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Smith JA, Petersmann S, Arbeiter F, Schäfer U. Optimization and manufacture of polyetheretherketone patient specific cranial implants by material extrusion - A clinical perspective. J Mech Behav Biomed Mater 2023; 144:105965. [PMID: 37343357 DOI: 10.1016/j.jmbbm.2023.105965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023]
Abstract
Polyetheretherketone (PEEK) is a high performing thermoplastic that has established itself as a 'gold-standard' material for cranial reconstruction. Traditionally, milled PEEK patient specific cranial implants (PSCIs) exhibit uniform levels of smoothness (excusing suture/drainage holes) to the touch (<1 μm) and homogenous coloration throughout. They also demonstrate predictable and repeatable levels of mechanical performance, as they are machined from isotropic material blocks. The combination of such factors inspires confidence from the surgeon and in turn, approval for implantation. However, manufacturing lead-times and affiliated costs to fabricate a PSCI are high. To simplify their production and reduce expenditure, hospitals are exploring the production of in-house PEEK PSCIs by material extrusion-based additive manufacturing. From a geometrical and morphological perspective, such implants have been produced with good-to-satisfactory clinical results. However, lack of clinical adoption persists. To determine the reasoning behind this, it was necessary to assess the benefits and limitations of current printed PEEK PSCIs in order to establish the status quo. Afterwards, a review on individual PEEK printing variables was performed in order to identify a combination of parameters that could enhance the aesthetics and performance of the PSCIs to that of milled implants/cranial bone. The findings from this review could be used as a baseline to help standardize the production of PEEK PSCIs by material extrusion in the hospital.
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Affiliation(s)
- James A Smith
- Research Unit Experimental Neurotraumatology, Department of Neurosurgery, Medical University of Graz, Auenbruggerplatz 2(9), 8036, Graz, Austria.
| | - Sandra Petersmann
- Materials Science and Testing of Polymers, Montanuniversitaet Leoben, Otto Gloeckel-Straße 2, 8700, Leoben, Austria
| | - Florian Arbeiter
- Materials Science and Testing of Polymers, Montanuniversitaet Leoben, Otto Gloeckel-Straße 2, 8700, Leoben, Austria
| | - Ute Schäfer
- Research Unit Experimental Neurotraumatology, Department of Neurosurgery, Medical University of Graz, Auenbruggerplatz 2(9), 8036, Graz, Austria; BioTechMed-Graz, Graz, Austria
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Żukowska M, Rad MA, Górski F. Additive Manufacturing of 3D Anatomical Models-Review of Processes, Materials and Applications. Materials (Basel) 2023; 16:880. [PMID: 36676617 PMCID: PMC9861235 DOI: 10.3390/ma16020880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
The methods of additive manufacturing of anatomical models are widely used in medical practice, including physician support, education and planning of treatment procedures. The aim of the review was to identify the area of additive manufacturing and the application of anatomical models, imitating both soft and hard tissue. The paper outlines the most commonly used methodologies, from medical imaging to obtaining a functional physical model. The materials used to imitate specific organs and tissues, and the related technologies used to produce, them are included. The study covers publications in English, published by the end of 2022 and included in the Scopus. The obtained results emphasise the growing popularity of the issue, especially in the areas related to the attempt to imitate soft tissues with the use of low-cost 3D printing and plastic casting techniques.
