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Dho YS, Lee D, Ha T, Ji SY, Kim KM, Kang H, Kim MS, Kim JW, Cho WS, Kim YH, Kim YG, Park SJ, Park CK. Clinical application of patient-specific 3D printing brain tumor model production system for neurosurgery. Sci Rep 2021; 11:7005. [PMID: 33772092 PMCID: PMC7998007 DOI: 10.1038/s41598-021-86546-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/17/2021] [Indexed: 12/15/2022] Open
Abstract
The usefulness of 3-dimensional (3D)-printed disease models has been recognized in various medical fields. This study aims to introduce a production platform for patient-specific 3D-printed brain tumor model in clinical practice and evaluate its effectiveness. A full-cycle platform was created for the clinical application of a 3D-printed brain tumor model (3D-printed model) production system. Essential elements included automated segmentation software, cloud-based interactive communication tools, customized brain models with exquisite expression of brain anatomy in transparent material, adjunctive devices for surgical simulation, and swift process cycles to meet practical needs. A simulated clinical usefulness validation was conducted in which neurosurgeons assessed the usefulness of the 3D-printed models in 10 cases. We successfully produced clinically applicable patient-specific models within 4 days using the established platform. The simulated clinical usefulness validation results revealed the significant superiority of the 3D-printed models in surgical planning regarding surgical posture (p = 0.0147) and craniotomy design (p = 0.0072) compared to conventional magnetic resonance images. The benefit was more noticeable for neurosurgeons with less experience. We established a 3D-printed brain tumor model production system that is ready to use in daily clinical practice for neurosurgery.
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Affiliation(s)
- Yun-Sik Dho
- Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Doohee Lee
- MEDICALIP Co. Ltd., Changgyeong Building, 174, Yulgok-ro, Jongno-gu, Seoul, 03127, Republic of Korea
| | - Teahyun Ha
- MEDICALIP Co. Ltd., Changgyeong Building, 174, Yulgok-ro, Jongno-gu, Seoul, 03127, Republic of Korea
| | - So Young Ji
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyung Min Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Ho Kang
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Min-Sung Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jin Wook Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Won-Sang Cho
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Yong Hwy Kim
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Young Gyu Kim
- Department of Neurosurgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Sang Joon Park
- MEDICALIP Co. Ltd., Changgyeong Building, 174, Yulgok-ro, Jongno-gu, Seoul, 03127, Republic of Korea. .,Department of Radiology, Seoul National University Hospital, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea.
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Guo XY, He ZQ, Duan H, Lin FH, Zhang GH, Zhang XH, Chen ZH, Sai K, Jiang XB, Wang ZN, Xie T, Chen ZP, Mou YG. The utility of 3-dimensional-printed models for skull base meningioma surgery. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:370. [PMID: 32355814 PMCID: PMC7186736 DOI: 10.21037/atm.2020.02.28] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Skull base meningioma surgery is often difficult and complicated to perform. Therefore, this study aims to investigate the effectiveness of 3-dimensional (3D)-printed models of skull base meningioma in the representation of anatomical structures, the simulation of surgical plans, and patient education on surgical outcomes. Methods A retrospective study of 35 patients (3D group: 19 patients and non-3D group: 16 patients) with skull base meningioma was conducted. Mimics software was used to create 3D reconstructions (with the skull, blood vessels, nerves, and tumors set to different colors), and 3D solid models were printed to determine the surgical protocols and communication pathways with the patient. Results The 3D-printed model can visually display the relationship of different structures, including the skull, blood vessels, cranial nerves, and tumors. The surgeon should select the proper surgical approaches before surgery through the model and pay attention to protecting the important structures during the operation. According to the models, the surgeon should cut off the blood supply to the tumor to reduce intraoperative bleeding. For patients with skull base bone destruction, the skull base repair should be prepared in advance. Patients and their families should have a thorough understanding of the disease through the model, and there should be effective communication between doctors and patients. Conclusions The 3D-printed model of a skull base meningioma can present the structures in a detailed manner and facilitate in helping the surgeon to develop a surgical plan. At the same time, it helps patients and their families to understand the condition and the surgical plan, which is conducive to better patient education.
