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Lan T, Dai Y, Hu P, Han J, Jin Y. Advancing Precision Surgery: The Role of 3D Printing in Liver Surgery. 3D PRINTING AND ADDITIVE MANUFACTURING 2025. [DOI: 10.1089/3dp.2024.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2025]
Affiliation(s)
- Tao Lan
- Department of Hepatobiliary Surgery, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Yihe Dai
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Pingping Hu
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Jiang Han
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Yun Jin
- The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
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Nizam M, Purohit R, Taufik M. Role of 3D printing in healthcare: A comprehensive review on treatment and training. Proc Inst Mech Eng H 2025; 239:239-265. [PMID: 40119709 DOI: 10.1177/09544119251321585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2025]
Abstract
Additive manufacturing (AM) is revolutionizing healthcare by enabling the creation of customized 3D printed (3DP) medical equipment, implants, orthoses, prosthetics, drugs, and organs. With the availability of different types of materials suitable for 3DP and healthcare applications, this technology allows for the precise fabrication of patient-oriented prosthetics, dental implants, and orthopedic devices, significantly improving fit and functionality. Additionally, 3DP drugs, such as Oral Dispersible Formulations (ODFs) and polypills, are surpassing the traditional "one pill fits all" concept, offering more tailored medication solutions. This innovation also supports the development of personalized medications and bioprinted tissues, opening the way for advancements in regenerative medications and tailored therapies. 3D-bioprinted organs are addressing the growing demand for organ transplants. In surgical planning, 3D-printed anatomical models provide students and professionals with hands-on practice, which is crucial for skill development and understanding complex anatomies. Surgeons can also practice and refine techniques before actual procedures, enhancing precision and improving outcomes during real operations. This paper focus on highlighting the progression and motivations behind the cross-disciplinary applications of AM within the healthcare sector providing customized medical devices, drug delivery systems and diagnostic tools for personalized treatment and skill refinement. This paper is designed for a broad audience, including manufacturing professionals and researchers, who are interested in exploring the medical implications of this transformative technology.
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Affiliation(s)
- Maruf Nizam
- Centre of Excellence in Product Design and Smart Manufacturing, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
| | - Rajesh Purohit
- Centre of Excellence in Product Design and Smart Manufacturing, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
- Department of Mechanical Engineering, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
| | - Mohammad Taufik
- Centre of Excellence in Product Design and Smart Manufacturing, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
- Department of Mechanical Engineering, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, India
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Ho M, Ravanpay A, Bastawrous S, Chorath K, Wu L. Enhancing Cervical Foraminotomy Outcomes With Patient-Specific 3D Anatomical Models: A Comparative Study. Cureus 2024; 16:e76426. [PMID: 39867039 PMCID: PMC11763347 DOI: 10.7759/cureus.76426] [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] [Accepted: 12/20/2024] [Indexed: 01/28/2025] Open
Abstract
INTRODUCTION Cervical foraminotomy is a procedure used to treat patients with radiculopathy. While the procedure can be performed using a minimally invasive technique, achieving complete visualization of relevant anatomy can be challenging. This study explores the use of patient-specific three-dimensional (3D) printed anatomical models, created from advanced medical imaging data, for preoperative planning and intraoperative guidance in cervical foraminotomy by comparing fluoroscopy time, operative time, estimated blood loss volume, and functional improvement. METHODS We conducted a retrospective case-controlled study comparing patients who underwent cervical foraminotomy with the aid of a 3D model to those who received standard of care. RESULTS Our findings indicate a statistically significant reduction in fluoroscopy time for the 3D model group (21.8 seconds vs 49.0 seconds, p<0.05). Although functional outcomes for the 3D model group showed a trend towards significance (p=0.14), no significant differences were observed in operative time or estimated blood loss (p=0.25 and p=0.31, respectively). CONCLUSION These results suggest that patient-specific 3D models can enhance the understanding of complex anatomical structures and may improve surgical outcomes in cervical foraminotomy.
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Affiliation(s)
- Michelle Ho
- Diagnostic Radiology, University of Washington, Seattle, USA
| | - Ali Ravanpay
- Neurological Surgery, University of Washington, Seattle, USA
| | | | - Kevin Chorath
- Diagnostic Radiology, University of Washington, Seattle, USA
| | - Lei Wu
- Diagnostic Radiology, University of Washington, Seattle, USA
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Wang KC, Ryan JR, Chepelev L, Wake N, Quigley EP, Santiago L, Wentworth A, Alexander A, Morris JM, Fleischmann D, Ballard DH, Ravi P, Hirsch JD, Sturgeon GM, Huang YH, Decker SJ, von Windheim N, Pugliese RS, Hidalgo RV, Patel P, Colon J, Thieringer FM, Rybicki FJ. Demographics, Utilization, Workflow, and Outcomes Based on Observational Data From the RSNA-ACR 3D Printing Registry. J Am Coll Radiol 2024; 21:1781-1791. [PMID: 39117182 DOI: 10.1016/j.jacr.2024.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE The aim of this study was to report data from the first 3 years of operation of the RSNA-ACR 3D Printing Registry. METHODS Data from June 2020 to June 2023 were extracted, including demographics, indications, workflow, and user assessments. Clinical indications were stratified by 12 organ systems. Imaging modalities, printing technologies, and numbers of parts per case were assessed. Effort data were analyzed, dividing staff members into provider and nonprovider categories. The opinions of clinical users were evaluated using a Likert scale questionnaire, and estimates of procedure time saved were collected. RESULTS A total of 20 sites and 2,637 cases were included, consisting of 1,863 anatomic models and 774 anatomic guides. Mean patient ages for models and guides were 42.4 ± 24.5 years and 56.3 ± 18.5 years, respectively. Cardiac models were the most common type of model (27.2%), and neurologic guides were the most common type of guide (42.4%). Material jetting, vat photopolymerization, and material extrusion were the most common printing technologies used overall (85.6% of all cases). On average, providers spent 92.4 min and nonproviders spent 335.0 min per case. Providers spent most time on consultation (33.6 min), while nonproviders focused most on segmentation (148.0 min). Confidence in treatment plans increased after using 3-D printing (P < .001). Estimated procedure time savings for 155 cases was 40.5 ± 26.1 min. CONCLUSIONS Three-dimensional printing is performed at health care facilities for many clinical indications. The registry provides insight into the technologies and workflows used to create anatomic models and guides, and the data show clinical benefits from 3-D printing.
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Affiliation(s)
- Kenneth C Wang
- Imaging Service, Baltimore VA Medical Center, Baltimore, Maryland; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland; and Co-chair, 3D Printing Registry Committee, American College of Radiology.
| | - Justin R Ryan
- 3D Innovations Lab, Rady Children's Hospital, San Diego, California; and Department of Neurological Surgery, University of California San Diego Health, San Diego, California
| | - Leonid Chepelev
- Joint Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Wake
- Director, Department of Research and Scientific Affairs, GE Healthcare, New York, New York; and Department of Radiology, NYU Grossman School of Medicine, New York, New York. https://twitter.com/Wake_Imaging
| | - Edward P Quigley
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah
| | - Lumarie Santiago
- Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas. https://twitter.com/LumarieSantiago
| | - Adam Wentworth
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Amy Alexander
- Division of Engineering, Mayo Clinic, Rochester, Minnesota. https://twitter.com/AmyAlexanderMC
| | - Jonathan M Morris
- Department of Radiology, Mayo Clinic, Rochester, Minnesota; Leadership roles: Executive Medical Director, Immersive and Experiential Learning, Mayo Clinic; Medical Director, Anatomic Modeling Unit, Mayo Clinic; and Medical Director, Biomedical and Scientific Visualization, Mayo Clinic
| | - Dominik Fleischmann
- Department of Radiology, Stanford University School of Medicine, Palo Alto, California; Director, Computed Tomography, Stanford University; Chief, Cardiovascular Imaging, Stanford University; and Medical Director, 3DQ Lab, Stanford University
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri. https://twitter.com/DavidBallardMD
| | - Prashanth Ravi
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jeffrey D Hirsch
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Gregory M Sturgeon
- Duke Children's Pediatric and Congenital Heart Center, Durham, North Carolina
| | - Yu-Hui Huang
- Department of Radiology, University of Minnesota, Minneapolis, Minnesota. https://twitter.com/yuhuihuang
| | - Summer J Decker
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Radiology, University of South Florida, Morsani College of Medicine, Tampa, Florida; and Director, Center for Advanced Visualization Technologies in Medicine, University of Southern California
| | - Natalia von Windheim
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio; and KLS Martin, Jacksonville, Florida
| | - Robert S Pugliese
- Health Design Lab, Thomas Jefferson University, Philadelphia, Pennsylvania. https://twitter.com/RSPugliese
| | - Ronald V Hidalgo
- Imagineering Lab, Southern Illinois University School of Medicine, Springfield, Illinois; and Department of Radiology, Springfield Clinic, Springfield, Illinois
| | | | - Joseb Colon
- Atrium Health Levine Children's HEARTest Yard Congenital Heart Center, Charlotte, North Carolina
| | - Florian M Thieringer
- Chair, Department of Oral and Cranio-Maxillofacial Surgery, and 3D Print Lab, University Hospital Basel, Basel, Switzerland; and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Frank J Rybicki
- Chair, Department of Radiology, University of Arizona College of Medicine, Phoenix, Arizona; Department of Radiology, Banner University Medical Group, Phoenix, Arizona; and Co-chair, 3D Printing Registry Committee, American College of Radiology. https://twitter.com/FrankRybicki
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Grigoroiu M, Paul JF, Brian E, Aegerter P, Boddaert G, Mariolo A, Jorrot P, Bellahoues M, Seguin-Givelet A, Perduca V. 3D printing in anatomical lung segmentectomies: A randomized pilot trial. Heliyon 2024; 10:e31842. [PMID: 38867971 PMCID: PMC11168317 DOI: 10.1016/j.heliyon.2024.e31842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 05/04/2024] [Accepted: 05/22/2024] [Indexed: 06/14/2024] Open
Abstract
Objective This pilot study evaluated the impact of using a 3D printed model of the patient's bronchovascular lung anatomy on the mental workload and fatigue of surgeons during full thoracoscopic segmentectomy. Design We performed a feasibility pilot study of a prospective randomized controlled trial with 2 parallel arms. All included patients underwent digital 3D visual reconstruction of their bronchovascular anatomy and were randomized into the following two groups: Digital arm (only a virtual 3D model was available) and Digital + Object arm (both virtual and printed 3D models were available). The primary end-point was the surgeons' mental workload measured using the National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score. Setting Between October 28, 2020 and October 05, 2021, we successively investigated all anatomic segmentectomies performed via thoracoscopy in the Thoracic Department of the Montsouris Mutualiste Institute, except for S6 segmentectomies and S4+5 left bi-segmentectomies. Participants We assessed 102 patients for anatomical segmentectomy. Among the, 40 were randomly assigned, and 34 were deemed analysable, with 17 patients included in each arm. Results Comparison of the two groups, each comprising 17 patients, revealed no statistically significant difference in primary or secondary end-points. The consultation of the visual digital model was significantly less frequent when a 3D printed model was available (6 versus 54 consultations, p = 0.001). Notably, both arms exhibited high NASA-TLX scores, particularly in terms of mental demand, temporal demand, and effort scores. Conclusion In our pilot study, 3D printed models and digital 3D reconstructions for pre-operative planning had an equivalent effect on thoracoscopic anatomic segmentectomy for experienced surgeons. The originality of this study lies in its focus on the impact of 3D printing of bronchovascular anatomy on surgeons, rather than solely on the surgical procedure.