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Affiliation(s)
- Magdalena Żukowska
- Faculty of Mechanical Engineering, Poznan University of Technology, Piotrowo 3, 61-138 Poznan, Poland
| | - Maryam Alsadat Rad
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology, Sydney, NSW 2007, Australia
| | - Filip Górski
- Faculty of Mechanical Engineering, Poznan University of Technology, Piotrowo 3, 61-138 Poznan, Poland
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Guy BJ, Morris A, Mirjalili SA. Toward Emulating Human Movement: Adopting a Data-Driven Bitmap-Based "Voxel" Multimaterial Workflow to Create a Flexible 3D Printed Neonatal Lower Limb. 3D Print Addit Manuf 2022; 9:349-364. [PMID: 36660289 PMCID: PMC9831563 DOI: 10.1089/3dp.2021.0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
It is increasingly common to produce physical anatomical medical models using high-fidelity multiproperty 3D printing to assist doctor-patient communication, presurgical planning, and surgical simulation. Currently, most medical models are created using image thresholding and traditional mesh-based segmentation techniques to produce mono-material boundaries (STL file formats) of anatomical features. Existing medical modeling manufacturing methods restrict shape specification to one material or density, which result in anatomically simple 3D printed medical models with no gradated material qualities. Currently, available high-resolution functionally graded multimaterial 3D printed medical models are rigid and do not represent biomechanical movement. To bypass the identified limitations of current 3D printing medical modeling workflows, we present a bitmap-based "voxel" multimaterial additive manufacturing workflow for the production of highly realistic and flexible anatomical models of the neonatal lower limb using computed tomographic ("CT") data. By interpolating and re-slicing a biomedical volumetric data set at the native 3D printer z resolution of 27 μm and using CT scan attenuation properties (Hounsfield units) to guide material mixing ratios, producing highly realistic models of the neonatal lower limb at a significantly faster rate than other manufacturing methods. The presented medical modeling workflow has considerable potential to improve medical modeling manufacturing methods by translating medical data directly into 3D printing files aiding in anatomical education and surgical simulation practices, especially in neonatal research and clinical training.
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Affiliation(s)
- Bernard Joseph Guy
- Industrial Design Department, School of Design Innovation, Victoria University of Wellington, Wellington, New Zealand
| | - Ana Morris
- Industrial Design Department, School of Design Innovation, Victoria University of Wellington, Wellington, New Zealand
| | - Seyed Ali Mirjalili
- Anatomy and Medical Imaging Department, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Jusufbegović M, Pandžić A, Šehić A, Jašić R, Julardžija F, Vegar-zubović S, Beganović A. Computed tomography tissue equivalence of 3D printing materials. Radiography (Lond) 2022. [DOI: 10.1016/j.radi.2022.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/22/2022]
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Wake N, Rosenkrantz AB, Huang WC, Wysock JS, Taneja SS, Sodickson DK, Chandarana H. A workflow to generate patient-specific three-dimensional augmented reality models from medical imaging data and example applications in urologic oncology. 3D Print Med 2021; 7:34. [PMID: 34709482 PMCID: PMC8554989 DOI: 10.1186/s41205-021-00125-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/03/2021] [Indexed: 01/12/2023] Open
Abstract
Augmented reality (AR) and virtual reality (VR) are burgeoning technologies that have the potential to greatly enhance patient care. Visualizing patient-specific three-dimensional (3D) imaging data in these enhanced virtual environments may improve surgeons' understanding of anatomy and surgical pathology, thereby allowing for improved surgical planning, superior intra-operative guidance, and ultimately improved patient care. It is important that radiologists are familiar with these technologies, especially since the number of institutions utilizing VR and AR is increasing. This article gives an overview of AR and VR and describes the workflow required to create anatomical 3D models for use in AR using the Microsoft HoloLens device. Case examples in urologic oncology (prostate cancer and renal cancer) are provided which depict how AR has been used to guide surgery at our institution.
