioners in needle biopsy on tissue-mimicking phantoms. This phantom should mimic the morphology as well as mechanical and acoustic properties of the human male pelvic region to provide a surgical experience and feedback. In this study, polyvinyl alcohol (PVA) was used and evaluated for prostate phantom development, that is stiffness tunable, US-compatible and durable phantom material. Three samples, each with 5%, 10%, and 15% concentration of PVA material, were prepared, and their mechanical and shrinkage characteristics were investigated. The anatomy of male pelvic region was used to develop an anatomically correct phantom. Later US-guided needle biopsy was performed on the phantom. The range of elastic moduli of the PVA samples was 2∼146 kPa. Their elastic moduli and volumes were found to remain statistically close from seventh to eighth freeze-thaw cycle (p>0.05). Initial US scans of the phantom resulted in satisfactory B-mode images, with a clear distinction between the prostate and its surrounding organs. This study demonstrated the applicability of PVA hydrogel as a phantom material for training in US-guided needle biopsy.
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Affiliation(s)
- Umesh C Gautam
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India; Department of Applied Mechanics, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India
| | - Yeswanth S Pydi
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India
| | | | - Chandan J Das
- Department of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Arun K Thittai
- Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai 600036, India
| | - Sitikantha Roy
- Department of Applied Mechanics, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India
| | - Naresh V Datla
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India.
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18
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Aseni P, Santaniello T, Rizzetto F, Gentili L, Pezzotta F, Cavaliere F, Vertemati M, Milani P. Hybrid Additive Fabrication of a Transparent Liver with Biosimilar Haptic Response for Preoperative Planning. Diagnostics (Basel) 2021; 11:1734. [PMID: 34574075 PMCID: PMC8471167 DOI: 10.3390/diagnostics11091734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 12/15/2022] Open
Abstract
Due to the complexity of liver surgery, the interest in 3D printing is constantly increasing among hepatobiliary surgeons. The aim of this study was to produce a patient-specific transparent life-sized liver model with tissue-like haptic properties by combining additive manufacturing and 3D moulding. A multistep pipeline was adopted to obtain accurate 3D printable models. Semiautomatic segmentation and registration of routine medical imaging using 3D Slicer software allowed to obtain digital objects representing the structures of interest (liver parenchyma, vasculo-biliary branching, and intrahepatic lesion). The virtual models were used as the source data for a hybrid fabrication process based on additive manufacturing using soft resins and casting of tissue-mimicking silicone-based blend into 3D moulds. The model of the haptic liver reproduced with high fidelity the vasculo-biliary branching and the relationship with the intrahepatic lesion embedded into the transparent parenchyma. It offered high-quality haptic perception and a remarkable degree of surgical and anatomical information. Our 3D transparent model with haptic properties can help surgeons understand the spatial changes of intrahepatic structures during surgical manoeuvres, optimising preoperative surgical planning.
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Affiliation(s)
- Paolo Aseni
- Department of Emergency, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy;
- Department of Biomedical and Clinical Sciences “L. Sacco”, Università degli Studi di Milano, Via Giovanni Battista Grassi 74, 20157 Milano, Italy
| | - Tommaso Santaniello
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Francesco Rizzetto
- Department of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy;
- Postgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Lorenzo Gentili
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Federico Pezzotta
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Francesco Cavaliere
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Maurizio Vertemati
- Department of Biomedical and Clinical Sciences “L. Sacco”, Università degli Studi di Milano, Via Giovanni Battista Grassi 74, 20157 Milano, Italy
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
| | - Paolo Milani
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
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Tan X, Li D, Jeong M, Yu T, Ma Z, Afat S, Grund KE, Qiu T. Soft Liver Phantom with a Hollow Biliary System. Ann Biomed Eng 2021; 49:2139-2149. [PMID: 33594636 PMCID: PMC8455397 DOI: 10.1007/s10439-021-02726-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/05/2021] [Indexed: 02/07/2023]
Abstract
Hepatobiliary interventions are regarded as difficult minimally-invasive procedures that require experience and skills of physicians. To facilitate the surgical training, we develop a soft, high-fidelity and durable liver phantom with detailed morphology. The phantom is anatomically accurate and feasible for the multi-modality medical imaging, including computer tomography (CT), ultrasound, and endoscopy. The CT results show that the phantom resembles the detailed anatomy of real livers including the biliary ducts, with a spatial root mean square error (RMSE) of 1.7 ± 0.7 mm and 0.9 ± 0.2 mm for the biliary duct and the liver outer shape, respectively. The sonographic signals and the endoscopic appearance highly mimic those of the real organ. An electric sensing system was developed for the real-time quantitative tracking of the transhepatic puncturing needle. The fabrication method herein is accurate and reproducible, and the needle tracking system offers a robust and general approach to evaluate the centesis outcome.