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Affiliation(s)
- Madalina Grigoroiu
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Jean-François Paul
- Institut Mutualiste Montsouris, Département de Radiologie, 42, Boulevard Jourdan, 75014, Paris, France
| | - Emmanuel Brian
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Philippe Aegerter
- GIRCI-IDF, Cellule Méthodologie, 4, Av Richerand, 75010, Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, 12, Av Paul-Couturier 94807, Villejuif, France
| | - Guillaume Boddaert
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Alessio Mariolo
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Pierre Jorrot
- Institut Mutualiste Montsouris, Département de Rythmologie, 42, Boulevard Jourdan, 75014. Paris, France
| | - Mouloud Bellahoues
- Institut Mutualiste Montsouris, Département de Recherche Clinique, 42, Boulevard Jourdan, 75014, Paris, France
| | - Agathe Seguin-Givelet
- Institut Mutualiste Montsouris, Institut Du Thorax Curie-Montsouris, 42, Boulevard Jourdan, 75014, Paris, France
| | - Vittorio Perduca
- Université Paris Cité, CNRS, MAP5, 44, Rue des Saint Pères, 75006, Paris, France
- Université Paris Saclay, UVSQ, INSERM, CESP U1018, « Exposome, Heredity, Cancer and Health » Team, Gustave Roussy, 12, Av Paul-Couturier, 94807, Villejuif, France
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Pulumati A, Algarin YA, Kim S, Latta S, Li JN, Nouri K. 3D bioprinting: a review and potential applications for Mohs micrographic surgery. Arch Dermatol Res 2024; 316:147. [PMID: 38698273 DOI: 10.1007/s00403-024-02893-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/14/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024]
Abstract
Mohs Micrographic Surgery (MMS) is effective for treating common cutaneous malignancies, but complex repairs may often present challenges for reconstruction. This paper explores the potential of three-dimensional (3D) bioprinting in MMS, offering superior outcomes compared to traditional methods. 3D printing technologies show promise in advancing skin regeneration and refining surgical techniques in dermatologic surgery. A PubMed search was conducted using the following keywords: "Three-dimensional bioprinting" OR "3-D printing" AND "Mohs" OR "Mohs surgery" OR "Surgery." Peer-reviewed English articles discussing medical applications of 3D bioprinting were included, while non-peer-reviewed and non-English articles were excluded. Patients using 3D MMS models had lower anxiety scores (3.00 to 1.7, p < 0.0001) and higher knowledge assessment scores (5.59 or 93.25% correct responses), indicating better understanding of their procedure. Surgical residents using 3D models demonstrated improved proficiency in flap reconstructions (p = 0.002) and knowledge assessment (p = 0.001). Additionally, 3D printing offers personalized patient care through tailored surgical guides and anatomical models, reducing intraoperative time while enhancing surgical. Concurrently, efforts in tissue engineering and regenerative medicine are being explored as potential alternatives to address organ donor shortages, eliminating autografting needs. However, challenges like limited training and technological constraints persist. Integrating optical coherence tomography with 3D bioprinting may expedite grafting, but challenges remain in pre-printing grafts for complex cases. Regulatory and ethical considerations are paramount for patient safety, and further research is needed to understand long-term effects and cost-effectiveness. While promising, significant advancements are necessary for full utilization in MMS.
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Affiliation(s)
- Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, 455 NE 24th St. Apt 615, Miami, FL, 33137, USA.
| | - Yanci A Algarin
- Eastern Virginia Medical School, Norfolk, VA, USA
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, 455 NE 24th St. Apt 615, Miami, FL, 33137, USA
| | - Sarah Kim
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Steven Latta
- Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA
| | - Jeffrey N Li
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, 455 NE 24th St. Apt 615, Miami, FL, 33137, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, 455 NE 24th St. Apt 615, Miami, FL, 33137, USA
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Reisman Y, van Renterghem K, Meijer B, Ricapito A, Fode M, Bettocchi C. Development and validation of 3-dimensional simulators for penile prosthesis surgery. J Sex Med 2024; 21:494-499. [PMID: 38477106 DOI: 10.1093/jsxmed/qdae020] [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: 07/20/2023] [Revised: 01/02/2024] [Accepted: 01/21/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND The acquisition of skills in penile prosthesis surgery has many limitations mainly due to the absence of simulators and models for training. Three-dimensional (3D) printed models can be utilized for surgical simulations, as they provide an opportunity to practice before entering the operating room and provide better understanding of the surgical approach. AIM This study aimed to evaluate and validate a 3D model of human male genitalia for penile prosthesis surgery. METHODS This study included 3 evaluation and validation stages. The first stage involved verification of the 3D prototype model for anatomic landmarks compared with a cadaveric pelvis. The second stage involved validation of the improved model for anatomic accuracy and teaching purposes with the Rochester evaluation score. The third stage comprised validation of the suitability of the 3D prototype model as a surgical simulator and for skill acquisition. The third stage was performed at 3 centers using a modified version of a pre-existing, validated questionnaire and correlated with the Rochester evaluation score. OUTCOME We sought to determine the suitability of 3D model for training in penile prosthesis surgery in comparison with the available cadaveric model. RESULTS The evaluation revealed a high Pearson correlation coefficient (0.86) between questions of the Rochester evaluation score and modified validated questionnaire. The 3D model scored 4.33 ± 0.57 (on a Likert scale from 1 to 5) regarding replication of the relevant human anatomy for the penile prosthesis surgery procedure. The 3D model scored 4.33 ± 0.57 (on a Likert scale from 1 to 5) regarding its ability to improve technical skills, teach and practice the procedure, and assess a surgeon's ability. Furthermore, the experts stated that compared with the cadaver, the 3D model presented greater ethical suitability, reduced costs, and easier accessibility. CLINICAL IMPLICATIONS A validated 3D model is a suitable alternative for penile prosthesis surgery training. STRENGTHS AND LIMITATIONS This is the first validated 3D hydrogel model for penile prosthesis surgery teaching and training that experts consider suitable for skill acquisition. Because specific validated guidelines and questionnaires for the validation and verifications of 3D simulators for penile surgery are not available, a modified questionnaire was used. CONCLUSION The current 3D model for penile prosthesis surgery shows promising results regarding anatomic properties and suitability to train surgeons to perform penile implant surgery. The possibility of having an ethical, easy-to-use model with lower costs and limited consequences for the environment is encouraging for further development of the models.
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Affiliation(s)
- Yacov Reisman
- Flare-Health, Amsterdam, the Netherlands
- Reuth Rehabilitation Hospital, Tel-Aviv 67062, Israel
| | | | - Boaz Meijer
- Department of Urology, Acibadem Medical Center, 1043, HP Amsterdam, the Netherlands
| | - Anna Ricapito
- Andrology and Male Genitalia Reconstructive Surgery Unit, University of Foggia, 71122, Foggia FG, Italy
| | - Mikkel Fode
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, 13DK-2730, Herlev, Denmark
| | - Carlo Bettocchi
- Andrology and Male Genitalia Reconstructive Surgery Unit, University of Foggia, 71122, Foggia FG, Italy
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Eveland R, Antloga K, Meyer A, Tuscano L. Low temperature vaporized hydrogen peroxide sterilization of 3D printed devices. 3D Print Med 2024; 10:6. [PMID: 38416324 PMCID: PMC10900786 DOI: 10.1186/s41205-024-00206-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/12/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Low temperature vaporized hydrogen peroxide sterilization (VH2O2) is used in hospitals today to sterilize reusable medical devices. VH2O2 sterilized 3D printed materials were evaluated for sterilization, biocompatibility and material compatibility. MATERIALS & METHODS Test articles were printed at Formlabs with BioMed Clear™ and BioMed Amber™, and at Stratasys with MED610™, MED615™ and MED620™. Sterilization, biocompatibility and material compatibility studies with 3D printed materials were conducted after VH2O2 sterilization in V-PRO™ Sterilizers. The overkill method was used to evaluate sterilization in a ½ cycle. Biocompatibility testing evaluated the processed materials as limited contact (< 24-hours) surface or externally communicating devices. Material compatibility after VH2O2 sterilization (material strength and dimensionality) was evaluated via ASTM methods and dimensional analysis. RESULTS 3D printed devices, within a specific design window, were sterile after VH2O2 ½ cycles. After multiple cycle exposure, the materials were not cytotoxic, not sensitizing, not an irritant, not a systemic toxin, not pyrogenic and were hemo-compatible. Material compatibility via ASTM testing and dimensionality evaluations did not indicate any significant changes to the 3D printed materials after VH2O2 sterilization. CONCLUSION Low temperature vaporized hydrogen peroxide sterilization is demonstrated as a suitable method to sterilize 3D printed devices. The results are a subset of the data used in a regulatory submission with the US FDA to support claims for sterilization of 3D printed devices with specified materials, printers, and device design 1.
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Affiliation(s)
| | | | - Ashley Meyer
- STERIS, 5960 Heisley Road, Mentor, OH, 44060, USA
| | - Lori Tuscano
- STERIS, 5960 Heisley Road, Mentor, OH, 44060, USA
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Monaco EA, Reed T, Lynn TJ, Rimini SA, Patel AA, Monaco SE, Patterson BS. Practical applications of three-dimensional printing for process improvement in the cytopathology laboratory. Cancer Cytopathol 2024; 132:75-83. [PMID: 37358185 DOI: 10.1002/cncy.22736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
With the increased availability of three-dimensional (3D) printers, innovative teaching and training materials have been created in medical fields. For pathology, the use of 3D printing has been largely limited to anatomic representations of disease processes or the development of supplies during the coronavirus disease 2019 pandemic. Herein, an institution's 3D printing laboratory and staff with expertise in additive manufacturing illustrate how this can address design issues in cytopathology specimen collection and processing. The authors' institutional 3D printing laboratory, along with students and trainees, used computer-aided design and 3D printers to iterate on design, create prototypes, and generate final usable materials using additive manufacturing. The program Microsoft Forms was used to solicit qualitative and quantitative feedback. The 3D-printed models were created to assist with cytopreparation, rapid on-site evaluation, and storage of materials in the preanalytical phase of processing. These parts provided better organization of materials for cytology specimen collection and staining, in addition to optimizing storage of specimens with multiple sized containers to optimize patient safety. The apparatus also allowed liquids to be stabilized in transport and removed faster at the time of rapid on-site evaluation. Rectangular boxes were also created to optimally organize all components of a specimen in cytopreparation to simplify and expedite the processes of accessioning and processing, which can minimize errors. These practical applications of 3D printing in the cytopathology laboratory demonstrate the utility of the design and printing process on improving aspects of the workflow in cytopathology laboratories to maximize efficiency, organization, and patient safety.
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Affiliation(s)
- Edward A Monaco
- Diagnostic Medicine Institute and 3D Printing Laboratory, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Toby Reed
- Diagnostic Medicine Institute and 3D Printing Laboratory, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Terrance J Lynn
- Diagnostic Medicine Institute and 3D Printing Laboratory, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Sarah A Rimini
- Additive Manufacturing Center of Excellence, Ricoh 3D for Healthcare, West Caldwell, New Jersey, USA
| | - Aalpen A Patel
- Diagnostic Medicine Institute and 3D Printing Laboratory, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Sara E Monaco
- Diagnostic Medicine Institute and 3D Printing Laboratory, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Brian S Patterson
- Diagnostic Medicine Institute and 3D Printing Laboratory, Geisinger Medical Center, Danville, Pennsylvania, USA
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Lucas SL, Gallagher BP, Mullinix KP, Brumback RJ, Cunningham BW. 3D-Printed Model in Preoperative Planning of Sciatic Nerve Decompression Because of Heterotopic Ossification: A Case Report. JBJS Case Connect 2024; 14:01709767-202403000-00033. [PMID: 38394316 DOI: 10.2106/jbjs.cc.23.00483] [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: 02/25/2024]
Abstract
CASE A 31-year-old patient presented with an encapsulated sciatic nerve secondary to extensive hip heterotopic ossification (HO), which prevented visualization of a safe osteotomy site to avoid nerve damage. The 3D-printed model demonstrated an easily identifiable osseous reference point along the inferior aspect of the heterotopic mass, allowing for a vertical osteotomy to be safely performed. CONCLUSION HO is associated with loss of normal anatomic topography. The current case report illustrates the use of a 3D-printed model to identify pertinent anatomic landmarks required for safe decompression of an encapsulated sciatic nerve within the anatomic region of the hip.