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Affiliation(s)
- Xiao-Yu Guo
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zhen-Qiang He
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Hao Duan
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Fu-Hua Lin
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Guan-Hua Zhang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Xiang-Heng Zhang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zheng-He Chen
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Ke Sai
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Xiao-Bing Jiang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zhen-Ning Wang
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Tian Xie
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Zhong-Ping Chen
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
| | - Yong-Gao Mou
- Department of Neurosurgery/Neuro-oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510000, China
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Rastogi P, Kandasubramanian B. Review of alginate-based hydrogel bioprinting for application in tissue engineering. Biofabrication 2019; 11:042001. [PMID: 31315105 DOI: 10.1088/1758-5090/ab331e] [Citation(s) in RCA: 258] [Impact Index Per Article: 51.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The dawn of 3D printing in medicine has given the field the hope of vitality in many patients fighting a multitude of diseases. Also entitled bioprinting, this appertains to its sequential printing of precursor ink, embodying cells and polymer/composite in a predetermined trajectory. The precursor ink, in addition to cells, is predominantly constituted of hydrogels due to its biodegradability and ability to mimic the body's anatomy and mechanical features, e.g. bones, etc. This review paper is devoted to explicating the bioprinting (3D/4D) of alginate hydrogels, which are extracts from brown algae, through extrusion additive manufacturing. Alginates are salt derivatives of alginic acid and constitute long chains of polysaccharides, which provides pliability and gelling adeptness to their structure. Alginate hydrogel (employed for extrusion) can be pristine or composite relying on the requisite properties (target application controlled or in vivo environment), e.g. alginate-natural (gelatin/agarose/collagen/hyaluronic acid/etc) and alginate-synthetic (polyethylene glycol (PEG)/pluronic F-127/etc). Extrusion additive manufacturing of alginate is preponderate among others with its uncomplicated processing, material efficiency (cut down on wastage), and outspread adaptability for viscosities (0.03-6 * 104 Pa.s), but the procedure is limited by resolution (200 μm) in addition to accuracy. However, 3D-fabricated biostructures display rigidness (unvarying with conditions) i.e. lacks a smart response, which is reassured by accounting time feature as a noteworthy accessory to printing, interpreted as 4D bioprinting. This review propounds the specific processing itinerary for alginate (meanwhile traversing across its composites/blends with natural and synthetic consideration) in extrusion along with its pre-/during/post-processing parameters intrinsic to the process. Furthermore, propensity is also presented in its (alginate extrusion processing) application for tissue engineering, i.e. bones, cartilage (joints), brain (neural), ear, heart (cardiac), eyes (corneal), etc, due to a worldwide quandary over accessibility to natural organs for diverse types of diseases. Additionally, the review contemplates recently invented advance printing, i.e. 4D printing for biotic species, with its challenges and future opportunities.
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Affiliation(s)
- Prasansha Rastogi
- Rapid Prototyping Laboratory, Department of Metallurgical and Materials Engineering, Defence Institute of Advanced Technology (DU), Ministry of Defence, Girinagar, Pune- 411025, India
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Kim PS, Choi CH, Han IH, Lee JH, Choi HJ, Lee JI. Obtaining Informed Consent Using Patient Specific 3D Printing Cerebral Aneurysm Model. J Korean Neurosurg Soc 2019; 62:398-404. [PMID: 31290295 PMCID: PMC6616983 DOI: 10.3340/jkns.2019.0092] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 04/22/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Recently, three-dimensional (3D) printed models of the intracranial vascular have served as useful tools in simulation and training for cerebral aneurysm clipping surgery. Precise and realistic 3D printed aneurysm models may improve patients' understanding of the 3D cerebral aneurysm structure. Therefore, we created patient-specific 3D printed aneurysm models as an educational and clinical tool for patients undergoing aneurysm clipping surgery. Herein, we describe how these 3D models can be created and the effects of applying them for patient education purpose. METHODS Twenty patients with unruptured intracranial aneurysm were randomly divided into two groups. We explained and received informed consent from patients in whom 3D printed models-(group I) or computed tomography angiography-(group II) was used to explain aneurysm clipping surgery. The 3D printed intracranial aneurysm models were created based on time-offlight magnetic resonance angiography using a 3D printer with acrylonitrile-butadiene-styrene resin as the model material. After describing the model to the patients, they completed a questionnaire about their understanding and satisfaction with aneurysm clipping surgery. RESULTS The 3D printed models were successfully made, and they precisely replicated the actual intracranial aneurysm structure of the corresponding patients. The use of the 3D model was associated with a higher understanding and satisfaction of preoperative patient education and consultation. On a 5-point Likert scale, the average level of understanding was scored as 4.7 (range, 3.0-5.0) in group I. In group II, the average response was 2.5 (range, 2.0-3.0). CONCLUSION The 3D printed models were accurate and useful for understanding the intracranial aneurysm structure. In this study, 3D printed intracranial aneurysm models were proven to be helpful in preoperative patient consultation.