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Affiliation(s)
- Xiangzhou Tan
- Cyber Valley Research Group, Institute of Physical Chemistry, University of Stuttgart, Pfaffenwaldring 55, 70569, Stuttgart, Germany.,Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen, 72072, Tuebingen, Germany.,Department of General Surgery, Xiangya Hospital Central South University, Changsha, 410008, China
| | - Dandan Li
- Cyber Valley Research Group, Institute of Physical Chemistry, University of Stuttgart, Pfaffenwaldring 55, 70569, Stuttgart, Germany.,Micro Nano and Molecular Systems Lab, Max Planck Institute for Intelligent Systems, Heisenbergstr. 3, 70569, Stuttgart, Germany
| | - Moonkwang Jeong
- Cyber Valley Research Group, Institute of Physical Chemistry, University of Stuttgart, Pfaffenwaldring 55, 70569, Stuttgart, Germany
| | - Tingting Yu
- Cyber Valley Research Group, Institute of Physical Chemistry, University of Stuttgart, Pfaffenwaldring 55, 70569, Stuttgart, Germany.,Micro Nano and Molecular Systems Lab, Max Planck Institute for Intelligent Systems, Heisenbergstr. 3, 70569, Stuttgart, Germany
| | - Zhichao Ma
- Micro Nano and Molecular Systems Lab, Max Planck Institute for Intelligent Systems, Heisenbergstr. 3, 70569, Stuttgart, Germany
| | - Saif Afat
- Department of Interventional and Diagnostic Radiology, University Hospital Tuebingen, 72072, Tuebingen, Germany
| | - Karl-Enrst Grund
- Department of General, Visceral and Transplant Surgery, University Hospital Tuebingen, 72072, Tuebingen, Germany
| | - Tian Qiu
- Cyber Valley Research Group, Institute of Physical Chemistry, University of Stuttgart, Pfaffenwaldring 55, 70569, Stuttgart, Germany. .,Micro Nano and Molecular Systems Lab, Max Planck Institute for Intelligent Systems, Heisenbergstr. 3, 70569, Stuttgart, Germany.
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20
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Dynamic Hepatocellular Carcinoma Model Within a Liver Phantom for Multimodality Imaging. Eur J Radiol Open 2020; 7:100257. [PMID: 32944594 PMCID: PMC7481524 DOI: 10.1016/j.ejro.2020.100257] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/24/2020] [Indexed: 02/06/2023] Open
Abstract
Introduction Hepatocellular carcinoma (HCC) is one of the most common cancer in the world, and the effectiveness of its treatment lies in its detection in its early stages. The aim of this study is to mimic HCC dynamically through a liver phantom and apply it in multimodality medical imaging techniques including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound. Methods and materials The phantom is fabricated with two main parts, liver parenchyma and HCC inserts. The liver parenchyma was fabricated by adding 2.5 wt% of agarose powder combined with 2.6 wt% of wax powder while the basic material for the HCC samples was made from polyurethane solution combined with 5 wt% glycerol. Three HCC samples were inserted into the parenchyma by using three cylinders implanted inside the liver parenchyma. An automatic injector is attached to the input side of the cylinders and a suction device connected to the output side of the cylinders. After the phantom was prepared, the contrast materials were injected into the phantom and imaged using MRI, CT, and ultrasound. Results Both HCC samples and liver parenchyma were clearly distinguished using the three imaging modalities: MRI, CT, and ultrasound. Doppler ultrasound was also applied through the HCC samples and the flow pattern was observed through the samples. Conclusion A multimodal dynamic liver phantom, with HCC tumor models have been fabricated. This phantom helps to improve and develop different methods for detecting HCC in its early stages.