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Affiliation(s)
- Sarah L Lucas
- Georgetown University School of Medicine, Washington, District of Columbia
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, MedStar Union Memorial Hospital, Baltimore, Maryland
| | - Brian P Gallagher
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, MedStar Union Memorial Hospital, Baltimore, Maryland
| | - Kenneth P Mullinix
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, MedStar Union Memorial Hospital, Baltimore, Maryland
| | - Robert J Brumback
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, MedStar Union Memorial Hospital, Baltimore, Maryland
| | - Bryan W Cunningham
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, MedStar Union Memorial Hospital, Baltimore, Maryland
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Stieger-Vanegas SM, Scollan KF. Development of three-dimensional (3D) cardiac models from computed tomography angiography. J Vet Cardiol 2023; 51:195-206. [PMID: 38198977 DOI: 10.1016/j.jvc.2023.11.017] [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: 01/15/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 01/12/2024]
Abstract
Three-dimensional (3D) modeling and printing is an emerging technology in veterinary cardiovascular medicine allowing the fabrication of anatomically correct patient-specific models. These patient-specific models can be used for a wide range of purposes including medical teaching, assessment of cardiac function and movement of valve leaflets, design and assessment of devices created for interventional procedures, and pre-surgical planning [1-3]. Additionally, these 3D models can facilitate communication between the clinical team and the patient's owner. The process of creating 3D models starts with acquiring volumetric imaging data sets of the area of interest. Three-dimensional modeling and printing are reliable when high-quality volumetric imaging data are used to create these models. Currently, only ungated- and electrocardiogram (ECG)-gated computed tomography (CT), cardiac magnetic resonance imaging (CMRI), and 3D echocardiography provide the volumetric data sets needed to create these 3D models. These imaging data sets are imported into a software or open-source freeware platform and then segmented to create a virtual 3D model. This virtual 3D model can be further refined using computer-aided design (CAD) software and then be printed to create a physical 3D model. Cardiovascular 3D modeling and printing is a new medical tool which allows us to expand the way we plan interventional procedures, practice interventional skills, communicate with the medical team and owner, and teach future veterinarians.
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Affiliation(s)
- S M Stieger-Vanegas
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA.
| | - K F Scollan
- Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331, USA
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12
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Senderovich N, Shah S, Ow TJ, Rand S, Nosanchuk J, Wake N. Assessment of Staphylococcus Aureus growth on biocompatible 3D printed materials. 3D Print Med 2023; 9:30. [PMID: 37914942 PMCID: PMC10621153 DOI: 10.1186/s41205-023-00195-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
The customizability of 3D printing allows for the manufacturing of personalized medical devices such as laryngectomy tubes, but it is vital to establish the biocompatibility of printing materials to ensure that they are safe and durable. The goal of this study was to assess the presence of S. aureus biofilms on a variety of 3D printed materials (two surgical guide resins, a photopolymer, an elastomer, and a thermoplastic elastomer filament) as compared to standard, commercially available laryngectomy tubes.C-shaped discs (15 mm in height, 20 mm in diameter, and 3 mm in thickness) were printed with five different biocompatible 3D printing materials and S. aureus growth was compared to Shiley™ laryngectomy tubes made from polyvinyl chloride. Discs of each material were inoculated with S. aureus cultures and incubated overnight. All materials were then removed from solution, washed in phosphate-buffered saline to remove planktonic bacteria, and sonicated to detach biofilms. Some solution from each disc was plated and colony-forming units were manually counted the following day. The resulting data was analyzed using a Kruskal-Wallis and Wilcoxon Rank Sum test to determine pairwise significance between the laryngectomy tube material and the 3D printed materials.The Shiley™ tube grew a median of 320 colonies (IQR 140-520), one surgical guide resin grew a median of 640 colonies (IQR 356-920), the photopolymer grew a median of 340 colonies (IQR 95.5-739), the other surgical guide resin grew a median of 431 colonies (IQR 266.5-735), the thermoplastic elastomer filament grew a median of 188 colonies (IQR 113.5-335), and the elastomer grew a median of 478 colonies (IQR 271-630). Using the Wilcoxon Rank Sum test, manual quantification showed a significant difference between biofilm formation only between the Shiley™ tube and a surgical guide resin (p = 0.018).This preliminary study demonstrates that bacterial colonization was comparable among most 3D printed materials as compared to the conventionally manufactured device. Continuation of this work with increased replicates will be necessary to determine which 3D printing materials optimally resist biofilm formation.
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Affiliation(s)
- Nicole Senderovich
- Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, USA.
| | - Sharan Shah
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Thomas J Ow
- Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Pathology, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stephanie Rand
- Department of Physical Medicine & Rehabilitation, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joshua Nosanchuk
- Department of Infectious Disease, Montefiore Health System, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicole Wake
- Department of Research and Scientific Affairs, GE HealthCare, New York, NY, 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
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13
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Graffeo CS, Bhandarkar AR, Carlstrom LP, Perry A, Nguyen B, Daniels DJ, Link MJ, Morris JM. That which is unseen: 3D printing for pediatric cerebrovascular education. Childs Nerv Syst 2023; 39:2449-2457. [PMID: 37272936 DOI: 10.1007/s00381-023-05987-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/06/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Pediatric cerebrovascular lesions are very rare and include aneurysms, arteriovenous malformations (AVM), and vein of Galen malformations (VOGM). OBJECTIVE To describe and disseminate a validated, reproducible set of 3D models for optimization of neurosurgical training with respect to pediatric cerebrovascular diseases METHODS: All pediatric cerebrovascular lesions treated at our institution with adequate imaging studies during the study period 2015-2020 were reviewed by the study team. Three major diagnostic groups were identified: aneurysm, AVM, and VOGM. For each group, a case deemed highly illustrative of the core diagnostic and therapeutic principles was selected by the lead and senior investigators for printing (CSG/JM). Files for model reproduction and free distribution were prepared for inclusion as Supplemental Materials. RESULTS Representative cases included a 7-month-old female with a giant left MCA aneurysm; a 3-day-old male with a large, complex, high-flow, choroidal-type VOGM, supplied from bilateral thalamic, choroidal, and pericallosal perforators, with drainage into a large prosencephalic vein; and a 7-year-old male with a left frontal AVM with one feeding arterial vessel from the anterior cerebral artery and one single draining vein into the superior sagittal sinus CONCLUSION: Pediatric cerebrovascular lesions are representative of rare but important neurosurgical diseases that require creative approaches for training optimization. As these lesions are quite rare, 3D-printed models and open source educational materials may provide a meaningful avenue for impactful clinical teaching with respect to a wide swath of uncommon or unusual neurosurgical diseases.
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Affiliation(s)
- Christopher S Graffeo
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Neurologic Surgery, OU Health University of Oklahoma Medical Center, Oklahoma City, OK, USA
| | | | | | - Avital Perry
- Department of Neurosurgery, Sheba Hospital, Tel Aviv, Israel
| | - Bachtri Nguyen
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - David J Daniels
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Michael J Link
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA
| | - Jonathan M Morris
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
- Department of Neurosurgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
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Patel P, Dhal K, Gupta R, Tappa K, Rybicki FJ, Ravi P. Medical 3D Printing Using Desktop Inverted Vat Photopolymerization: Background, Clinical Applications, and Challenges. Bioengineering (Basel) 2023; 10:782. [PMID: 37508810 PMCID: PMC10376892 DOI: 10.3390/bioengineering10070782] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Medical 3D printing is a complex, highly interdisciplinary, and revolutionary technology that is positively transforming the care of patients. The technology is being increasingly adopted at the Point of Care (PoC) as a consequence of the strong value offered to medical practitioners. One of the key technologies within the medical 3D printing portfolio enabling this transition is desktop inverted Vat Photopolymerization (VP) owing to its accessibility, high quality, and versatility of materials. Several reports in the peer-reviewed literature have detailed the medical impact of 3D printing technologies as a whole. This review focuses on the multitude of clinical applications of desktop inverted VP 3D printing which have grown substantially in the last decade. The principles, advantages, and challenges of this technology are reviewed from a medical standpoint. This review serves as a primer for the continually growing exciting applications of desktop-inverted VP 3D printing in healthcare.
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Affiliation(s)
- Parimal Patel
- Department of Mechanical & Aerospace Engineering, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Kashish Dhal
- Department of Mechanical & Aerospace Engineering, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Rajul Gupta
- Department of Orthopedic Surgery, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Karthik Tappa
- Department of Breast Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Prashanth Ravi
- Department of Radiology, University of Cincinnati, Cincinnati, OH 45219, USA
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15
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Marturello DM, James JC, Perry KL, Déjardin LM. Accuracy of anatomic 3-dimensionally printed canine humeral models. Vet Surg 2023; 52:116-126. [PMID: 36134757 DOI: 10.1111/vsu.13899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/19/2022] [Accepted: 09/05/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the accuracy of various three-dimensional print (3DP) technologies using morphometric measurements. STUDY DESIGN Experimental. SAMPLE POPULATION Cadaveric canine humeri and size-matched 3DP models. METHODS Fiduciary radiopaque markers were affixed to canine humeri of three different sizes (4, 13, 29 kg) at predetermined anatomical landmarks. 3DP models were created using one of three printers; desktop printers Form 3L and Ultimaker 5S, and industrial printer Objet Connex (n = 5/group/printer). Marker based morphometric dimensions between cadavers and 3DP models were statistically compared using 2-factor repeated measures ANOVA followed by Tukey's post-hoc test (p < .05). RESULTS Bone size and printer type both significantly affected 3DP accuracy, with size having the larger effect (p < .0001 and p < .02, respectively). Regardless of printing technology, model size was smaller than native bone in most cases. At the humeral condylar level, the best accuracy was seen in the medium-sized humerus with the Ultimaker printer ([0.09 mm], p < .03). Accuracy was reduced in the proximal humerus in all groups. CONCLUSION Desktop printers were overall more accurate than the industrial printer. Although significant differences were identified between models of different sizes, the submillimetric magnitude of these differences is unlikely to be clinically relevant. CLINICAL SIGNIFICANCE While preoperative planning using 3DP models is becoming mainstream, accurate representation of the actual bone is critical. This study demonstrates that common desktop printers are suitable for this purpose.
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Affiliation(s)
- Danielle M Marturello
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Jordan C James
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Karen L Perry
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Loïc M Déjardin
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
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16
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Fidvi S, Holder J, Li H, Parnes GJ, Shamir SB, Wake N. Advanced 3D Visualization and 3D Printing in Radiology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1406:103-138. [PMID: 37016113 DOI: 10.1007/978-3-031-26462-7_6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Since the discovery of X-rays in 1895, medical imaging systems have played a crucial role in medicine by permitting the visualization of internal structures and understanding the function of organ systems. Traditional imaging modalities including Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasound (US) present fixed two-dimensional (2D) images which are difficult to conceptualize complex anatomy. Advanced volumetric medical imaging allows for three-dimensional (3D) image post-processing and image segmentation to be performed, enabling the creation of 3D volume renderings and enhanced visualization of pertinent anatomic structures in 3D. Furthermore, 3D imaging is used to generate 3D printed models and extended reality (augmented reality and virtual reality) models. A 3D image translates medical imaging information into a visual story rendering complex data and abstract ideas into an easily understood and tangible concept. Clinicians use 3D models to comprehend complex anatomical structures and to plan and guide surgical interventions more precisely. This chapter will review the volumetric radiological techniques that are commonly utilized for advanced 3D visualization. It will also provide examples of 3D printing and extended reality technology applications in radiology and describe the positive impact of advanced radiological image visualization on patient care.