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Affiliation(s)
- Nicole Wake
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. .,Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
| | - Andrew B Rosenkrantz
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - William C Huang
- Department of Urology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - James S Wysock
- Department of Urology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Samir S Taneja
- Department of Urology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Daniel K Sodickson
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Hersh Chandarana
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
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Amini M, Reisinger A, Pahr DH. Influence of processing parameters on mechanical properties of a 3D-printed trabecular bone microstructure. J Biomed Mater Res B Appl Biomater 2020; 108:38-47. [PMID: 30893513 PMCID: PMC6916655 DOI: 10.1002/jbm.b.34363] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/25/2019] [Accepted: 02/27/2019] [Indexed: 01/29/2023]
Abstract
Natural bone microstructure has shown to be the most efficient choice for the bone scaffold design. However, there are several process parameters involved in the generation of a microCT-based 3D-printed (3DP) bone. In this study, the effect of selected parameters on the reproducibility of mechanical properties of a 3DP trabecular bone structure is investigated. MicroCT images of a distal radial sample were used to reconstruct a 3D ROI of trabecular bone. Nine tensile tests on bulk material and 54 compression tests on 8.2 mm cubic samples were performed (9 cases × 6 specimens/case). The effect of input-image resolution, STL mesh decimation, boundary condition, support material, and repetition parameters on the weight, elastic modulus, and strength were studied. The elastic modulus and the strength of bulk material showed consistent results (CV% = 9 and 6%, respectively). The weight, elastic modulus, and strength of the cubic samples showed small intragroup variation (average CV% = 1.2, 9, and 5.5%, respectively). All studied parameters had a significant effect on the outcome variables with less effect on the weight. Utmost care to every step of the 3DP process and involved parameters is required to be able to reach the desired mechanical properties in the final printed specimen. © 2019 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials published by Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:38-47, 2020.
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Affiliation(s)
- Morteza Amini
- Institute for lightweight design and structural biomechanicsVienna University of Technology1060 ViennaAustria
- Department of Anatomy and BiomechanicsKarl Landsteiner University for Health Sciences3500 KremsAustria
| | - Andreas Reisinger
- Department of Anatomy and BiomechanicsKarl Landsteiner University for Health Sciences3500 KremsAustria
| | - Dieter H. Pahr
- Institute for lightweight design and structural biomechanicsVienna University of Technology1060 ViennaAustria
- Department of Anatomy and BiomechanicsKarl Landsteiner University for Health Sciences3500 KremsAustria
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de Lima Moreno JJ, Liedke GS, Soler R, da Silveira HED, da Silveira HLD. Imaging Factors Impacting on Accuracy and Radiation Dose in 3D Printing. J Maxillofac Oral Surg 2018; 17:582-587. [PMID: 30344404 DOI: 10.1007/s12663-018-1098-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/22/2018] [Indexed: 11/25/2022] Open
Abstract
Objectives To compare reconstructed area and surface roughness of 3D models acquired using nine image acquisition protocols. Radiation dose was also compared among acquisition protocols. Methods A dry craniofacial specimen was scanned using three CT devices (a cone beam CT, a 16-channel fan beam CT, and a 64-channel fan beam CT), with three different acquisition protocols each. Nine 3D models were manufactured using polylactic acid. Surface roughness and reconstructed area were determined for each 3D model. The radiation dose during acquisitions was measured using lithium crystals. ANOVA was used to compare the data among the 3D models. Linear function optimization techniques based on stochastic variables were applied to identify the most suitable protocol for use. Results For surface roughness, statistically significant differences were observed among all 3D models and the specimen. For reconstructed area, CBCT and one CT-16 channel protocols originated 3D models statistically significant different from the specimen. Higher radiation doses were observed with fan beam CT acquisitions. Conclusions All three CT devices were suitable for 3D printing when used at full resolution. The highest reconstruct area vs. radiation dose ratio was found for 64-channel CT devices.