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Zachariadis O, Teatini A, Satpute N, Gómez-Luna J, Mutlu O, Elle OJ, Olivares J. Accelerating B-spline interpolation on GPUs: Application to medical image registration. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 193:105431. [PMID: 32283385 DOI: 10.1016/j.cmpb.2020.105431] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/14/2020] [Accepted: 03/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE B-spline interpolation (BSI) is a popular technique in the context of medical imaging due to its adaptability and robustness in 3D object modeling. A field that utilizes BSI is Image Guided Surgery (IGS). IGS provides navigation using medical images, which can be segmented and reconstructed into 3D models, often through BSI. Image registration tasks also use BSI to transform medical imaging data collected before the surgery and intra-operative data collected during the surgery into a common coordinate space. However, such IGS tasks are computationally demanding, especially when applied to 3D medical images, due to the complexity and amount of data involved. Therefore, optimization of IGS algorithms is greatly desirable, for example, to perform image registration tasks intra-operatively and to enable real-time applications. A traditional CPU does not have sufficient computing power to achieve these goals and, thus, it is preferable to rely on GPUs. In this paper, we introduce a novel GPU implementation of BSI to accelerate the calculation of the deformation field in non-rigid image registration algorithms. METHODS Our BSI implementation on GPUs minimizes the data that needs to be moved between memory and processing cores during loading of the input grid, and leverages the large on-chip GPU register file for reuse of input values. Moreover, we re-formulate our method as trilinear interpolations to reduce computational complexity and increase accuracy. To provide pre-clinical validation of our method and demonstrate its benefits in medical applications, we integrate our improved BSI into a registration workflow for compensation of liver deformation (caused by pneumoperitoneum, i.e., inflation of the abdomen) and evaluate its performance. RESULTS Our approach improves the performance of BSI by an average of 6.5× and interpolation accuracy by 2× compared to three state-of-the-art GPU implementations. Through pre-clinical validation, we demonstrate that our optimized interpolation accelerates a non-rigid image registration algorithm, which is based on the Free Form Deformation (FFD) method, by up to 34%. CONCLUSION Our study shows that we can achieve significant performance and accuracy gains with our novel parallelization scheme that makes effective use of the GPU resources. We show that our method improves the performance of real medical imaging registration applications used in practice today.
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Affiliation(s)
- Orestis Zachariadis
- Department of Electronics and Computer Engineering, Universidad de Cordoba, Córdoba, Spain.
| | - Andrea Teatini
- The Intervention Centre, Oslo University Hospital - Rikshospitalet, Oslo, Norway; Department of Informatics, University of Oslo, Oslo, Norway.
| | - Nitin Satpute
- Department of Electronics and Computer Engineering, Universidad de Cordoba, Córdoba, Spain
| | - Juan Gómez-Luna
- Department of Computer Science, ETH Zurich, Zurich, Switzerland
| | - Onur Mutlu
- Department of Computer Science, ETH Zurich, Zurich, Switzerland
| | - Ole Jakob Elle
- The Intervention Centre, Oslo University Hospital - Rikshospitalet, Oslo, Norway; Department of Informatics, University of Oslo, Oslo, Norway
| | - Joaquín Olivares
- Department of Electronics and Computer Engineering, Universidad de Cordoba, Córdoba, Spain
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Mackle EC, Shapey J, Maneas E, Saeed SR, Bradford R, Ourselin S, Vercauteren T, Desjardins AE. Patient-Specific Polyvinyl Alcohol Phantom Fabrication with Ultrasound and X-Ray Contrast for Brain Tumor Surgery Planning. J Vis Exp 2020. [PMID: 32744524 PMCID: PMC7610642 DOI: 10.3791/61344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Phantoms are essential tools for clinical training, surgical planning and the development of novel medical devices. However, it is challenging to create anatomically accurate head phantoms with realistic brain imaging properties because standard fabrication methods are not optimized to replicate any patient-specific anatomical detail and 3D printing materials are not optimized for imaging properties. In order to test and validate a novel navigation system for use during brain tumor surgery, an anatomically accurate phantom with realistic imaging and mechanical properties was required. Therefore, a phantom was developed using real patient data as input and 3D printing of molds to fabricate a patient-specific head phantom comprising the skull, brain and tumor with both ultrasound and X-ray contrast. The phantom also had mechanical properties that allowed the phantom tissue to be manipulated in a similar manner to how human brain tissue is handled during surgery. The phantom was successfully tested during a surgical simulation in a virtual operating room. The phantom fabrication method uses commercially available materials and is easy to reproduce. The 3D printing files can be readily shared, and the technique can be adapted to encompass many different types of tumor.