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Affiliation(s)
- Shabnam Fidvi
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.
| | - Justin Holder
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
| | - Hong Li
- Department of Radiology, Jacobi Medical Center, Bronx, NY, USA
| | | | | | - Nicole Wake
- GE Healthcare, Aurora, OH, USA
- Center for Advanced Imaging Innovation and Research, NYU Langone Health, New York, NY, USA
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17
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AlRawi A, Basha T, Elmeligy AO, Mousa NA, Mohammed G. The Role of Three-dimensional Printed Models in Women's Health. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231199040. [PMID: 37688305 PMCID: PMC10493061 DOI: 10.1177/17455057231199040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/26/2023] [Accepted: 08/11/2023] [Indexed: 09/10/2023]
Abstract
Three-dimensional printing is an innovative technology that has gained prominence in recent years due to its attractive features such as affordability, efficiency, and quick production. The technology is used to produce a three-dimensional model by depositing materials in layers using specific printers. In the medical field, it has been increasingly used in various specialties, including neurosurgery, cardiology, and orthopedics, most commonly for the pre-planning of complex surgeries. In addition, it has been applied in therapeutic treatments, patient education, and training wof medical professionals. In the field of obstetrics and gynecology, there is a limited number of studies in which three-dimensional printed models were applied. In this review, we aim to provide an overview of three-dimensional printing applications in the medical field, highlighting the few reported applications in obstetrics and gynecology. We also review all relevant studies and discuss the current challenges and limitations of adopting the technology in routine clinical practice. The technology has the potential to expand for wider applications related to women's health, including patient counseling, surgical training, and medical education.
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Affiliation(s)
- Afnan AlRawi
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Tasneem Basha
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ahmed O Elmeligy
- Department of Electrical and Computer Engineering, Faculty of Engineering, McGill University, Montreal, QC, Canada
| | - Noha A Mousa
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ghada Mohammed
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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18
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Capelli C, Bertolini M, Schievano S. 3D-printed and computational models: a combined approach for patient-specific studies. 3D Print Med 2023. [DOI: 10.1016/b978-0-323-89831-7.00011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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19
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Ostaș D, Almășan O, Ileșan RR, Andrei V, Thieringer FM, Hedeșiu M, Rotar H. Point-of-Care Virtual Surgical Planning and 3D Printing in Oral and Cranio-Maxillofacial Surgery: A Narrative Review. J Clin Med 2022; 11:jcm11226625. [PMID: 36431101 PMCID: PMC9692897 DOI: 10.3390/jcm11226625] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/04/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
This paper provides an overview on the use of virtual surgical planning (VSP) and point-of-care 3D printing (POC 3DP) in oral and cranio-maxillofacial (CMF) surgery based on a literature review. The authors searched PubMed, Web of Science, and Embase to find papers published between January 2015 and February 2022 in English, which describe human applications of POC 3DP in CMF surgery, resulting in 63 articles being included. The main review findings were as follows: most used clinical applications were anatomical models and cutting guides; production took place in-house or as "in-house-outsourced" workflows; the surgeon alone was involved in POC 3DP in 36 papers; the use of free versus paid planning software was balanced (50.72% vs. 49.27%); average planning time was 4.44 h; overall operating time decreased and outcomes were favorable, though evidence-based studies were limited; and finally, the heterogenous cost reports made a comprehensive financial analysis difficult. Overall, the development of in-house 3D printed devices supports CMF surgery, and encouraging results indicate that the technology has matured considerably.
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Affiliation(s)
- Daniel Ostaș
- Department of Oral and Cranio-Maxillofacial Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
| | - Oana Almășan
- Department of Prosthetic Dentistry and Dental Materials, “Iuliu Hațieganu” University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania
| | - Robert R. Ileșan
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 21 Spitalstrasse, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 16 Gewerbestrasse, 4123 Allschwil, Switzerland
- Correspondence:
| | - Vlad Andrei
- Department of Oral Rehabilitation, Faculty of Dentistry, “Iuliu Hațieganu” University of Medicine and Pharmacy, 15 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Florian M. Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 21 Spitalstrasse, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 16 Gewerbestrasse, 4123 Allschwil, Switzerland
| | - Mihaela Hedeșiu
- Department of Maxillofacial Surgery and Implantology, “Iuliu Hațieganu” University of Medicine and Pharmacy, 37 Cardinal Iuliu Hossu, 400029 Cluj-Napoca, Romania
| | - Horațiu Rotar
- Department of Oral and Cranio-Maxillofacial Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
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20
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Implementation of an In-House 3D Manufacturing Unit in a Public Hospital’s Radiology Department. Healthcare (Basel) 2022; 10:healthcare10091791. [PMID: 36141403 PMCID: PMC9498605 DOI: 10.3390/healthcare10091791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/30/2022] [Accepted: 09/14/2022] [Indexed: 11/23/2022] Open
Abstract
Objective: Three-dimensional printing has become a leading manufacturing technique in healthcare in recent years. Doubts in published studies regarding the methodological rigor and cost-effectiveness and stricter regulations have stopped the transfer of this technology in many healthcare organizations. The aim of this study was the evaluation and implementation of a 3D printing technology service in a radiology department. Methods: This work describes a methodology to implement a 3D printing service in a radiology department of a Spanish public hospital, considering leadership, training, workflow, clinical integration, quality processes and usability. Results: The results correspond to a 6-year period, during which we performed up to 352 cases, requested by 85 different clinicians. The training, quality control and processes required for the scaled implementation of an in-house 3D printing service are also reported. Conclusions: Despite the maturity of the technology and its impact on the clinic, it is necessary to establish new workflows to correctly implement them into the strategy of the health organization, adjusting it to the needs of clinicians and to their specific resources. Significance: This work allows hospitals to bridge the gap between research and 3D printing, setting up its transfer to clinical practice and using implementation methodology for decision support.
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21
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Graffeo CS, Perry A, Carlstrom LP, Peris-Celda M, Alexander A, Dickens HJ, Holroyd MJ, Driscoll CLW, Link MJ, Morris J. 3D Printing for Complex Cranial Surgery Education: Technical Overview and Preliminary Validation Study. Skull Base Surg 2022; 83:e105-e112. [DOI: 10.1055/s-0040-1722719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
Abstract
Background 3D printing—also known as additive manufacturing—has a wide range of applications. Reproduction of low-cost, high-fidelity, disease- or patient-specific models presents a key developmental area in simulation and education research for complex cranial surgery.
Methods Using cadaveric dissections as source materials, skull base models were created, printed, and tested for educational value in teaching complex cranial approaches. In this pilot study, assessments were made on the value of 3D printed models demonstrating the retrosigmoid and posterior petrosectomy approaches. Models were assessed and tested in a small cohort of neurosurgery resident subjects (n = 3) using a series of 10 radiographic and 2 printed case examples, with efficacy determined via agreement survey and approach selection accuracy.
Results All subjects indicated agreement or strong agreement for all study endpoints that 3D printed models provided significant improvements in understanding of neuroanatomic relationships and principles of approach selection, as compared to 2D dissections or patient cross-sectional imaging alone. Models were not superior to in-person hands-on teaching. Mean approach selection accuracy was 90% (±13%) for 10 imaging-based cases, or 92% (±7%) overall. Trainees strongly agreed that approach decision-making was enhanced by adjunctive use of 3D models for both radiographic and printed cases.
Conclusion 3D printed models incorporating skull base approaches and/or pathologies provide a compelling addition to the complex cranial education armamentarium. Based on our preliminary analysis, 3D printed models offer substantial potential for pedagogical value as dissection guides, adjuncts to preoperative study and case preparation, or tools for approach selection training and evaluation.
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Affiliation(s)
| | - Avital Perry
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Lucas P Carlstrom
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Maria Peris-Celda
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
- Department of Neurosurgery, Albany Medical Center, Albany, New York, United States
| | - Amy Alexander
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, United States
| | - Hunter J Dickens
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael J Holroyd
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Colin L W Driscoll
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael J Link
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Jonathan Morris
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, United States
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22
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An overview of 3D printing and the orthopaedic application of patient-specific models in malunion surgery. Injury 2022; 53:977-983. [PMID: 34838259 DOI: 10.1016/j.injury.2021.11.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/12/2021] [Accepted: 11/09/2021] [Indexed: 02/02/2023]
Abstract
As the emerging technology of three-dimensional (3D) printing impacts several facets of medicine, innovative techniques and applications are increasingly being incorporated into clinical workflows. Specifically, 3D printing technology has allowed for the individualization of patient care through the creation of printed surgical guides, patient-specific anatomical models, and simulation practice models. In this paper, we review the broad applications of 3D printing in orthopaedic surgery. The purpose of this paper is to help orthopaedic trauma surgeons understand 3D printing's emerging influence on the delivery of care as well as how to directly apply this technology to their practice. We aim to illustrate these principles through a specific example of a patient who presented for malunion surgery. A 3D printed model of a very complex traumatic scapula malunion was used to not only pre-surgically plan the reconstruction, but to also facilitate provider and patient education. This paper highlights the benefits of 3D printing and how trauma surgeons are uniquely positioned to apply this technology to improve patient care.
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23
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Bastawrous S, Wu L, Liacouras PC, Levin DB, Ahmed MT, Strzelecki B, Amendola MF, Lee JT, Coburn J, Ripley B. Establishing 3D Printing at the Point of Care: Basic Principles and Tools for Success. Radiographics 2022; 42:451-468. [PMID: 35119967 DOI: 10.1148/rg.210113] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
As the medical applications of three-dimensional (3D) printing increase, so does the number of health care organizations in which adoption or expansion of 3D printing facilities is under consideration. With recent advancements in 3D printing technology, medical practitioners have embraced this powerful tool to help them to deliver high-quality patient care, with a focus on sustainability. The use of 3D printing in the hospital or clinic at the point of care (POC) has profound potential, but its adoption is not without unanticipated challenges and considerations. The authors provide the basic principles and considerations for building the infrastructure to support 3D printing inside the hospital. This process includes building a business case; determining the requirements for facilities, space, and staff; designing a digital workflow; and considering how electronic health records may have a role in the future. The authors also discuss the supported applications and benefits of medical 3D printing and briefly highlight quality and regulatory considerations. The information presented is meant to be a practical guide to assist radiology departments in exploring the possibilities of POC 3D printing and expanding it from a niche application to a fixture of clinical care. An invited commentary by Ballard is available online. ©RSNA, 2022.
