1
|
Wendo K, Behets C, Barbier O, Herman B, Schubert T, Raucent B, Olszewski R. Dimensional Accuracy Assessment of Medical Anatomical Models Produced by Hospital-Based Fused Deposition Modeling 3D Printer. J Imaging 2025; 11:39. [PMID: 39997541 PMCID: PMC11856956 DOI: 10.3390/jimaging11020039] [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: 12/02/2024] [Revised: 01/13/2025] [Accepted: 01/23/2025] [Indexed: 02/26/2025] Open
Abstract
As 3D printing technology expands rapidly in medical disciplines, the accuracy evaluation of 3D-printed medical models is required. However, no established guidelines to assess the dimensional error of anatomical models exist. This study aims to evaluate the dimensional accuracy of medical models 3D-printed using a hospital-based Fused Deposition Modeling (FDM) 3D printer. Two dissected cadaveric right hands were marked with Titanium Kirshner wires to identify landmarks on the heads and bases of all metacarpals and proximal and middle phalanges. Both hands were scanned using a Cone Beam Computed Tomography scanner. Image post-processing and segmentation were performed on 3D Slicer software. Hand models were 3D-printed using a professional hospital-based FDM 3D printer. Manual measurements of all landmarks marked on both pairs of cadaveric and 3D-printed hands were taken by two independent observers using a digital caliper. The Mean Absolute Difference (MAD) and Mean Dimensional Error (MDE) were calculated. Our results showed an acceptable level of dimensional accuracy. The overall study's MAD was 0.32 mm (±0.34), and its MDE was 1.03% (±0.83). These values fall within the recommended range of errors. A high level of dimensional accuracy of the 3D-printed anatomical models was achieved, suggesting their reliability and suitability for medical applications.
Collapse
Affiliation(s)
- Kevin Wendo
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium; (O.B.); (T.S.); (R.O.)
- Oral and Maxillofacial Surgery Lab (OMFS Lab), NMSK, IREC, Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium
- Department of Pediatrics, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
| | - Catherine Behets
- Morphology Lab (MORF), IREC, Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium;
| | - Olivier Barbier
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium; (O.B.); (T.S.); (R.O.)
- Department of Orthopedic Surgery, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
| | - Benoit Herman
- Institute of Mechanics, Materials and Civil Engineering, Université Catholique de Louvain (UCLouvain), 1348 Louvain-La-Neuve, Belgium; (B.H.); (B.R.)
| | - Thomas Schubert
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium; (O.B.); (T.S.); (R.O.)
- Department of Orthopedic Surgery, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
| | - Benoit Raucent
- Institute of Mechanics, Materials and Civil Engineering, Université Catholique de Louvain (UCLouvain), 1348 Louvain-La-Neuve, Belgium; (B.H.); (B.R.)
| | - Raphael Olszewski
- Neuro Musculo Skeletal Lab (NMSK), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium; (O.B.); (T.S.); (R.O.)
- Oral and Maxillofacial Surgery Lab (OMFS Lab), NMSK, IREC, Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium
- Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
- Department of Perioperative Dentistry, L. Rydygiera Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland
| |
Collapse
|
2
|
Paleel F, Qin M, Tagalakis AD, Yu-Wai-Man C, Lamprou DA. Manufacturing and characterisation of 3D-printed sustained-release Timolol implants for glaucoma treatment. Drug Deliv Transl Res 2025; 15:242-252. [PMID: 38578377 PMCID: PMC11614933 DOI: 10.1007/s13346-024-01589-8] [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] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
Timolol maleate (TML) is a beta-blocker drug that is commonly used to lower the intraocular pressure in glaucoma. This study focused on using a 3D printing (3DP) method for the manufacturing of an ocular, implantable, sustained-release drug delivery system (DDS). Polycaprolactone (PCL), and PCL with 5 or 10% TML implants were manufactured using a one-step 3DP process. Their physicochemical characteristics were analysed using light microscopy, scanning electronic microscopy (SEM), differential scanning calorimetry (DSC) / thermal gravimetric analysis (TGA), and Fourier-transform infrared spectroscopy (FTIR). The in vitro drug release was evaluated by UV-spectrophotometry. Finally, the effect of the implants on cell viability in human trabecular meshwork cells was assessed. All the implants showed a smooth surface. Thermal analysis demonstrated that the implants remained thermally stable at the temperatures used for the printing, and FTIR studies showed that there were no significant interactions between PCL and TML. Both concentrations (5 & 10%) of TML achieved sustained release from the implants over the 8-week study period. All implants were non-cytotoxic to human trabecular cells. This study shows proof of concept that 3DP can be used to print biocompatible and personalised ocular implantable sustained-release DDSs for the treatment of glaucoma.