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Affiliation(s)
- Jorge Javier de Lima Moreno
- 1Department of Maxillofacial Prosthesis, School of Dentistry, Universidad de la Republica, Las Heras 1925, Montevideo, Uruguay
| | - Gabriela Salatino Liedke
- 2Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Roberto Soler
- 1Department of Maxillofacial Prosthesis, School of Dentistry, Universidad de la Republica, Las Heras 1925, Montevideo, Uruguay
| | | | - Heraldo Luis Dias da Silveira
- 3Department of Surgery and Orthopedics, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Martinez-Marquez D, Mirnajafizadeh A, Carty CP, Stewart RA. Application of quality by design for 3D printed bone prostheses and scaffolds. PLoS One 2018; 13:e0195291. [PMID: 29649231 PMCID: PMC5896968 DOI: 10.1371/journal.pone.0195291] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 03/20/2018] [Indexed: 12/14/2022] Open
Abstract
3D printing is an emergent manufacturing technology recently being applied in the medical field for the development of custom bone prostheses and scaffolds. However, successful industry transformation to this new design and manufacturing approach requires technology integration, concurrent multi-disciplinary collaboration, and a robust quality management framework. This latter change enabler is the focus of this study. While a number of comprehensive quality frameworks have been developed in recent decades to ensure that the manufacturing of medical devices produces reliable products, they are centred on the traditional context of standardised manufacturing techniques. The advent of 3D printing technologies and the prospects for mass customisation provides significant market opportunities, but also presents a serious challenge to regulatory bodies tasked with managing and assuring product quality and safety. Before 3D printing bone prostheses and scaffolds can gain traction, industry stakeholders, such as regulators, clients, medical practitioners, insurers, lawyers, and manufacturers, would all require a high degree of confidence that customised manufacturing can achieve the same quality outcomes as standardised manufacturing. A Quality by Design (QbD) approach to custom 3D printed prostheses can help to ensure that products are designed and manufactured correctly from the beginning without errors. This paper reports on the adaptation of the QbD approach for the development process of 3D printed custom bone prosthesis and scaffolds. This was achieved through the identification of the Critical Quality Attributes of such products, and an extensive review of different design and fabrication methods for 3D printed bone prostheses. Research outcomes include the development of a comprehensive design and fabrication process flow diagram, and categorised risks associated with the design and fabrication processes of such products. An extensive systematic literature review and post-hoc evaluation survey with experts was completed to evaluate the likely effectiveness of the herein suggested QbD framework.
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Affiliation(s)
| | - Ali Mirnajafizadeh
- Molecular Cell Biomechanics Laboratory, University of California, Berkeley, California, United States of America
| | - Christopher P. Carty
- School of Allied Health Sciences and Innovations in Health Technology, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Centre for Musculoskeletal Research, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Queensland Children's Gait Laboratory, Queensland Paediatric Rehabilitation Service, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
| | - Rodney A. Stewart
- School of Engineering, Griffith University, Gold Coast, Queensland, Australia
- * E-mail:
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Shah P, Chong BS. 3D imaging, 3D printing and 3D virtual planning in endodontics. Clin Oral Investig 2018; 22:641-54. [DOI: 10.1007/s00784-018-2338-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 01/07/2018] [Indexed: 01/22/2023]
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10
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Barui S, Mandal S, Basu B. Thermal inkjet 3D powder printing of metals and alloys: Current status and challenges. Current Opinion in Biomedical Engineering 2017; 2:116-23. [DOI: 10.1016/j.cobme.2017.05.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Thompson A, McNally D, Maskery I, Leach RK. X-ray computed tomography and additive manufacturing in medicine: a review. Int J Metrol Qual Eng 2017. [DOI: 10.1051/ijmqe/2017015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Johnson T, Levison P, Shearing P, Bracewell D. X-ray computed tomography of packed bed chromatography columns for three dimensional imaging and analysis. J Chromatogr A 2017; 1487:108-15. [DOI: 10.1016/j.chroma.2017.01.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/04/2017] [Accepted: 01/05/2017] [Indexed: 11/17/2022]