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Affiliation(s)
- Eleanor C Mackle
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London;
| | - Jonathan Shapey
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London; Department of Neurosurgery, National Hospital for Neurology and Neurosurgery; School of Biomedical Engineering & Imaging Sciences, King's College London
| | - Efthymios Maneas
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London
| | - Shakeel R Saeed
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery; The Ear Institute, University College London; The Royal National Throat, Nose and Ear Hospital, London
| | - Robert Bradford
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London
| | - Tom Vercauteren
- School of Biomedical Engineering & Imaging Sciences, King's College London
| | - Adrien E Desjardins
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London; Department of Medical Physics and Biomedical Engineering, University College London
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Stepniak K, Ursani A, Paul N, Naguib H. Novel 3D printing technology for CT phantom coronary arteries with high geometrical accuracy for biomedical imaging applications. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.bprint.2020.e00074] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Mu Y, Hocking D, Wang ZT, Garvin GJ, Eagleson R, Peters TM. Augmented reality simulator for ultrasound-guided percutaneous renal access. Int J Comput Assist Radiol Surg 2020; 15:749-757. [DOI: 10.1007/s11548-020-02142-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/26/2020] [Indexed: 12/27/2022]
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Müller PC, Haslebacher C, Steinemann DC, Müller-Stich BP, Hackert T, Peterhans M, Eigl B. Image-guided minimally invasive endopancreatic surgery using a computer-assisted navigation system. Surg Endosc 2020; 35:1610-1617. [PMID: 32253555 DOI: 10.1007/s00464-020-07540-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 03/31/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Minimally invasive endopancreatic surgery (EPS), performing a pancreatic resection from inside the pancreatic duct, has been proposed as an experimental alternative to duodenum-preserving pancreatic head resection in benign diseases such as chronic pancreatitis, but is complicated by difficult spatial orientation when trying to reach structures of interest. This study assessed the feasibility and potential benefits of image-guided EPS using a computer-assisted navigation system in artificial pancreas silicon model. METHODS A surgical navigation system displayed a 3D reconstruction of the original computed tomography (CT) scan and the endoscope in relation to a selected target structure. In a first step, different surface landmark (LM)-based and intraparenchymal LM-based approaches for image-to-physical space registration were evaluated. The accuracy of registration was measured as fiducial registration error (FRE). Subsequently, intrapancreatic lesions (n = 8) that were visible on preoperative imaging, but not on the endoscopic view, were targeted with a computer-assisted, image-guided endopancreatic resection technique in pancreas silicon models. After each experiment, a CT scan was obtained for measurement of the shortest distance from the resection cavity to the centre of the lesion. RESULTS Intraparenchymal LM registration [FRE 2.24 mm (1.40-2.85)] was more accurate than surface LM registration [FRE 3.46 mm (2.25-4.85); p = 0.035], but not more accurate than combined registration of intraparenchymal and surface LM [FRE 2.46 mm (1.60-3.35); p = 0.052]. Using image-guided EPS, six of seven lesions were successfully targeted. The median distance from the resection cavity to the centre of the lesion on CT was 1.52 mm (0-2.4). In one pancreas, a lesion could not be resected due to the fragility of the pancreas model. CONCLUSION Image-guided minimally invasive EPS using a computer-assisted navigation system enabled successful targeting of pancreatic lesions that were invisible on the endoscopic image, but detectable on preoperative imaging. In the clinical setting, this tool could facilitate complex minimally invasive and robotic pancreatic procedures.
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Affiliation(s)
- Philip C Müller
- Department of Visceral and Transplant Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
| | | | - Daniel C Steinemann
- Department of Surgery, Clarunis, University Hospital Basel, Basel, Switzerland
| | - Beat P Müller-Stich
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Thilo Hackert
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Benjamin Eigl
- CAScination AG, Bern, Switzerland.,ARTORG Center for Computer-Aided Surgery, University of Bern, Bern, Switzerland
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Teatini A, Pérez de Frutos J, Eigl B, Pelanis E, Aghayan DL, Lai M, Kumar RP, Palomar R, Edwin B, Elle OJ. Influence of sampling accuracy on augmented reality for laparoscopic image-guided surgery. MINIM INVASIV THER 2020; 30:229-238. [DOI: 10.1080/13645706.2020.1727524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Andrea Teatini
- The Intervention Centre, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Department of Informatics, University of Oslo, Oslo, Norway
| | - Javier Pérez de Frutos
- SINTEF Digital, SINTEF A.S, Trondheim, Norway
- Department of Computer Science, NTNU, Trondheim, Norway
| | | | - Egidijus Pelanis
- The Intervention Centre, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Davit L. Aghayan