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Affiliation(s)
- Pil Soo Kim
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Chang Hwa Choi
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - In Ho Han
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jung Hwan Lee
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Hyuk Jin Choi
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jae Il Lee
- Department of Neurosurgery and Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
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Kravchuk AD, Potapov AA, Panchenko VY, Komlev VS, Novikov MM, Okhlopkov VA, Maryakhin AD, Duvidzon VG, Latyshev YA, Chelushkin DM, Chobulov SA, Aleksandrov AP, Shkarubo AN. [Additive technologies in neurosurgery]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2018; 82:97-104. [PMID: 30721223 DOI: 10.17116/neiro20188206197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Modern achievements of technical progress, in particular additive technologies (ATs) and three-dimensional printing, have been increasingly introduced in neurosurgical practice. The increasing complexity of surgical interventions requires thorough planning of surgery and a high level of training of young neurosurgeons. Creation of full-scale three-dimensional models for planning of surgery enables visualization of the anatomical region of interest. Additive technologies are especially extensively used in reconstructive surgery of skull defects. ATs enable fast and efficient solving of the following tasks: - generation of accurate models of the skull and an implant; - development and fabrication of individual molds for intraoperative formation of implants from polymeric two-component materials (e.g., PMMA); - fabrication of individual implants from titanium alloys or polyetheretherketone (PEEK) for further use in surgery.
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Affiliation(s)
- A D Kravchuk
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - A A Potapov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - V Ya Panchenko
- Institute of Problems of Laser and Information Technologies, Branch of the Federal Research Center of Crystallography and Photonics, Moscow Region, Russia
| | - V S Komlev
- Baikov Institute of Metallurgy and Materials Science, Moscow, Russia
| | - M M Novikov
- Institute of Problems of Laser and Information Technologies, Branch of the Federal Research Center of Crystallography and Photonics, Moscow Region, Russia
| | | | | | - V G Duvidzon
- AB Universal Engineering Company, Moscow, Russia
| | | | | | - S A Chobulov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - A N Shkarubo
- Burdenko Neurosurgical Institute, Moscow, Russia
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Jiménez Ormabera B, Díez Valle R, Zaratiegui Fernández J, Llorente Ortega M, Unamuno Iñurritegui X, Tejada Solís S. [3D printing in neurosurgery: a specific model for patients with craniosynostosis]. Neurocirugia (Astur) 2017; 28:260-265. [PMID: 28666846 DOI: 10.1016/j.neucir.2017.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/04/2017] [Accepted: 05/09/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Craniosynostosis is a rare condition and requires a personalised surgical approach, which is why we consider the use of 3D printed models beneficial in the surgical planning of this procedure. MATERIAL AND METHODS Acrylonitrile butadiene styrene plastic skull models were designed and printed from CT images of patients between 3 and 6 months of age with craniosynostosis of different sutures. The models were used to simulate surgical procedures. RESULTS Four models of four patients with craniosynostosis were produced: two with closure of the metopic suture and two with sagittal suture closure. The mean age of the patients was 5 months (3-6m) and the mean duration of the surgery was 286min (127-380min). The acrylonitrile butadiene styrene plastic models printed for the project proved to be optimal for the simulation of craniosynostosis surgeries, both anatomically and in terms of mechanical properties and reaction to surgical instruments. CONCLUSIONS 3D printers have a wide range of medical applications and they offer an easy and affordable way to produce skull models. The acrylonitrile butadiene styrene material is suitable for the production of operable bone models as it faithfully reproduces the mechanical characteristics of bone tissue.