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Crafts TD, Ellsperman SE, Wannemuehler TJ, Bellicchi TD, Shipchandler TZ, Mantravadi AV. Three-Dimensional Printing and Its Applications in Otorhinolaryngology-Head and Neck Surgery. Otolaryngol Head Neck Surg 2016; 156:999-1010. [PMID: 28421875 DOI: 10.1177/0194599816678372] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective Three-dimensional (3D)-printing technology is being employed in a variety of medical and surgical specialties to improve patient care and advance resident physician training. As the costs of implementing 3D printing have declined, the use of this technology has expanded, especially within surgical specialties. This article explores the types of 3D printing available, highlights the benefits and drawbacks of each methodology, provides examples of how 3D printing has been applied within the field of otolaryngology-head and neck surgery, discusses future innovations, and explores the financial impact of these advances. Data Sources Articles were identified from PubMed and Ovid MEDLINE. Review Methods PubMed and Ovid Medline were queried for English articles published between 2011 and 2016, including a few articles prior to this time as relevant examples. Search terms included 3-dimensional printing, 3 D printing, otolaryngology, additive manufacturing, craniofacial, reconstruction, temporal bone, airway, sinus, cost, and anatomic models. Conclusions Three-dimensional printing has been used in recent years in otolaryngology for preoperative planning, education, prostheses, grafting, and reconstruction. Emerging technologies include the printing of tissue scaffolds for the auricle and nose, more realistic training models, and personalized implantable medical devices. Implications for Practice After the up-front costs of 3D printing are accounted for, its utilization in surgical models, patient-specific implants, and custom instruments can reduce operating room time and thus decrease costs. Educational and training models provide an opportunity to better visualize anomalies, practice surgical technique, predict problems that might arise, and improve quality by reducing mistakes.
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Affiliation(s)
- Trevor D Crafts
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Susan E Ellsperman
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Todd J Wannemuehler
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Travis D Bellicchi
- 2 Department of Prosthodontics and Facial Prosthetics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Taha Z Shipchandler
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Avinash V Mantravadi
- 1 Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Marro A, Bandukwala T, Mak W. Three-Dimensional Printing and Medical Imaging: A Review of the Methods and Applications. Curr Probl Diagn Radiol 2015; 45:2-9. [PMID: 26298798 DOI: 10.1067/j.cpradiol.2015.07.009] [Citation(s) in RCA: 184] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 07/18/2015] [Accepted: 07/19/2015] [Indexed: 01/17/2023]
Abstract
The purpose of this article is to review recent innovations on the process and application of 3-dimensional (3D) printed objects from medical imaging data. Data for 3D printed medical models can be obtained from computed tomography, magnetic resonance imaging, and ultrasound using the Data Imaging and Communications in Medicine (DICOM) software. The data images are processed using segmentation and mesh generation tools and converted to a standard tessellation language (STL) file for printing. 3D printing technologies include stereolithography, selective laser sintering, inkjet, and fused-deposition modeling . 3D printed models have been used for preoperative planning of complex surgeries, the creation of custom prosthesis, and in the education and training of physicians. The application of medical imaging and 3D printers has been successful in providing solutions to many complex medical problems. As technology advances, its applications continue to grow in the future.
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Affiliation(s)
- Alessandro Marro
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
| | - Taha Bandukwala
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Walter Mak
- Department of Medical Imaging, St. Michael's Hospital, Toronto, Ontario, Canada
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Kim HN, Liu XN, Noh KC. Use of a real-size 3D-printed model as a preoperative and intraoperative tool for minimally invasive plating of comminuted midshaft clavicle fractures. J Orthop Surg Res 2015; 10:91. [PMID: 26054648 PMCID: PMC4465325 DOI: 10.1186/s13018-015-0233-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 05/24/2015] [Indexed: 12/11/2022] Open
Abstract
Background Open reduction and plate fixation is the standard operative treatment for displaced midshaft clavicle fracture. However, sometimes it is difficult to achieve anatomic reduction by open reduction technique in cases with comminution. Methods We describe a novel technique using a real-size three dimensionally (3D)-printed clavicle model as a preoperative and intraoperative tool for minimally invasive plating of displaced comminuted midshaft clavicle fractures. A computed tomography (CT) scan is taken of both clavicles in patients with a unilateral displaced comminuted midshaft clavicle fracture. Both clavicles are 3D printed into a real-size clavicle model. Using the mirror imaging technique, the uninjured side clavicle is 3D printed into the opposite side model to produce a suitable replica of the fractured side clavicle pre-injury. Results The 3D-printed fractured clavicle model allows the surgeon to observe and manipulate accurate anatomical replicas of the fractured bone to assist in fracture reduction prior to surgery. The 3D-printed uninjured clavicle model can be utilized as a template to select the anatomically precontoured locking plate which best fits the model. The plate can be inserted through a small incision and fixed with locking screws without exposing the fracture site. Seven comminuted clavicle fractures treated with this technique achieved good bone union. Conclusions This technique can be used for a unilateral displaced comminuted midshaft clavicle fracture when it is difficult to achieve anatomic reduction by open reduction technique. Level of evidence V.