- The Intervention Centre, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Surgery N1, Yerevan State Medical University, Yerevan, Armenia
| | - Marco Lai
- Philips Research, High Tech, Eindhoven, The Netherlands
| | | | - Rafael Palomar
- The Intervention Centre, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Department of Computer Science, NTNU, Trondheim, Norway
| | - Bjørn Edwin
- The Intervention Centre, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Hepato-Pancreatic-Biliary Surgery, Oslo University Hospital, Oslo, Norway
| | - Ole Jakob Elle
- The Intervention Centre, Oslo University Hospital Rikshospitalet, Oslo, Norway
- SINTEF Digital, SINTEF A.S, Trondheim, Norway
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Ahmad MS, Suardi N, Shukri A, Mohammad H, Oglat AA, Alarab A, Makhamrah O. Chemical Characteristics, Motivation and Strategies in choice of Materials used as Liver Phantom: A Literature Review. J Med Ultrasound 2020; 28:7-16. [PMID: 32368444 PMCID: PMC7194418 DOI: 10.4103/jmu.jmu_4_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/26/2019] [Accepted: 05/24/2019] [Indexed: 12/27/2022] Open
Abstract
Liver phantoms have been developed as an alternative to human tissue and have been used for different purposes. In this article, the items used for liver phantoms fabrication are mentioned same as in the previous literature reviews. Summary and characteristics of these materials are presented. The main factors that need to be available in the materials used for fabrication in computed tomography, ultrasound, magnetic resonance imaging, and nuclear medicine were analyzed. Finally, the discussion focuses on some purposes and aims of the liver phantom fabrication for use in several areas such as training, diagnoses of different diseases, and treatment planning for therapeutic strategies – for example, in selective internal radiation therapy, stereotactic body radiation therapy, laser-induced thermotherapy, radiofrequency ablation, and microwave coagulation therapy. It was found that different liver substitutes can be developed to fulfill the different requirements.
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Affiliation(s)
- Muntaser S Ahmad
- Department of Medical Physics and Radiation Science, School of Physics, Universiti Sains Malaysia, Malaysia
| | - Nursakinah Suardi
- Department of Medical Physics and Radiation Science, School of Physics, Universiti Sains Malaysia, Malaysia
| | - Ahmad Shukri
- Department of Medical Physics and Radiation Science, School of Physics, Universiti Sains Malaysia, Malaysia
| | - Hjouj Mohammad
- Department of Medical Imaging, Faculty of Health Professions, Al-Quds University, Abu Deis - Main Campus, Jerusalem, Palestine
| | - Ammar A Oglat
- Department of Medical Imaging, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan, Palestine
| | - Azzam Alarab
- Department of Medical Imaging, Faculty of Allied Medical Health, Palestine Ahlyia University, Bethlehem, Palestine
| | - Osama Makhamrah
- Department of Medical Imaging, Faculty of Health Professions, Al-Quds University, Abu Deis - Main Campus, Jerusalem, Palestine
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Eigl B, Haslebacher C, Muller PC, Andreou A, Gloor B, Peterhans M. A Multimodal Pancreas Phantom for Computer-Assisted Surgery Training. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2020; 1:166-173. [PMID: 35402946 PMCID: PMC8975253 DOI: 10.1109/ojemb.2020.2999786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 11/17/2022] Open
Abstract
Training of surgical residents and the establishment of innovative surgical techniques require training phantoms that realistically mimic human anatomy. Because animal models have their limitations due to ethical aspects, costs, and the required efforts to set up such training, artificial phantoms are a promising alternative. In the field of image-guided surgery, the challenge lies in developing phantoms that are accurate both anatomically and in terms of imaging properties, while taking the cost factor into account. With respect to the pancreas, animal models are less suitable because their anatomy differs significantly from human anatomy and tissue properties rapidly degrade in the case of ex vivo models. Nevertheless, progress with artificial phantoms has been sparse, although the need for innovative, minimally invasive therapies that require adequate training is steadily increasing. Methods: In the course of this project, an artificial pancreas phantom that is compatible with basic electrosurgical techniques was developed with realistic anatomic and haptic properties, computed tomography, and ultrasound imaging capabilities. This article contains step-by-step instructions for the fabrication of a low-cost pancreatic phantom. The molds are also available for download in a 3D file format. Results: The phantom was successfully validated with regard to its computed tomography and ultrasound properties. As a result, the phantom could be used in combination with a state-of-the-art computer-assisted navigation system. The resection capabilities were positively evaluated in a preclinical study evaluating endoscopic resections using the navigation system. Finally, the durability of the phantom material was tested in a study with multiple needle insertions. Conclusion: The developed phantom represents an open-access and low-cost durable alternative to conventional animal models in the continuous process of surgical training and development of new techniques.