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Affiliation(s)
- Sarah Bastawrous
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Lei Wu
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Peter C Liacouras
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Dmitry B Levin
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Mohamed Tarek Ahmed
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Brian Strzelecki
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Michael F Amendola
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - James T Lee
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - James Coburn
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Beth Ripley
- Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, Seattle, Wash; Departments of Radiology (S.B., L.W., B.R.) and Research and Development (B.S.), VA Puget Sound Health Care System, Mailbox S-114, Radiology, 1660 S Columbian Way, Seattle, WA 98108-1597; 3D Medical Applications Center, Walter Reed National Military Medical Center, Bethesda, Md (P.C.L.); Department of Radiology, University of Kentucky College of Medicine, Lexington, Ky (M.T.A., J.T.L.); Department of Surgery, Division of Vascular Surgery, Surgical Services (112), Virginia Commonwealth University School of Medicine, Richmond, Va (M.F.A.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
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24
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Krauel L, Valls-Esteve A, Tejo-Otero A, Fenollosa-Artés F. 3D-Printing in surgery: Beyond bone structures. A review. ANNALS OF 3D PRINTED MEDICINE 2021. [DOI: 10.1016/j.stlm.2021.100039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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25
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Prabhu SP. 3D Modeling and Advanced Visualization of the Pediatric Brain, Neck, and Spine. Magn Reson Imaging Clin N Am 2021; 29:655-666. [PMID: 34717852 DOI: 10.1016/j.mric.2021.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The ready availability of advanced visualization tools on picture archiving and communication systems workstations or even standard laptops through server-based or cloud-based solutions has enabled greater adoption of these techniques. We describe how radiologists can tailor imaging techniques for optimal 3D reconstructions provide a brief overview of the standard and newer "on-screen" techniques. We describe the process of creating 3D printed models for surgical simulation and education, with examples from the authors' institution and the existing literature. Finally, the review highlights current uses and potential future use cases for virtual reality and augmented reality applications in a pediatric neuroimaging setting.
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Affiliation(s)
- Sanjay P Prabhu
- Neuroradiology Division, Department of Radiology, Boston Children's Hospital, Harvard Medical School, SIMPeds3D Print, 300 Longwood Avenue, Boston, MA 02115, USA.
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26
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Silvestro E, Betts KN, Francavilla ML, Andronikou S, Sze RW. Imaging Properties of Additive Manufactured (3D Printed) Materials for Potential Use for Phantom Models. J Digit Imaging 2021; 33:456-464. [PMID: 31520278 DOI: 10.1007/s10278-019-00257-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Over the last few decades, there has been growing interest in the application of additive manufacturing (AM) or 3D printing for medical research and clinical application. Imaging phantoms offer clear benefits in the way of training, planning, and quality assurance, but the model's availability per catalog tend to be suited for general testing purposes only. AM, on the contrary, offers flexibility to clinicians by enabling custom-built phantoms based on specific interests or even individual patient needs. This study aims to quantify the radiographic properties (ultrasound, magnetic resonance imaging, and computed tomography) of common additive manufacturing technologies and to discuss potential opportunities to fabricate imaging phantoms. Test phantoms were composed of samples from the three most common AM styles, namely PolyJet, fused deposition modeling (FDM), and stereolithography (SLA). Test imaging of the phantoms was performed on ultrasound, MRI, and CT and reviewed and evaluated with radiology software. The ultrasound images showed clearly defined upper and lower edges of the material but did not demonstrate distinct differences in internal echogenicity between materials. The MR scans revealed a distinct signal intensity difference between the model (17 grayscale value) and the printer support (778 grayscale value). Finally, the CT images showed a slight variation between the plastic (82 HU) and rubber (145 HU) materials. The radiographic properties of AM offer a clear opportunity to create basic two- or three-material phantoms. These would be high-accuracy and cost-effective models. Although the materials currently available are not suitable for complex multi-material applications as realistic as true human anatomy, one can easily foresee the development of new materials with broader density in the near future.
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Affiliation(s)
- Elizabeth Silvestro
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Khalil N Betts
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael L Francavilla
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Savvas Andronikou
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Raymond W Sze
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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27
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3D Printing for Medical Applications: Current State of the Art and Perspectives during the COVID-19 Crisis. SURGERIES 2021. [DOI: 10.3390/surgeries2030025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The coronavirus SARS-CoV-2 pandemic has affected over one hundred million people worldwide and has resulted in over two million deaths. In addition to the toll that coronavirus takes on the health of humans infected with the virus and the potential long term effects of infection, the repercussions of the pandemic on the economy as well as on the healthcare system have been enormous. The global supply of equipment necessary for dealing with the pandemic experienced extreme stress as healthcare systems around the world attempted to acquire personal protective equipment for their workers and medical devices for treating COVID-19. This review describes how 3D printing is currently being used in life saving surgeries such as heart and lung surgery and how 3D printing can address some of the worldwide shortage of personal protective equipment, by examining recent trends of the use of 3D printing and how these technologies can be applied during and after the pandemic. We review the use of 3D printed models for treating the long term effects of COVID-19. We then focus on methods for generating face shields and different types of respirators. We conclude with areas for future investigation and application of 3D printing technology.
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28
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Bastawrous S, Wu L, Strzelecki B, Levin DB, Li JS, Coburn J, Ripley B. Establishing Quality and Safety in Hospital-based 3D Printing Programs: Patient-first Approach. Radiographics 2021; 41:1208-1229. [PMID: 34197247 DOI: 10.1148/rg.2021200175] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The adoption of three-dimensional (3D) printing is rapidly spreading across hospitals, and the complexity of 3D-printed models and devices is growing. While exciting, the rapid growth and increasing complexity also put patients at increased risk for potential errors and decreased quality of the final product. More than ever, a strong quality management system (QMS) must be in place to identify potential errors, mitigate those errors, and continually enhance the quality of the product that is delivered to patients. The continuous repetition of the traditional processes of care, without insight into the positive or negative impact, is ultimately detrimental to the delivery of patient care. Repetitive tasks within a process can be measured, refined, and improved and translate into high levels of quality, and the same is true within the 3D printing process. The authors share their own experiences and growing pains in building a QMS into their 3D printing processes. They highlight errors encountered along the way, how they were addressed, and how they have strived to improve consistency, facilitate communication, and replicate successes. They also describe the vital intersection of health care providers, regulatory groups, and traditional manufacturers, who contribute essential elements to a common goal of providing quality and safety to patients. ©RSNA, 2021.
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Affiliation(s)
- Sarah Bastawrous
- From the Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, 1959 NE Pacific St, Seattle WA 98195; Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (S.B., L.W., B.R.); Department of Mechanical Engineering, University of Washington, Seattle, Wash (J.S.L.); Research and Development, Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Wash (B.S., J.S.L.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Lei Wu
- From the Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, 1959 NE Pacific St, Seattle WA 98195; Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (S.B., L.W., B.R.); Department of Mechanical Engineering, University of Washington, Seattle, Wash (J.S.L.); Research and Development, Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Wash (B.S., J.S.L.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Brian Strzelecki
- From the Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, 1959 NE Pacific St, Seattle WA 98195; Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (S.B., L.W., B.R.); Department of Mechanical Engineering, University of Washington, Seattle, Wash (J.S.L.); Research and Development, Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Wash (B.S., J.S.L.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Dmitry B Levin
- From the Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, 1959 NE Pacific St, Seattle WA 98195; Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (S.B., L.W., B.R.); Department of Mechanical Engineering, University of Washington, Seattle, Wash (J.S.L.); Research and Development, Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Wash (B.S., J.S.L.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Jing-Sheng Li
- From the Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, 1959 NE Pacific St, Seattle WA 98195; Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (S.B., L.W., B.R.); Department of Mechanical Engineering, University of Washington, Seattle, Wash (J.S.L.); Research and Development, Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Wash (B.S., J.S.L.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - James Coburn
- From the Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, 1959 NE Pacific St, Seattle WA 98195; Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (S.B., L.W., B.R.); Department of Mechanical Engineering, University of Washington, Seattle, Wash (J.S.L.); Research and Development, Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Wash (B.S., J.S.L.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
| | - Beth Ripley
- From the Department of Radiology (S.B., L.W., B.R.) and Department of Medicine, Division of Cardiology (D.B.L.), University of Washington School of Medicine, 1959 NE Pacific St, Seattle WA 98195; Department of Radiology, VA Puget Sound Health Care System, Seattle, Wash (S.B., L.W., B.R.); Department of Mechanical Engineering, University of Washington, Seattle, Wash (J.S.L.); Research and Development, Center for Limb Loss and MoBility (CLiMB), VA Puget Sound Health Care System, Seattle, Wash (B.S., J.S.L.); and Department of Bioengineering, University of Maryland, College Park, Md (J.C.)
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29
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Tejo-Otero A, Fenollosa-Artés F, Uceda R, Castellví-Fernández A, Lustig-Gainza P, Valls-Esteve A, Ayats-Soler M, Munuera J, Buj-Corral I, Krauel L. 3D printed prototype of a complex neuroblastoma for preoperative surgical planning. ANNALS OF 3D PRINTED MEDICINE 2021. [DOI: 10.1016/j.stlm.2021.100014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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30
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Bois MC, Morris JM, Boland JM, Larson NL, Scharrer EF, Aubry MC, Maleszewski JJ. Three-Dimensional Surface Imaging and Printing in Anatomic Pathology. J Pathol Inform 2021; 12:22. [PMID: 34267987 PMCID: PMC8274305 DOI: 10.4103/jpi.jpi_8_21] [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: 01/21/2021] [Accepted: 03/25/2021] [Indexed: 01/04/2023] Open
Abstract
Three-dimensional (3D) imaging is increasingly being incorporated into a variety of medical specialties: surgery and radiology being but two prominent examples. Image-intensive disciplines, such as anatomic pathology (AP), represent excellent potential candidates for further exploration of this innovative technology. Multiple potential use cases exist within AP, involving patient care, education, and research. These use cases broadly include direct utilization of the 3D digital assets for viewing on a 2D screen, populating 3D extended reality platforms (virtual reality, augmented reality, and mixed reality) as well as generation of 3D printed photorealistic specimen models. Herein, these use cases are explored with specific regard to our experiences and yet unrealized potential. Future directions and considerations are also discussed.
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Affiliation(s)
- Melanie C Bois
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Jennifer M Boland
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Nicole L Larson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Emily F Scharrer
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Joseph J Maleszewski
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.,Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
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31
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Guo HH, Persson M, Weinheimer O, Rosenberg J, Robinson TE, Wang J. A calibration CT mini-lung-phantom created by 3-D printing and subtractive manufacturing. J Appl Clin Med Phys 2021; 22:183-190. [PMID: 33949078 PMCID: PMC8200432 DOI: 10.1002/acm2.13263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/15/2021] [Accepted: 03/30/2021] [Indexed: 11/06/2022] Open
Abstract
We describe the creation and characterization of a calibration CT mini‐lung‐phantom incorporating simulated airways and ground‐glass densities. Ten duplicate mini‐lung‐phantoms with Three‐Dimensional (3‐D) printed tubes simulating airways and gradated density polyurethane foam blocks were designed and built. Dimensional accuracy and CT numbers were measured using micro‐CT and clinical CT scanners. Micro‐CT images of airway tubes demonstrated an average dimensional variation of 0.038 mm from nominal values. The five different densities of incorporated foam blocks, simulating ground‐glass, showed mean CT numbers (±standard deviation) of −897.0 ± 1.5, −844.1 ± 1.5, −774.1 ± 2.6, −695.3 ± 1.6, and −351.0 ± 3.7 HU, respectively. Three‐Dimensional printing and subtractive manufacturing enabled rapid, cost‐effective production of ground‐truth calibration mini‐lung‐phantoms with low inter‐sample variation that can be scanned simultaneously with the patient undergoing lung quantitative CT.