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Affiliation(s)
- Hyong Nyun Kim
- Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 948-1, Dalim-1dong, Youngdeungpo-gu, Seoul, 150-950, South Korea.
| | - Xiao Ning Liu
- Department of Orthopaedic Surgery, The Second Hospital, Jilin University, Changchun, China.
| | - Kyu Cheol Noh
- Department of Orthopaedic Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 948-1, Dalim-1dong, Youngdeungpo-gu, Seoul, 150-950, South Korea.
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Pinto JM, Arrieta C, Andia ME, Uribe S, Ramos-grez J, Vargas A, Irarrazaval P, Tejos C. Sensitivity analysis of geometric errors in additive manufacturing medical models. Med Eng Phys 2015; 37:328-34. [DOI: 10.1016/j.medengphy.2015.01.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 01/13/2015] [Accepted: 01/15/2015] [Indexed: 11/19/2022]
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17
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Lim CGT, Campbell DI, Cook N, Erasmus J. A case series of rapid prototyping and intraoperative imaging in orbital reconstruction. Craniomaxillofac Trauma Reconstr 2014; 8:105-10. [PMID: 26000080 DOI: 10.1055/s-0034-1395384] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 07/09/2014] [Indexed: 10/24/2022] Open
Abstract
In Christchurch Hospital, rapid prototyping (RP) and intraoperative imaging are the standard of care in orbital trauma and has been used since February 2013. RP allows the fabrication of an anatomical model to visualize complex anatomical structures which is dimensionally accurate and cost effective. This assists diagnosis, planning, and preoperative implant adaptation for orbital reconstruction. Intraoperative imaging involves a computed tomography scan during surgery to evaluate surgical implants and restored anatomy and allows the clinician to correct errors in implant positioning that may occur during the same procedure. This article aims to demonstrate the potential clinical and cost saving benefits when both these technologies are used in orbital reconstruction which minimize the need for revision surgery.
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Affiliation(s)
- Christopher G T Lim
- Department of Oral and Maxillofacial Surgery, Canterbury District Health Board, Christchurch, New Zealand
| | - Duncan I Campbell
- Department of Oral and Maxillofacial Surgery, Royal Brisbane Hospital, Herston, Australia
| | - Nicholas Cook
- Diagnostic Physics Section, Medical Physics and Bioengineering, Christchurch Hospital, New Zealand
| | - Jason Erasmus
- Department of Oral and Maxillofacial Surgery, Canterbury District Health Board, Christchurch, New Zealand
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Tuomi J, Paloheimo KS, Vehviläinen J, Björkstrand R, Salmi M, Huotilainen E, Kontio R, Rouse S, Gibson I, Mäkitie AA. A Novel Classification and Online Platform for Planning and Documentation of Medical Applications of Additive Manufacturing. Surg Innov 2014; 21:553-9. [DOI: 10.1177/1553350614524838] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Additive manufacturing technologies are widely used in industrial settings and now increasingly also in several areas of medicine. Various techniques and numerous types of materials are used for these applications. There is a clear need to unify and harmonize the patterns of their use worldwide. We present a 5-class system to aid planning of these applications and related scientific work as well as communication between various actors involved in this field. An online, matrix-based platform and a database were developed for planning and documentation of various solutions. This platform will help the medical community to structurally develop both research innovations and clinical applications of additive manufacturing. The online platform can be accessed through http://www.medicalam.info .