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Affiliation(s)
- Benjamin Eigl
- ARTORG Center for Biomedical Engineering ResearchUniversity of Bern Bern 3012 Switzerland
- CAScination AG Bern 3008 Switzerland
| | - Caroline Haslebacher
- CAScination Bern 3008 Switzerland
- Physical Institute of the University of Bern Bern 3012 Switzerland
| | - Philip C Muller
- Department of Visceral and Transplant SurgeryUniversity Hospital Zurich Zurich 8091 Switzerland
| | - Andreas Andreou
- Department of Visceral Surgery and MedicineUniversity Hospital of Bern Bern 3012 Switzerland
| | - Beat Gloor
- Department of Visceral Surgery and MedicineUniversity Hospital of Bern Bern 3012 Switzerland
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3D Printing-Based Pediatric Trainer for Ultrasound-Guided Peripheral Venous Access. IFMBE PROCEEDINGS 2020. [DOI: 10.1007/978-3-030-31635-8_87] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Nagassa RG, McMenamin PG, Adams JW, Quayle MR, Rosenfeld JV. Advanced 3D printed model of middle cerebral artery aneurysms for neurosurgery simulation. 3D Print Med 2019; 5:11. [PMID: 31372773 PMCID: PMC6743137 DOI: 10.1186/s41205-019-0048-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/12/2019] [Indexed: 11/11/2022] Open
Abstract
Background Neurosurgical residents are finding it more difficult to obtain experience as the primary operator in aneurysm surgery. The present study aimed to replicate patient-derived cranial anatomy, pathology and human tissue properties relevant to cerebral aneurysm intervention through 3D printing and 3D print-driven casting techniques. The final simulator was designed to provide accurate simulation of a human head with a middle cerebral artery (MCA) aneurysm. Methods This study utilized living human and cadaver-derived medical imaging data including CT angiography and MRI scans. Computer-aided design (CAD) models and pre-existing computational 3D models were also incorporated in the development of the simulator. The design was based on including anatomical components vital to the surgery of MCA aneurysms while focusing on reproducibility, adaptability and functionality of the simulator. Various methods of 3D printing were utilized for the direct development of anatomical replicas and moulds for casting components that optimized the bio-mimicry and mechanical properties of human tissues. Synthetic materials including various types of silicone and ballistics gelatin were cast in these moulds. A novel technique utilizing water-soluble wax and silicone was used to establish hollow patient-derived cerebrovascular models. Results A patient-derived 3D aneurysm model was constructed for a MCA aneurysm. Multiple cerebral aneurysm models, patient-derived and CAD, were replicated as hollow high-fidelity models. The final assembled simulator integrated six anatomical components relevant to the treatment of cerebral aneurysms of the Circle of Willis in the left cerebral hemisphere. These included models of the cerebral vasculature, cranial nerves, brain, meninges, skull and skin. The cerebral circulation was modeled through the patient-derived vasculature within the brain model. Linear and volumetric measurements of specific physical modular components were repeated, averaged and compared to the original 3D meshes generated from the medical imaging data. Calculation of the concordance correlation coefficient (ρc: 90.2%–99.0%) and percentage difference (≤0.4%) confirmed the accuracy of the models. Conclusions A multi-disciplinary approach involving 3D printing and casting techniques was used to successfully construct a multi-component cerebral aneurysm surgery simulator. Further study is planned to demonstrate the educational value of the proposed simulator for neurosurgery residents.
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Affiliation(s)
- Ruth G Nagassa
- Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia.