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Affiliation(s)
- H Henry Guo
- Department of Radiology, Stanford Medical Center, Stanford, CA, USA
| | - Mats Persson
- Department of Physics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Oliver Weinheimer
- Department of Radiology, University of Heidelberg, Heidelberg, Germany
| | | | - Terry E Robinson
- Emeritus, Department of Pediatrics, Stanford Medical Center, Stanford, CA, USA
| | - Jia Wang
- Environmental Health and Safety, Stanford University, Stanford, CA, USA
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32
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Guler E, Ozer MA, Bati AH, Govsa F, Erozkan K, Vatansever S, Ersin MS, Elmas NZ. Patient-centered oncosurgical planning with cancer models in subspecialty education. Surg Oncol 2021; 37:101537. [PMID: 33711767 DOI: 10.1016/j.suronc.2021.101537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 01/20/2021] [Accepted: 03/02/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND A fundamental aspect of oncosurgical planning in organ resections is the identification of feeder vessel details to preserve healthy organ tissue while fully resecting the tumors. The purpose of this study was to determine whether three-dimensional (3D) cancer case models of computed tomography (CT) images will assist resident-level trainees in making appropriate operative plans for organ resection surgery. METHODS This study was based on the perception of surgery residents who were presented with 5 different oncosurgical scenarios. A five-station carousel including cases of liver mass, stomach mass, annular pancreas, pelvic mass and mediastinal mass was formed for the study. The residents were required to compare their perception level of the cases with their CT images, and 3D models in terms of identifying the invasion of the mass, making differential diagnosis and preoperative planning stage. RESULTS All residents have given higher scores for models. 3D models provided better understanding of oncopathological anatomy and improved surgical planning. In all scenarios, 70-80% of the residents preferred the model for preoperative planning. For surgical choice, compared to the CT, the model provided a statistically significant difference in terms of visual assessment, such as tumor location, distal or proximal organotomy (p:0.009). In the evaluation of presacral mass, the perception of model was significantly better than the CT in terms of bone-foramen relationship of chondrosarcoma, its origin, geometric shape, localization, invasion, and surgical preference (p:0.004). The model statistically significantly provided help to evaluate and prepare the case together with the colleagues performing surgery (p:0.007). Commenting on the open-ended question, they stated that the tumor-vessel relationship was clearly demonstrated in the 3D model, which has been very useful. CONCLUSIONS With the help of 3D printing technology in this study, it is possible to implement and evaluate a well-structured real patient scenario setup in cancer surgery training. It can be used to improve the understanding of pathoanatomical changes of multidisciplinary oncologic cases. Namely, it is used in guiding the surgical strategy and determining whether patient-specific 3D models change pre-operative planning decisions made by surgeons in complex cancer mass surgical procedures.
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Affiliation(s)
- Ezgi Guler
- Department of Radiology, Ege University Faculty of Medicine, Turkey
| | - Mehmet Asim Ozer
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Ege University Faculty of Medicine, Turkey
| | - Ayse Hilal Bati
- Department of Medical Education, Ege University Faculty of Medicine, Turkey
| | - Figen Govsa
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Ege University Faculty of Medicine, Turkey.
| | - Kamil Erozkan
- Department of General Surgery, Ege University Faculty of Medicine, Turkey
| | - Safa Vatansever
- Department of General Surgery, Ege University Faculty of Medicine, Turkey
| | - Muhtar Sinan Ersin
- Department of General Surgery, Ege University Faculty of Medicine, Turkey
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33
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Mallow GM, Siyaji ZK, Galbusera F, Espinoza-Orías AA, Giers M, Lundberg H, Ames C, Karppinen J, Louie PK, Phillips FM, Pourzal R, Schwab J, Sciubba DM, Wang JC, Wilke HJ, Williams FMK, Mohiuddin SA, Makhni MC, Shepard NA, An HS, Samartzis D. Intelligence-Based Spine Care Model: A New Era of Research and Clinical Decision-Making. Global Spine J 2021; 11:135-145. [PMID: 33251858 PMCID: PMC7882816 DOI: 10.1177/2192568220973984] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- G. Michael Mallow
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Zakariah K. Siyaji
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | | | - Alejandro A. Espinoza-Orías
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Morgan Giers
- School of Chemical, Biological, and Environmental Engineering, Oregon State University, Corvallis, OR, USA
| | - Hannah Lundberg
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Christopher Ames
- Department of Neurosurgery, University of California San Francisco, CA, USA
| | - Jaro Karppinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | | | - Frank M. Phillips
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Robin Pourzal
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Joseph Schwab
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Daniel M. Sciubba
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | - Jeffrey C. Wang
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA
| | - Hans-Joachim Wilke
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Ulm, Germany
| | - Frances M. K. Williams
- Department of Twin Research and Genetic Epidemiology, King’s College London, London, United Kingdom
| | | | - Melvin C. Makhni
- Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Nicholas A. Shepard
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Howard S. An
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Dino Samartzis
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
- The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
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Park JY, Kwon HM, Lee WS, Yang IH, Park KK. Anthropometric Measurement About the Safe Zone for Transacetabular Screw Placement in Total Hip Arthroplasty in Asian Middle-Aged Women: In Vivo Three-Dimensional Model Analysis. J Arthroplasty 2021; 36:744-751. [PMID: 32950340 DOI: 10.1016/j.arth.2020.08.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/06/2020] [Accepted: 08/18/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Although the pelvic vascular injury caused by a transacetabular screw is rare, it is a major local complication of total hip arthroplasty. We aimed to obtain anthropometric data about the safe zone for the placement of transacetabular screws by analyzing the three-dimensional (3D) reconstruction model and determine the safe length of transacetabular screws by performing the 3D simulated surgery. METHODS We reviewed 50 hips of 25 patients who underwent lower extremity angiographic computed tomography scans retrospectively. We reconstructed the 3D models of 50 hips with normal pelvic bone and vascular status using the customized computer software. We measured the central angle and safe depth of the safe zone of the transacetabular screws on the 3D models. We also performed the 3D simulated surgery to confirm the safe length of screws in each hole of the customized cup implant. RESULTS The measured central angle of the posterior-superior area was 79.5°. And we determined a mean safe depth of 49.8 mm in the safe zone, with a central angle of 47.7°. During the 3D simulated surgery, we determined a mean safe length of the transacetabular screw of 43.3 mm when applied to a lateral hole on a line bisecting the posterior-superior area. CONCLUSION Although our study was limited by the use of a virtual computer program, the quantitative measurements obtained can help reduce the incidence of pelvic vascular injury during transacetabular screw fixation in total hip arthroplasty.
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Affiliation(s)
- Jun Young Park
- Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyuck Min Kwon
- Department of Orthopedic Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Woo-Suk Lee
- Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ick Hwan Yang
- Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kwan Kyu Park
- Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Surgical Advances in Osteosarcoma. Cancers (Basel) 2021; 13:cancers13030388. [PMID: 33494243 PMCID: PMC7864509 DOI: 10.3390/cancers13030388] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Osteosarcoma (OS) is the most common bone cancer in children. OS most commonly arises in the legs, but can arise in any bone, including the spine, head or neck. Along with chemotherapy, surgery is a mainstay of OS treatment and in the 1990s, surgeons began to shift from amputation to limb-preserving surgery. Since then, improvements in imaging, surgical techniques and implant design have led to improvements in functional outcomes without compromising on the cancer outcomes for these patients. This paper summarises these advances, along with a brief discussion of future technologies currently in development. Abstract Osteosarcoma (OS) is the most common primary bone cancer in children and, unfortunately, is associated with poor survival rates. OS most commonly arises around the knee joint, and was traditionally treated with amputation until surgeons began to favour limb-preserving surgery in the 1990s. Whilst improving functional outcomes, this was not without problems, such as implant failure and limb length discrepancies. OS can also arise in areas such as the pelvis, spine, head, and neck, which creates additional technical difficulty given the anatomical complexity of the areas. We reviewed the literature and summarised the recent advances in OS surgery. Improvements have been made in many areas; developments in pre-operative imaging technology have allowed improved planning, whilst the ongoing development of intraoperative imaging techniques, such as fluorescent dyes, offer the possibility of improved surgical margins. Technological developments, such as computer navigation, patient specific instruments, and improved implant design similarly provide the opportunity to improve patient outcomes. Going forward, there are a number of promising avenues currently being pursued, such as targeted fluorescent dyes, robotics, and augmented reality, which bring the prospect of improving these outcomes further.
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Wang KC, Jones A, Kambhampati S, Gilotra MN, Liacouras PC, Stuelke S, Shiu B, Leong N, Hasan SA, Siegel EL. CT-Based 3D Printing of the Glenoid Prior to Shoulder Arthroplasty: Bony Morphology and Model Evaluation. J Digit Imaging 2020; 32:816-826. [PMID: 30820811 DOI: 10.1007/s10278-019-00177-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
To demonstrate the 3D printed appearance of glenoid morphologies relevant to shoulder replacement surgery and to evaluate the benefits of printed models of the glenoid with regard to surgical planning. A retrospective review of patients referred for shoulder CT was performed, leading to a cohort of nine patients without arthroplasty hardware and exhibiting glenoid changes relevant to shoulder arthroplasty planning. Thin slice CT images were used to create both humerus-subtracted volume renderings of the glenoid, as well as 3D surface models of the glenoid, and 11 printed models were created. Volume renderings, surface models, and printed models were reviewed by a musculoskeletal radiologist for accuracy. Four fellowship-trained orthopaedic surgeons specializing in shoulder surgery reviewed each case individually as follows: First, the source CT images were reviewed, and a score for the clarity of the bony morphologies relevant to shoulder arthroplasty surgery was given. The volume rendering was reviewed, and the clarity was again scored. Finally, the printed model was reviewed, and the clarity again scored. Each printed model was also scored for morphologic complexity, expected usefulness of the printed model, and physical properties of the model. Mann-Whitney-Wilcoxon signed rank tests of the clarity scores were calculated, and the Spearman's ρ correlation coefficient between complexity and usefulness scores was computed. Printed models demonstrated a range of glenoid bony changes including osteophytes, glenoid bone loss, retroversion, and biconcavity. Surgeons rated the glenoid morphology as more clear after review of humerus-subtracted volume rendering, compared with review of the source CT images (p = 0.00903). Clarity was also better with 3D printed models compared to CT (p = 0.00903) and better with 3D printed models compared to humerus-subtracted volume rendering (p = 0. 00879). The expected usefulness of printed models demonstrated a positive correlation with morphologic complexity, with Spearman's ρ 0.73 (p = 0.0108). 3D printing of the glenoid based on pre-operative CT provides a physical representation of patient anatomy. Printed models enabled shoulder surgeons to appreciate glenoid bony morphology more clearly compared to review of CT images or humerus-subtracted volume renderings. These models were more useful as glenoid complexity increased.