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Affiliation(s)
- Jukka Tuomi
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Kaija-Stiina Paloheimo
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Juho Vehviläinen
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Roy Björkstrand
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Mika Salmi
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Eero Huotilainen
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Risto Kontio
- Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | | | - Ian Gibson
- National University of Singapore, Singapore
| | - Antti A. Mäkitie
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
- Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
- Karolinska Institutet, Division of ENT Diseases, CLINTEC, Stockholm, Sweden
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Ferraz EG, Andrade LCS, dos Santos AR, Torregrossa VR, Rubira-Bullen IRF, Sarmento VA. Application of two segmentation protocols during the processing of virtual images in rapid prototyping: ex vivo study with human dry mandibles. Clin Oral Investig 2013; 17:2113-8. [DOI: 10.1007/s00784-013-0921-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 01/09/2013] [Indexed: 11/30/2022]
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Debarre E, Hivart P, Baranski D, Déprez P. Speedy skeletal prototype production to help diagnosis in orthopaedic and trauma surgery. Methodology and examples of clinical applications. Orthop Traumatol Surg Res 2012; 98:597-602. [PMID: 22878141 DOI: 10.1016/j.otsr.2012.03.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 11/30/2011] [Accepted: 03/19/2012] [Indexed: 02/02/2023]
Abstract
As a medical imaging complement, a real 3D replica of the anatomical area of interest can be of substantial advantage in orthopaedic and trauma surgery. Unlike the 3D virtual, it makes palpable the notion of scale and volume, and apparent hidden or ambiguous details and thus enhance or facilitate the diagnosis and eventual surgical solutions. CT data of patients, in DICOM3 standard, were used for digital 3D reconstruction followed by rapid prototyping (fused deposition modelling) of acrylonitrile-butadiene-styrene (ABS) replicas of the areas of interest. Three applications were realized: osteotomy for epiphyseal malunion, shoulder arthroplasty and femoral trochleoplasty. The actual size replicas (obtained in less than thirty hours) provided excellent spatial representation with estimation of available bone stock and materialization of relief. The process has proven to be appropriate (and economically reasonable), including for common cases, when it comes to complex spatial geometry and objective representation of the scale of volumes.
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Affiliation(s)
- E Debarre
- Artois Biomaterials Research Unit, Artois University, 62408 Béthune cedex, France
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Shen F, Chen B, Guo Q, Qi Y, Shen Y. Augmented reality patient-specific reconstruction plate design for pelvic and acetabular fracture surgery. Int J Comput Assist Radiol Surg 2012; 8:169-79. [PMID: 22752350 DOI: 10.1007/s11548-012-0775-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 06/11/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE The objective of this work is to develop a preoperative reconstruction plate design system for unilateral pelvic and acetabular fracture reduction and internal fixation surgery, using computer graphics and augmented reality (AR) techniques, in order to respect the patient-specific morphology and to reduce surgical invasiveness, as well as to simplify the surgical procedure. MATERIALS AND METHODS Our AR-aided implant design and contouring system is composed of two subsystems: a semi-automatic 3D virtual fracture reduction system to establish the patient-specific anatomical model and a preoperative templating system to create the virtual and real surgical implants. Preoperative 3D CT data are taken as input. The virtual fracture reduction system exploits the symmetric nature of the skeletal system to build a "repaired" pelvis model, on which reconstruction plates are planned interactively. A lightweight AR environment is set up to allow surgeons to match the actual implants to the digital ones intuitively. The effectiveness of this system is qualitatively demonstrated with 6 clinical cases. Its reliability was assessed based on the inter-observer reproducibility of the resulting virtual implants. RESULTS The implants designed with the proposed system were successfully applied to all cases through minimally invasive surgeries. After the treatments, no further complications were reported. The inter-observer variability of the virtual implant geometry is 0.63 mm on average with a standard deviation of 0.49 mm. The time required for implant creation with our system is 10 min on average. CONCLUSION It is feasible to apply the proposed AR-aided design system for noninvasive implant contouring for unilateral fracture reduction and internal fixation surgery. It also enables a patient-specific surgical planning procedure with potentially improved efficiency.