| | - Paul G McMenamin
- Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
| | - Justin W Adams
- Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
| | - Michelle R Quayle
- Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia
| | - Jeffrey V Rosenfeld
- Monash Institute of Medical Engineering, Monash University, Clayton, VIC, Australia.,Department of Neurosurgery, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Surgery, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA
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Stepniak K, Ursani A, Paul N, Naguib H. Development of a phantom network for optimization of coronary artery disease imaging using computed tomography. Biomed Phys Eng Express 2019. [DOI: 10.1088/2057-1976/ab2696] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Viglialoro R, Esposito N, Condino S, Cutolo F, Guadagni S, Gesi M, Ferrari M, Ferrari V. Augmented Reality to Improve Surgical Simulation. Lessons Learned Towards the Design of a Hybrid Laparoscopic Simulator for Cholecystectomy. IEEE Trans Biomed Eng 2018; 66:2091-2104. [PMID: 30507490 DOI: 10.1109/tbme.2018.2883816] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hybrid surgical simulators based on Augmented Reality (AR) solutions benefit from the advantages of both the box trainers and the Virtual Reality simulators. This paper reports on the results of a long development stage of a hybrid simulator for laparoscopic cholecystectomy that integrates real and the virtual components. We first outline the specifications of the AR simulator and then we explain the strategy adopted for implementing it based on a careful selection of its simulated anatomical components, and characterized by a real-time tracking of both a target anatomy and of the laparoscope. The former is tracked by means of an electromagnetic field generator, while the latter requires an additional camera for video tracking. The new system was evaluated in terms of AR visualization accuracy, realism and hardware robustness. Obtained results show that the accuracy of AR visualization is adequate for training purposes. The qualitative evaluation confirms the robustness and the realism of the simulator. The AR simulator satisfies all the initial specifications in terms of anatomical appearance, modularity, reusability, minimization of spare parts cost, and ability to record surgical errors and to track in real-time the Calot's triangle and the laparoscope. The proposed system could be an effective training tool for learning the task of identification and isolation of Calot's triangle in laparoscopic cholecystectomy. Moreover, the presented strategy could be applied to simulate other surgical procedures involving the task of identification and isolation of generic tubular structures, such as blood vessels, biliary tree and nerves, which are not directly visible.
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Li P, Yang Z, Jiang S. Tissue mimicking materials in image-guided needle-based interventions: A review. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 93:1116-1131. [PMID: 30274042 DOI: 10.1016/j.msec.2018.09.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 08/25/2018] [Accepted: 09/07/2018] [Indexed: 12/17/2022]
Abstract
Image-guided interventions are widely employed in clinical medicine, which brings significant revolution in healthcare in recent years. However, it is impossible for medical trainees to experience the image-guided interventions physically in patients due to the lack of certificated skills. Therefore, training phantoms, which are normally tissue mimicking materials, are widely used in medical research, training, and quality assurance. This review focuses on the tissue mimicking materials used in image-guided needle-based interventions. In this case, we need to investigate the microstructure characteristics and mechanical properties (for needle intervention), optical properties and acoustical properties (for imaging) of these training phantoms to compare with the related properties of human real tissues. The widely used base materials, additives and the corresponding concentrations of the training phantoms are summarized from the literatures in recent ten years. The microstructure characteristics, mechanical behavior, optical properties and acoustical properties of the tissue mimicking materials are investigated, accompanied with the common experimental methods, apparatus and theoretical algorithm. The influence of the concentrations of the base materials and additives on these characteristics are compared and classified. In this review, we assess a comprehensive overview of the existing techniques with the main accomplishments, and limitations as well as recommendations for tissue mimicking materials used in image-guided needle-based interventions.
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Affiliation(s)
- Pan Li
- Centre for Advanced Mechanisms and Robotics, School of Mechanical Engineering, Tianjin University, No. 135, Yaguan Road, Jinnan District, Tianjin City 300354, China
| | - Zhiyong Yang
- Centre for Advanced Mechanisms and Robotics, School of Mechanical Engineering, Tianjin University, No. 135, Yaguan Road, Jinnan District, Tianjin City 300354, China
| | - Shan Jiang
- Centre for Advanced Mechanisms and Robotics, School of Mechanical Engineering, Tianjin University, No. 135, Yaguan Road, Jinnan District, Tianjin City 300354, China.