Collapse
Affiliation(s)
- Fathima Paleel
- School of Pharmacy, Queen's University Belfast, BT9 7BL, Belfast, UK
- Faculty of Life Sciences & Medicine, King's College London, SE1 7EH, London, UK
| | - Mengqi Qin
- Faculty of Life Sciences & Medicine, King's College London, SE1 7EH, London, UK
| | | | - Cynthia Yu-Wai-Man
- Faculty of Life Sciences & Medicine, King's College London, SE1 7EH, London, UK.
| | | |
Collapse
|
3
|
Mersanne A, Foresti R, Martini C, Caffarra Malvezzi C, Rossi G, Fornasari A, De Filippo M, Freyrie A, Perini P. In-House Fabrication and Validation of 3D-Printed Custom-Made Medical Devices for Planning and Simulation of Peripheral Endovascular Therapies. Diagnostics (Basel) 2024; 15:8. [PMID: 39795536 PMCID: PMC11719810 DOI: 10.3390/diagnostics15010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2024] [Revised: 12/23/2024] [Accepted: 12/23/2024] [Indexed: 01/13/2025] Open
Abstract
Objectives: This study aims to develop and validate a standardized methodology for creating high-fidelity, custom-made, patient-specific 3D-printed vascular models that serve as tools for preoperative planning and training in the endovascular treatment of peripheral artery disease (PAD). Methods: Ten custom-made 3D-printed vascular models were produced using computed tomography angiography (CTA) scans of ten patients diagnosed with PAD. CTA images were analyzed using Syngo.via by a specialist to formulate a medical prescription that guided the model's creation. The CTA data were then processed in OsiriX MD to generate the .STL file, which is further refined in a Meshmixer. Stereolithography (SLA) 3D printing technology was employed, utilizing either flexible or rigid materials. The dimensional accuracy of the models was evaluated by comparing their CT scan images with the corresponding patient data, using OsiriX MD. Additionally, both flexible and rigid models were evaluated by eight vascular surgeons during simulations in an in-house-designed setup, assessing both the technical aspects and operator perceptions of the simulation. Results: Each model took approximately 21.5 h to fabricate, costing €140 for flexible and €165 for rigid materials. Bland-Alman plots revealed a strong agreement between the 3D models and patient anatomy, with outliers ranging from 4.3% to 6.9%. Simulations showed that rigid models performed better in guidewire navigation and catheter stability, while flexible models offered improved transparency and lesion treatment. Surgeons confirmed the models' realism and utility. Conclusions: The study highlights the cost-efficient, high-fidelity production of 3D-printed vascular models, emphasizing their potential to enhance training and planning in endovascular surgery.
Collapse
Affiliation(s)
- Arianna Mersanne
- Vascular Surgery, Cardio-Thoracic and Vascular Department, University-Hospital of Parma, 43126 Parma, Italy
| | - Ruben Foresti
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (R.F.)
- Center of Excellence for Toxicological Research (CERT), University of Parma, 43126 Parma, Italy
- Italian National Research Council, Institute of Materials for Electronics and Magnetism (CNR-IMEM), 43124 Parma, Italy
| | - Chiara Martini
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (R.F.)
- Diagnostic Department, University-Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy
| | | | - Giulia Rossi
- Vascular Surgery, Cardio-Thoracic and Vascular Department, University-Hospital of Parma, 43126 Parma, Italy
| | - Anna Fornasari
- Vascular Surgery, Cardio-Thoracic and Vascular Department, University-Hospital of Parma, 43126 Parma, Italy
| | - Massimo De Filippo
- Department of Medicine and Surgery, Section of Radiology, University of Parma, Maggiore Hospital, Via Gramsci 14, 43126 Parma, Italy
| | - Antonio Freyrie
- Vascular Surgery, Cardio-Thoracic and Vascular Department, University-Hospital of Parma, 43126 Parma, Italy
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (R.F.)
| | - Paolo Perini
- Vascular Surgery, Cardio-Thoracic and Vascular Department, University-Hospital of Parma, 43126 Parma, Italy
- Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43126 Parma, Italy; (R.F.)