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Affiliation(s)
| | - Ricardo Díez Valle
- Departamento de Neurocirugía, Clínica Universidad de Navarra, Pamplona, España
| | - Javier Zaratiegui Fernández
- Laboratorio de Arquitectura - Fabricación Digital, Escuela Técnica Superior de Arquitectura de la Universidad de Navarra, Pamplona, España
| | - Marcos Llorente Ortega
- Laboratorio de Ingeniería Médica, Facultad de Medicina de la Universidad de Navarra, Pamplona, España
| | | | - Sonia Tejada Solís
- Departamento de Neurocirugía, Clínica Universidad de Navarra, Pamplona, España.
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Simonin A, Martinerie S, Levivier M, Daniel RT. Three-dimensional printing of a sinus pericranii model: technical note. Childs Nerv Syst 2017; 33:499-502. [PMID: 28247114 DOI: 10.1007/s00381-017-3357-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 01/31/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sinus pericranii (SP) is a rare venous malformation consisting of a single or multiple abnormal emissary veins communicating between intracranial sinuses and dilated epicranial veins. There is no consensus concerning diagnosis, management, and treatment of SP. TECHNICAL NOTE We report the case of a 4-month-old infant with a SP for whom we used a three-dimensional printed model in order to define the angioarchitecture, improve management, and help parents' understanding of this uncommon condition.
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Affiliation(s)
- Alexandre Simonin
- Neurosurgery, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 21, 1010, Lausanne, Switzerland.
| | - Sébastien Martinerie
- Service de Reprographie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Marc Levivier
- Neurosurgery, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 21, 1010, Lausanne, Switzerland
| | - Roy Thomas Daniel
- Neurosurgery, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 21, 1010, Lausanne, Switzerland
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Tomasello F, Conti A, La Torre D. 3D printing in Neurosurgery. World Neurosurg 2016; 91:633-4. [DOI: 10.1016/j.wneu.2016.04.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 04/12/2016] [Indexed: 10/21/2022]
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Using 3D Printing to Create Personalized Brain Models for Neurosurgical Training and Preoperative Planning. World Neurosurg 2016; 90:668-674. [PMID: 26924117 DOI: 10.1016/j.wneu.2016.02.081] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/15/2016] [Accepted: 02/17/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Three-dimensional (3D) printing holds promise for a wide variety of biomedical applications, from surgical planning, practicing, and teaching to creating implantable devices. The growth of this cheap and easy additive manufacturing technology in orthopedic, plastic, and vascular surgery has been explosive; however, its potential in the field of neurosurgery remains underexplored. A major limitation is that current technologies are unable to directly print ultrasoft materials like human brain tissue. OBJECTIVE In this technical note, the authors present a new technology to create deformable, personalized models of the human brain. METHODS The method combines 3D printing, molding, and casting to create a physiologically, anatomically, and tactilely realistic model based on magnetic resonance images. Created from soft gelatin, the model is easy to produce, cost-efficient, durable, and orders of magnitude softer than conventionally printed 3D models. The personalized brain model cost $50, and its fabrication took 24 hours. RESULTS In mechanical tests, the model stiffness (E = 25.29 ± 2.68 kPa) was 5 orders of magnitude softer than common 3D printed materials, and less than an order of magnitude stiffer than mammalian brain tissue (E = 2.64 ± 0.40 kPa). In a multicenter surgical survey, model size (100.00%), visual appearance (83.33%), and surgical anatomy (81.25%) were perceived as very realistic. The model was perceived as very useful for patient illustration (85.00%), teaching (94.44%), learning (100.00%), surgical training (95.00%), and preoperative planning (95.00%). CONCLUSIONS With minor refinements, personalized, deformable brain models created via 3D printing will improve surgical training and preoperative planning with the ultimate goal to provide accurate, customized, high-precision treatment.
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