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Filippou V, Tsoumpas C. Recent advances on the development of phantoms using 3D printing for imaging with CT, MRI, PET, SPECT, and ultrasound. Med Phys 2018; 45. [PMID: 29933508 PMCID: PMC6849595 DOI: 10.1002/mp.13058] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/03/2018] [Accepted: 06/15/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Printing technology, capable of producing three-dimensional (3D) objects, has evolved in recent years and provides potential for developing reproducible and sophisticated physical phantoms. 3D printing technology can help rapidly develop relatively low cost phantoms with appropriate complexities, which are useful in imaging or dosimetry measurements. The need for more realistic phantoms is emerging since imaging systems are now capable of acquiring multimodal and multiparametric data. This review addresses three main questions about the 3D printers currently in use, and their produced materials. The first question investigates whether the resolution of 3D printers is sufficient for existing imaging technologies. The second question explores if the materials of 3D-printed phantoms can produce realistic images representing various tissues and organs as taken by different imaging modalities such as computer tomography (CT), positron emission tomography (PET), single-photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), ultrasound (US), and mammography. The emergence of multimodal imaging increases the need for phantoms that can be scanned using different imaging modalities. The third question probes the feasibility and easiness of "printing" radioactive or nonradioactive solutions during the printing process. METHODS A systematic review of medical imaging studies published after January 2013 is performed using strict inclusion criteria. The databases used were Scopus and Web of Knowledge with specific search terms. In total, 139 papers were identified; however, only 50 were classified as relevant for this paper. In this review, following an appropriate introduction and literature research strategy, all 50 articles are presented in detail. A summary of tables and example figures of the most recent advances in 3D printing for the purposes of phantoms across different imaging modalities are provided. RESULTS All 50 studies printed and scanned phantoms in either CT, PET, SPECT, mammography, MRI, and US-or a combination of those modalities. According to the literature, different parameters were evaluated depending on the imaging modality used. Almost all papers evaluated more than two parameters, with the most common being Hounsfield units, density, attenuation and speed of sound. CONCLUSIONS The development of this field is rapidly evolving and becoming more refined. There is potential to reach the ultimate goal of using 3D phantoms to get feedback on imaging scanners and reconstruction algorithms more regularly. Although the development of imaging phantoms is evident, there are still some limitations to address: One of which is printing accuracy, due to the printer properties. Another limitation is the materials available to print: There are not enough materials to mimic all the tissue properties. For example, one material can mimic one property-such as the density of real tissue-but not any other property, like speed of sound or attenuation.
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Affiliation(s)
- Valeria Filippou
- Institute of Medical and Biological EngineeringFaculty of Mechanical EngineeringUniversity of LeedsLeedsLS2 9JTWest YorkshireUK
| | - Charalampos Tsoumpas
- Department of Biomedical Imaging ScienceSchool of MedicineUniversity of LeedsLeedsLS2 9NLWest YorkshireUK
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Rethy A, Sæternes JO, Halgunset J, Mårvik R, Hofstad EF, Sánchez-Margallo JA, Langø T. Anthropomorphic liver phantom with flow for multimodal image-guided liver therapy research and training. Int J Comput Assist Radiol Surg 2017; 13:61-72. [PMID: 28929364 PMCID: PMC5754383 DOI: 10.1007/s11548-017-1669-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/11/2017] [Indexed: 11/11/2022]
Abstract
Purpose The objective of this study was to develop a multimodal, permanent liver phantom displaying functional vasculature and common pathologies, for teaching, training and equipment development in laparoscopic ultrasound and navigation. Methods Molten wax was injected simultaneously into the portal and hepatic veins of a human liver. Upon solidification of the wax, the surrounding liver tissue was dissolved, leaving a cast of the vessels. A connection was established between the two vascular trees by manually manipulating the wax. The cast was placed, along with different multimodal tumor models, in a liver shaped mold, which was subsequently filled with a polymer. After curing, the wax was melted and flushed out of the model, thereby establishing a system of interconnected channels, replicating the major vasculature of the original liver. Thus, a liquid can be circulated through the model in a way that closely mimics the natural blood flow. Results Both the tumor models, i.e., the metastatic tumors, hepatocellular carcinoma and benign cyst, and the vessels inside the liver model, were clearly visualized by all the three imaging modalities: CT, MR and ultrasound. Doppler ultrasound images of the vessels proved the blood flow functionality of the phantom. Conclusion By a two-step casting procedure, we produced a multimodal liver phantom, with open vascular channels, and tumor models, that is the next best thing to practicing imaging and guidance procedures in animals or humans. The technique is in principle applicable to any organ of the body.
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Affiliation(s)
- Anna Rethy
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jørn Ove Sæternes
- Department of Laboratory Medicine, Children's and Women's Health, NTNU, Trondheim, Norway
| | - Jostein Halgunset
- Department of Laboratory Medicine, Children's and Women's Health, NTNU, Trondheim, Norway
| | - Ronald Mårvik
- Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Gastrointestinal Surgery, St. Olavs Hospital, Trondheim, Norway
| | - Erlend F Hofstad
- Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Medical Technology, SINTEF, 7465, Trondheim, Norway
| | - Juan A Sánchez-Margallo
- Department of Medical Technology, SINTEF, 7465, Trondheim, Norway.,Department of Computer Systems and Telematics Engineering, University of Extremadura, Badajoz, Spain
| | - Thomas Langø
- Norwegian National Advisory Unit on Ultrasound and Image-Guided Therapy, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. .,Department of Medical Technology, SINTEF, 7465, Trondheim, Norway.
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