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Affiliation(s)
- Kenneth C Wang
- Baltimore VA Medical Center, Baltimore, MD, USA. .,Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, School of Medicine, Baltimore, MD, USA.
| | - Anja Jones
- Department of Pathology and Laboratory Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | | | - Mohit N Gilotra
- Baltimore VA Medical Center, Baltimore, MD, USA.,Department of Orthopaedics, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Peter C Liacouras
- 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Radiology and Radiological Services & Naval Postgraduate Dental School, Uniform Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Brian Shiu
- Department of Orthopaedics, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Natalie Leong
- Baltimore VA Medical Center, Baltimore, MD, USA.,Department of Orthopaedics, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - S Ashfaq Hasan
- Baltimore VA Medical Center, Baltimore, MD, USA.,Department of Orthopaedics, University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Eliot L Siegel
- Baltimore VA Medical Center, Baltimore, MD, USA.,Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, School of Medicine, Baltimore, MD, USA
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Persad U, Mencia M. The value of 3D Printing in Orthopaedics. CARIBBEAN MEDICAL JOURNAL 2020. [DOI: 10.48107/cmj.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Umesh Persad
- Mechanical Engineering, Manufacturing, and Entrepreneurship Unit, The University of Trinidad and Tobago, Brechin Castle, Couva, Trinidad and Tobago, West Indies
| | - Marlon Mencia
- Department of Clinical Surgical Sciences, School of Medicine, The University of The West Indies, St. Augustine, Trinidad and Tobago, West Indies
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Pereira da Silva N, Abreu I, Serôdio M, Ferreira L, Alexandrino H, Donato P. Advanced hepatic vasculobiliary imaging segmentation and 3D reconstruction as an aid in the surgical management of high biliary stenosis. BMC Med Imaging 2020; 20:120. [PMID: 33092546 PMCID: PMC7584102 DOI: 10.1186/s12880-020-00520-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/13/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) models are increasingly used to help surgeons, guiding them through the complex hepatic vasculobiliary anatomy. The biliary tract is a relatively untapped territory with only a few case reports described in medical literature. Our aim is to present an innovative 3D reconstruction methodology for biliary imaging and surgical planning, applied to a case of iatrogenic biliary stricture, with fusion of segmented CT and MRI images. CASE PRESENTATION A selected case of Bismuth type III iatrogenic biliary stenosis for 3D planning. CT and MR studies were acquired with dedicated protocols for segmentation. Two radiologists performed segmentation and 3D model post-processing, fusing both imaging techniques to faithfully render the anatomical structures. Measurements of anatomical landmarks were taken in both the CT/MRI and the 3D model to assure its accuracy and differences in measurement were calculated. The 3D model replicates anatomical structures and pathology with high accuracy, with only 2.2% variation between STL, CT and MRI measurements. The model was discussed with the surgical team and used in the surgical planning, improving confidence in this delicate procedure, due to the detailed prior knowledge of the patient's anatomy. CONCLUSION Three-dimensional reconstructions are a rapidly growing area of research with a significant impact in the personalized and precision medicine. The construction of 3D models that combine vascular and biliary anatomy, using different imaging techniques, respectively CT and MRI, will predictably contribute to a more rigorous planning of complex liver surgeries.
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Affiliation(s)
- Nuno Pereira da Silva
- Medical Imaging Department, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal.
| | - Inês Abreu
- Medical Imaging Department, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal
| | - Marco Serôdio
- Department of Surgery, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal
| | - Luís Ferreira
- Department of Surgery, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal
| | - Henrique Alexandrino
- Department of Surgery, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal.,University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Rua Larga, 3004-504, Coimbra, Portugal.,University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, 3004-504, Coimbra, Portugal
| | - Paulo Donato
- Medical Imaging Department, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal
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Riedle H, Chaban R, Ghazy A, Piplat C, Dorweiler B, Franke J. Experimental determination of the suture behavior of aortic tissue in comparison to 3D printed silicone modelling material. J Mech Behav Biomed Mater 2020; 112:104033. [PMID: 32882678 DOI: 10.1016/j.jmbbm.2020.104033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 02/25/2020] [Accepted: 08/08/2020] [Indexed: 11/16/2022]
Abstract
The imitation of biological tissue in a synthetic physical model can benefit many medical applications, e.g. pre surgical planning or education. For a quantitative validation of the model's mechanical behavior, standardized testing on both, the biological original and the artificial material, is necessary. In four parts, this study focuses on the biomechanical analysis of the impact of sutures for aortic modelling using 3D printed silicone. Testing methods are developed and executed on biological and synthetic samples. The first part is the determination of the pullout strength of a single stitch. The second part is the investigation of the reduction of the tensile strength and elongation of tensile bars due to stitching. Third, the tensile testing of biological and artificial vessels repaired with an anastomosis gives information about the transferability to real surgical applications. A qualitative feedback study with surgical experts concludes the evaluation. The study reveals that the pullout strength is independent from the fiber or notch direction, but that repaired aortic tensile bars show a dependency on the fiber direction of the tissue. Additionally, the circular seam of the anastomosis provides a more stable connection than multiple single stitches. For the artificial models, the mechanical behavior mainly depends on the mechanical properties of the base silicone, here represented by the Shore A hardness, rather than the manufacturing process. When compared to the biological original the most similar material varies depending on the mechanical property in focus.
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Affiliation(s)
- Hannah Riedle
- Institute for Factory Automation and Production Systems, Friedrich-Alexander-University of Erlangen-Nuremberg, Egerlandstr. 7-9, 91058, Erlangen, Germany.
| | - Ryan Chaban
- Cardiothoracic & Vascular Surgery and Research Platform BiomaTiCS, University Medical Center, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Ahmed Ghazy
- Cardiothoracic & Vascular Surgery and Research Platform BiomaTiCS, University Medical Center, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Charlotte Piplat
- Institute for Factory Automation and Production Systems, Friedrich-Alexander-University of Erlangen-Nuremberg, Egerlandstr. 7-9, 91058, Erlangen, Germany
| | - Bernhard Dorweiler
- Department of Vascular Surgery, University Medical Center Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Jörg Franke
- Institute for Factory Automation and Production Systems, Friedrich-Alexander-University of Erlangen-Nuremberg, Egerlandstr. 7-9, 91058, Erlangen, Germany
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Wake N, Nussbaum JE, Elias MI, Nikas CV, Bjurlin MA. 3D Printing, Augmented Reality, and Virtual Reality for the Assessment and Management of Kidney and Prostate Cancer: A Systematic Review. Urology 2020; 143:20-32. [DOI: 10.1016/j.urology.2020.03.066] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/19/2020] [Accepted: 03/26/2020] [Indexed: 02/06/2023]
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Cogswell PM, Rischall MA, Alexander AE, Dickens HJ, Lanzino G, Morris JM. Intracranial vasculature 3D printing: review of techniques and manufacturing processes to inform clinical practice. 3D Print Med 2020; 6:18. [PMID: 32761490 PMCID: PMC7409717 DOI: 10.1186/s41205-020-00071-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/22/2020] [Indexed: 11/17/2022] Open
Abstract
Background In recent years, three-dimensional (3D) printing has been increasingly applied to the intracranial vasculature for patient-specific surgical planning, training, education, and research. Unfortunately, though, much of the prior literature regarding 3D printing has focused on the end-product and not the process. In addition, for 3D printing/manufacturing to occur on a large scale, challenges and bottlenecks specific to each modeled anatomy must be overcome. Main body In this review article, limitations and considerations of each 3D printing processing step, as they relate to printing individual intracranial vasculature models and providing an active clinical service for a quaternary care center, are discussed. Relevant advantages and disadvantages of the available acquisition techniques (computed tomography, magnetic resonance, and digital subtraction angiography) are reviewed. Specific steps in segmentation, processing, and creation of a printable file may impede the workflow or degrade the fidelity of the printed model and are, therefore, given added attention. The various available printing techniques are compared with respect to printing the intracranial vasculature. Finally, applications are discussed, and a variety of example models are shown. Conclusion In this review we provide insight into the manufacturing of 3D models of the intracranial vasculature that may facilitate incorporation into or improve utility of 3D vascular models in clinical practice.
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Affiliation(s)
- Petrice M Cogswell
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
| | - Matthew A Rischall
- Suburban Imaging, 4801 West 81st Street, Suite 108, Bloomington, MN, 55437, USA
| | - Amy E Alexander
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Hunter J Dickens
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Giuseppe Lanzino
- Department of Neurosurgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Jonathan M Morris
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
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Larghi Laureiro Z, Novelli S, Lai Q, Mennini G, D'andrea V, Gaudenzi P, Marinozzi F, Engelmann C, Mookarje R, Raptis D, Rossi M, Jalan R. There Is a Great Future in Plastics: Personalized Approach to the Management of Hilar Cholangiocarcinoma Using a 3-D-Printed Liver Model. Dig Dis Sci 2020; 65:2210-2215. [PMID: 32440740 DOI: 10.1007/s10620-020-06326-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In recent years, three-dimensional (3-D) printing technology has become a standard tool that is used in several medical applications such as education, surgical training simulation and planning, and doctor-patient communication. Although liver surgery is ideally complemented by the use of preoperative 3-D-printed models, only a few publications have addressed this topic. We report the case of a 29-year-old Caucasian woman admitted for a Klatskin tumor infiltrating the right portal vein requiring surgery that required complex vascular reconstruction. A life-sized liver model with colorful plastic vessels and realistic looking tumor was created with the aim of planning an optimal surgical approach. According to the 3-D model, we performed a right hepatic trisectionectomy, also removing enbloc the tract of portal vein encased by the tumor and the neoplastic thrombus, followed by a complex vascular reconstruction between the main portal vein and the left portal branch. After 22 months of follow-up, the patient was alive and continuing chemotherapy. The use of the 3-D models in liver surgery helps clarify several useful preoperative issues. The accuracy of the model regarding anatomical findings was high. In the case of complex vascular reconstruction strategies, rational use of 3-D printing technology should be implemented.
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Affiliation(s)
- Zoe Larghi Laureiro
- Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Simone Novelli
- Department of Mechanical and Aerospace Engineering, La Sapienza University of Rome, Rome, Italy
- Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
| | - Quirino Lai
- Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Gianluca Mennini
- Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Vito D'andrea
- Department of Surgical Sciences, La Sapienza University of Rome, Rome, Italy
| | - Paolo Gaudenzi
- Department of Mechanical and Aerospace Engineering, La Sapienza University of Rome, Rome, Italy
| | - Franco Marinozzi
- Department of Mechanical and Aerospace Engineering, La Sapienza University of Rome, Rome, Italy
| | - Cornelius Engelmann
- Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
| | - Raj Mookarje
- Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
| | - Dimitri Raptis
- Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
| | - Massimo Rossi
- Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Rajiv Jalan
- Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
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Bati AH, Guler E, Ozer MA, Govsa F, Erozkan K, Vatansever S, Ersin MS, Elmas ZN, Harman M. Surgical planning with patient-specific three-dimensional printed pancreaticobiliary disease models - Cross-sectional study. Int J Surg 2020; 80:175-183. [PMID: 32622058 DOI: 10.1016/j.ijsu.2020.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Three-dimensional (3D) printing has been increasingly used in medical applications with the creation of accurate patient-specific 3D printed models in medical imaging data. This study has been planned based on the fact that research on 3D printing in pancreaticobiliary disease is limited due to lack of studies on validation of model accuracy. METHODS This is an innovative study where general surgery residents are presented 5 distinct hepatopancreatobiliary disease scenarios to generate a perception and required to compare their perception level of these cases with magnetic resonance cholangiopancreatography (MRCP), 3D images and 1:1 solid models that the pathology, diverse diagnosis and presurgery diagnosis stages can be observed. This study is single-centered. RESULTS The dilated pancreaticobiliary intervention based on scenarios for general surgery residency was more original since there was no prior study that includes both model building and the evaluation of the perception created by the model. Five scenarios provided qualitative assessment with results showing the usefulness of 3D models when used as clinical tools in preoperative planning, simulation of interventional procedures, surgical education, and training. The perception level in the 3D model, MRCP (Z: 3.854, p: 0.000) and the 3D image (Z: 2.865, p: 0.004) was higher; likewise, the 3D-STL image was higher compared to the MRCP image (Z: 3.779, p: 0.000). All subspecialists agree that 3D models provided better understanding of dilated pancreaticobiliary pathoanatomy and improved surgical planning. CONCLUSIONS A thoroughly outlined genuine patient situation layout aimed for general surgery training can be installed and monitored with the support of 3D printing technology of this study. This can be utilized to develop the comprehension of pathoanatomical variations of complex pancreaticobiliary illness and to adopt a surgical approach.