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Affiliation(s)
- Fangyang Shen
- State Key Laboratory of Virtual Reality Technology and Systems, Beihang University, Beijing, China.
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Reynolds M, Reynolds M, Adeeb S, El-Bialy T. 3-d volumetric evaluation of human mandibular growth. Open Biomed Eng J 2011; 5:83-9. [PMID: 22046201 PMCID: PMC3204416 DOI: 10.2174/1874120701105010083] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Revised: 06/17/2011] [Accepted: 06/29/2011] [Indexed: 11/22/2022] Open
Abstract
Bone growth is a complex process that is controlled by a multitude of mechanisms that are not fully understood.Most of the current methods employed to measure the growth of bones focus on either studying cadaveric bones from different individuals of different ages, or successive two-dimensional (2D) radiographs. Both techniques have their known limitations. The purpose of this study was to explore a technique for quantifying the three dimensional (3D) growth of an adolescent human mandible over the period of one year utilizing cone beam computed tomography (CBCT) scans taken for regular orthodontic records. Three -dimensional virtual models were created from the CBCT data using mainstream medical imaging software. A comparison between computer-generated surface meshes of successive 3-D virtual models illustrates the magnitude of relative mandible growth. The results of this work are in agreement with previously reported data from human cadaveric studies and implantable marker studies. The presented method provides a new relatively simple basis (utilizing commercially available software) to visualize and evaluate individualized 3D (mandibular) growth in vivo.
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Affiliation(s)
- Mathew Reynolds
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, AB, Canada
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Liu G, Zhang S, Qiu M, Tan L, Li Q, Li K. A Novel Technique for Three-Dimensional Reconstruction for Surgical Simulation Around the Craniocervical Junction Region. Int Surg 2011; 96:274-80. [DOI: 10.9738/cc14.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Performing surgeries on the craniocervical junction presents a technical challenge for operating surgeons. Three-dimensional (3D) reconstruction and surgical simulation have improved the efficacy and success rate of surgeries. The aim of this study was to create a 3D, digitized visible model of the craniocervical junction region to help realize accurate simulation of craniocervical surgery on a graphic workstation. Transverse sectional anatomy data for the study were chosen from the first Chinese visible human. Manual axial segmentation of the skull base, cervical spine, cerebellum, vertebral artery, internal carotid artery, sigmoid sinus, internal jugular vein, brain stem, and spinal cord were carried out by using Photoshop software. The segmented structures were reconstructed in 3 dimensions with surface and volume rendering to accurately display 3D models spatially. In contrast to conventional 3D reconstruction techniques that are based on computed tomography and magnetic resonance imaging Digital Imaging and Communications in Medicine (DICOM) inputs and provide mostly osseous details, this technique can help to illustrate the surrounding soft tissue structure and provide a realistic surgical simulation. The reconstructed 3D model was successfully used in simulating complex procedures in the virtual environment, including the transoral approach, bone drillings, and clivus resection.
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Seeram E. Computed Tomography: Physical Principles and Recent Technical Advances. J Med Imaging Radiat Sci 2010; 41:87-109. [DOI: 10.1016/j.jmir.2010.04.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 04/07/2010] [Indexed: 11/16/2022]
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