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Affiliation(s)
| | | | - Mehmet Asim Ozer
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Turkey
| | - Figen Govsa
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Turkey.
| | - Kamil Erozkan
- Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Safa Vatansever
- Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Muhtar Sinan Ersin
- Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
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O'Reilly M, Hoff M, Friedman SD, Jones JFX, Cross NM. Simulating Tissues with 3D-Printed and Castable Materials. J Digit Imaging 2020; 33:1280-1291. [PMID: 32556912 DOI: 10.1007/s10278-020-00358-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Manufacturing technologies continue to be developed and utilized in medical prototyping, simulations, and imaging phantom production. For radiologic image-guided simulation and instruction, models should ideally have similar imaging characteristics and physical properties to the tissues they replicate. Due to the proliferation of different printing technologies and materials, there is a diverse and broad range of approaches and materials to consider before embarking on a project. Although many printed materials' biomechanical parameters have been reported, no manufacturer includes medical imaging properties that are essential for realistic phantom production. We hypothesize that there are now ample materials available to create high-fidelity imaging anthropomorphic phantoms using 3D printing and casting of common commercially available materials. A material database of radiological, physical, manufacturing, and economic properties for 29 castable and 68 printable materials was generated from samples fabricated by the authors or obtained from the manufacturer and scanned with CT at multiple tube voltages. This is the largest study assessing multiple different parameters associated with 3D printing to date. These data are being made freely available on GitHub, thus affording medical simulation experts access to a database of relevant imaging characteristics of common printable and castable materials. Full data available at: https://github.com/nmcross/Material-Imaging-Characteristics .
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Affiliation(s)
| | - Michael Hoff
- University of Washington, 1959 NE Pacific St., Seattle, WA, USA
| | - Seth D Friedman
- Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, USA
| | - James F X Jones
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Nathan M Cross
- University of Washington, 1959 NE Pacific St., Seattle, WA, USA.
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Sindi R, Wong YH, Yeong CH, Sun Z. Development of patient-specific 3D-printed breast phantom using silicone and peanut oils for magnetic resonance imaging. Quant Imaging Med Surg 2020; 10:1237-1248. [PMID: 32550133 DOI: 10.21037/qims-20-251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Despite increasing reports of 3D printing in medical applications, the use of 3D printing in breast imaging is limited, thus, personalized 3D-printed breast model could be a novel approach to overcome current limitations in utilizing breast magnetic resonance imaging (MRI) for quantitative assessment of breast density. The aim of this study is to develop a patient-specific 3D-printed breast phantom and to identify the most appropriate materials for simulating the MR imaging characteristics of fibroglandular and adipose tissues. Methods A patient-specific 3D-printed breast model was generated using 3D-printing techniques for the construction of the hollow skin and fibroglandular region shells. Then, the T1 relaxation times of the five selected materials (agarose gel, silicone rubber with/without fish oil, silicone oil, and peanut oil) were measured on a 3T MRI system to determine the appropriate ones to represent the MR imaging characteristics of fibroglandular and adipose tissues. Results were then compared to the reference values of T1 relaxation times of the corresponding tissues: 1,324.42±167.63 and 449.27±26.09 ms, respectively. Finally, the materials that matched the T1 relaxation times of the respective tissues were used to fill the 3D-printed hollow breast shells. Results The silicone and peanut oils were found to closely resemble the T1 relaxation times and imaging characteristics of these two tissues, which are 1,515.8±105.5 and 405.4±15.1 ms, respectively. The agarose gel with different concentrations, ranging from 0.5 to 2.5 wt%, was found to have the longest T1 relaxation times. Conclusions A patient-specific 3D-printed breast phantom was successfully designed and constructed using silicone and peanut oils to simulate the MR imaging characteristics of fibroglandular and adipose tissues. The phantom can be used to investigate different MR breast imaging protocols for the quantitative assessment of breast density.
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Affiliation(s)
- Rooa Sindi
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, WA, Australia.,Radio-diagnostic and Medical Imaging Department, Medical Physics Section, King Fahd Armed Forces Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Yin How Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, WA, Australia
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Jacob S, Pooley RA, Thomas M. Three-Dimensional-Printed Model as a Template for Chest Wall Reconstruction. Heart Lung Circ 2020; 29:1566-1570. [PMID: 32280015 DOI: 10.1016/j.hlc.2020.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/14/2020] [Accepted: 02/20/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND To our knowledge, this is the first time that a three-dimensional (3D)-printed model was used as an intraoperative template to recreate the resected portion of the lateral chest wall after resection of a large chest-wall tumour. METHODS Fabrication of 3D-printed models requires collaboration among a surgeon, radiologist, segmenter, and 3D printing centre. Three-dimensional models are created with computed tomographic and magnetic resonance data. These models can provide an accurate guide for surgical resection and can be used intraoperatively as a template to construct tailored prostheses. RESULTS We achieved complete resection of the chest wall defect, restored skeletal function and physiologic chest excursion, and achieved the best cosmetic appearance in all cases. CONCLUSIONS Small- to medium-sized chest wall defects can be repaired with musculocutaneous flaps with or without prosthetic materials, but more complicated defects require increasingly sophisticated reconstructive techniques and technologies. An advanced technique is the use of a 3D-printed model of the chest wall as an intraoperative template.
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Affiliation(s)
- Samuel Jacob
- Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA.
| | | | - Mathew Thomas
- Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, USA
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Weadock WJ, Heisel CJ, Kahana A, Kim J. Use of 3D Printed Models to Create Molds for Shaping Implants for Surgical Repair of Orbital Fractures. Acad Radiol 2020; 27:536-542. [PMID: 31466890 DOI: 10.1016/j.acra.2019.06.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
RATIONALE AND OBJECTIVES Surgical repair of an isolated orbital fracture requires anatomically accurate implant shape and placement. We describe a three-dimensional (3D) printing technique to customize the shape of commercially available absorbable implants. MATERIALS AND METHODS We reviewed our early experience with three cases in which 3D printed molds were utilized for fracture repair. The institution's medical records were reviewed to assess operative time for orbital floor blow-out fracture repairs. Thin section computed tomography (CT) images were loaded into a clinical 3D visualization software, and stereolithography models were created. The models were loaded into stereolithography editing software in which the nonfractured side was mirrored and overlaid with the fractured side. Sterilizable 3D printed molds were created using the fracture images as well as the virtual mirrored images. The molds were taken to the operating room and used to shape a customized orbital implant for fracture repair, using off-the-shelf bioabsorbable implants. RESULTS The three patients treated using 3D printed molds had excellent outcomes, with decreased postoperative edema and rapid resolution of ocular misalignment/strabismus. Surgical times were decreased from an average of 93.3 minutes using standard implants to 48.3 minutes following adoption of 3D printed molds. CONCLUSION Three-dimensional printed models can be used to create molds for shaping bioabsorbable implants for customized surgical repair, improving fit, reducing tissue handling and postoperative edema, and reducing surgical times.
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Schmitt JJ, Baker MV, Occhino JA, McGree ME, Weaver AL, Bakkum-Gamez JN, Dowdy SC, Pasupathy KS, Gebhart JB. Prospective Implementation and Evaluation of a Decision-Tree Algorithm for Route of Hysterectomy. Obstet Gynecol 2020; 135:761-769. [PMID: 32168206 PMCID: PMC10947415 DOI: 10.1097/aog.0000000000003725] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the rate of vaginal hysterectomy and outcomes after initiation of a prospective decision-tree algorithm to determine the optimal surgical route of hysterectomy. METHODS A prospective algorithm to determine optimal route of hysterectomy was developed, which uses the following factors: history of laparotomy, uterine size, and vaginal access. The algorithm was implemented at our institution from November 24, 2015, to December 31, 2017, for patients requiring hysterectomy for benign indications. Expected route of hysterectomy was assigned by the algorithm and was compared with the actual route performed to identify compliance compared with deviation. Surgical outcomes were analyzed. RESULTS Of 365 patients who met inclusion criteria, 202 (55.3%) were expected to have a total vaginal hysterectomy, 57 (15.6%) were expected to have an examination under anesthesia followed by total vaginal hysterectomy, 52 (14.2%) were expected to have an examination under anesthesia followed by robotic-assisted total laparoscopic hysterectomy, and 54 (14.8%) were expected to have an abdominal or robotic-laparoscopic route of hysterectomy. Forty-six procedures (12.6%) deviated from the algorithm to a more invasive route (44 robotic, two abdominal). Seven patients had total vaginal hysterectomy when robotic-assisted total laparoscopic hysterectomy or abdominal hysterectomy was expected by the algorithm. Overall, 71% of patients were expected to have a vaginal route of hysterectomy per the algorithm, of whom 81.5% had a total vaginal hysterectomy performed; more than 99% of the total vaginal hysterectomies attempted were successfully completed. CONCLUSION Vaginal surgery is feasible, carries a low complication rate with excellent outcomes, and should have a place in gynecologic surgery. National use of this prospective algorithm may increase the rate of total vaginal hysterectomy and decrease health care costs.
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Affiliation(s)
- Jennifer J Schmitt
- Female Pelvic Medicine and Reconstructive Surgery, Allina Health, St. Paul, and the Department of Obstetrics and Gynecology, the Division of Biomedical Statistics and Informatics, and the Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
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Liu P, Hu Z, Huang S, Wang P, Dong Y, Cheng P, Xu H, Tang B, Zhu J. Application of 3D Printed Models of Complex Hypertrophic Scars for Preoperative Evaluation and Surgical Planning. Front Bioeng Biotechnol 2020; 8:115. [PMID: 32195230 PMCID: PMC7062670 DOI: 10.3389/fbioe.2020.00115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/05/2020] [Indexed: 11/28/2022] Open
Abstract
Background Complex hypertrophic scar is a condition that causes multiple joint contractures and deformities after trauma or burn injuries. Three-dimensional (3D) printing technology provides a new evaluation method for this condition. The objective of this study was to print individualized 3D models of complex hypertrophic scars and to assess the accuracy of these models. Methods Twelve patients with complex hypertrophic scars were included in this study. Before surgery, each patient underwent a computed tomography (CT) scan to obtain cross-sectional information for 3D printing. Mimics software was used to process the CT data and create 3D printed models. The length, width, height, and volume measurements of the physical scars and 3D printed models were compared. Experienced surgeons used the 3D models to plan the operation and simulate the surgical procedure. The hypertrophic scar was completely removed for each patient and covered with skin autografts. The surgical time, bleeding, complications, and skin autograft take rate were recorded. All patients were followed up at 12 months. The surgeons, young doctors, medical students, and patients involved in the study completed questionnaires to assess the use of the 3D printed models. Results The 3D models of the hypertrophic scars were printed successfully. The length, width, height, and volume measurements were significantly smaller for the 3D printed models than for the physical hypertrophic scars. Based on preoperative simulations with the 3D printed models, the surgeries were performed successfully and each hypertrophic scar was completely removed. The surgery time was shortened and the bleeding was decreased. On postoperative day 7, there were two cases of subcutaneous hemorrhage, one case of infection and one case of necrosis. On postoperative day 12, the average take rate of the skin autografts was 97.75%. At the 12-month follow-up, all patients were satisfied with the appearance and function. Conclusion Accurate 3D printed models can help surgeons plan and perform successful operations, help young doctors and medical students learn surgical methods, and enhance patient comprehension and confidence in their surgeons.
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Affiliation(s)
- Peng Liu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Department of Burn and Plastic Surgery, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, China
| | - Zhicheng Hu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shaobin Huang
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Peng Wang
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yunxian Dong
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Pu Cheng
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hailin Xu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bing Tang
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiayuan Zhu
- Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Biglino G, Caputo M. Commentary: On the road toward routine use of 3-dimensional techniques in complex congenital surgery. JTCVS Tech 2020; 1:88-89. [PMID: 34317726 PMCID: PMC8288822 DOI: 10.1016/j.xjtc.2020.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 12/13/2019] [Accepted: 01/03/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Giovanni Biglino
- Bristol Medical School, University of Bristol, Bristol, United Kingdom.,Bristol Heart Institute, University Hospitals Bristol, Bristol, United Kingdom.,National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Massimo Caputo
- Bristol Medical School, University of Bristol, Bristol, United Kingdom.,Bristol Heart Institute, University Hospitals Bristol, Bristol, United Kingdom
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