| |
Collapse
|
4
|
Schulze M, Juergensen L, Rischen R, Toennemann M, Reischle G, Puetzler J, Gosheger G, Hasselmann J. Quality assurance of 3D-printed patient specific anatomical models: a systematic review. 3D Print Med 2024; 10:9. [PMID: 38536566 PMCID: PMC10967057 DOI: 10.1186/s41205-024-00210-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/14/2024] [Indexed: 01/03/2025] Open
Abstract
BACKGROUND The responsible use of 3D-printing in medicine includes a context-based quality assurance. Considerable literature has been published in this field, yet the quality of assessment varies widely. The limited discriminatory power of some assessment methods challenges the comparison of results. The total error for patient specific anatomical models comprises relevant partial errors of the production process: segmentation error (SegE), digital editing error (DEE), printing error (PrE). The present review provides an overview to improve the general understanding of the process specific errors, quantitative analysis, and standardized terminology. METHODS This review focuses on literature on quality assurance of patient-specific anatomical models in terms of geometric accuracy published before December 4th, 2022 (n = 139). In an attempt to organize the literature, the publications are assigned to comparable categories and the absolute values of the maximum mean deviation (AMMD) per publication are determined therein. RESULTS The three major examined types of original structures are teeth or jaw (n = 52), skull bones without jaw (n = 17) and heart with coronary arteries (n = 16). VPP (vat photopolymerization) is the most frequently employed basic 3D-printing technology (n = 112 experiments). The median values of AMMD (AMMD: The metric AMMD is defined as the largest linear deviation, based on an average value from at least two individual measurements.) are 0.8 mm for the SegE, 0.26 mm for the PrE and 0.825 mm for the total error. No average values are found for the DEE. CONCLUSION The total error is not significantly higher than the partial errors which may compensate each other. Consequently SegE, DEE and PrE should be analyzed individually to describe the result quality as their sum according to rules of error propagation. Current methods for quality assurance of the segmentation are often either realistic and accurate or resource efficient. Future research should focus on implementing models for cost effective evaluations with high accuracy and realism. Our system of categorization may be enhancing the understanding of the overall process and a valuable contribution to the structural design and reporting of future experiments. It can be used to educate specialists for risk assessment and process validation within the additive manufacturing industry.
Collapse
Affiliation(s)
- Martin Schulze
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Muenster, 48149, Münster, Germany.
| | - Lukas Juergensen
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Muenster, 48149, Münster, Germany
| | - Robert Rischen
- Clinic for Radiology, University Hospital Muenster, 48149, Muenster, Germany
| | - Max Toennemann
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Muenster, 48149, Münster, Germany
| | | | - Jan Puetzler
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Muenster, 48149, Münster, Germany
| | - Georg Gosheger
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Muenster, 48149, Münster, Germany
| | - Julian Hasselmann
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Muenster, 48149, Münster, Germany
- Department of Mechanical Engineering, Materials Engineering Laboratory, University of Applied Sciences Muenster, 48565, Steinfurt, Germany
| |
Collapse
|
5
|
Cha BK, Lee KH, Lee Y, Kim K. Optimization Method to Predict Optimal Noise Reduction Parameters for the Non-Local Means Algorithm Based on the Scintillator Thickness in Radiography. SENSORS (BASEL, SWITZERLAND) 2023; 23:9803. [PMID: 38139649 PMCID: PMC10747373 DOI: 10.3390/s23249803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
The resulting image obtained from an X-ray imaging system depends significantly on the characteristics of the detector. In particular, when an X-ray image is acquired by thinning the detector, a relatively large amount of noise inevitably occurs. In addition, when a thick detector is used to reduce noise in X-ray images, blurring increases and the ability to distinguish target areas deteriorates. In this study, we aimed to derive the optimal X-ray image quality by deriving the optimal noise reduction parameters based on the non-local means (NLM) algorithm. The detectors used were of two thicknesses (96 and 140 μm), and images were acquired based on the IEC 62220-1-1:2015 RQA-5 protocol. The optimal parameters were derived by calculating the edge preservation index and signal-to-noise ratio according to the sigma value of the NLM algorithm. As a result, a sigma value of the optimized NLM algorithm (0.01) was derived, and this algorithm was applied to a relatively thin X-ray detector system to obtain appropriate noise level and spatial resolution data. The no-reference-based blind/referenceless image spatial quality evaluator value, which analyzes the overall image quality, was best when using the proposed method. In conclusion, we propose an optimized NLM algorithm based on a new method that can overcome the noise amplification problem in thin X-ray detector systems and is expected to be applied in various photon imaging fields in the future.
Collapse
Affiliation(s)
- Bo Kyung Cha
- Precision Medical Device Research Center, Korea Electrotechnology Research Institute (KERI), 111 Hanggaul-ro, Sangnok-gu, Ansan-si 15588, Republic of Korea; (B.K.C.); (K.-H.L.)
| | - Kyeong-Hee Lee
- Precision Medical Device Research Center, Korea Electrotechnology Research Institute (KERI), 111 Hanggaul-ro, Sangnok-gu, Ansan-si 15588, Republic of Korea; (B.K.C.); (K.-H.L.)
| | - Youngjin Lee
- Department of Radiological Science, Gachon University, 191 Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea
| | - Kyuseok Kim
- Department of Biomedical Engineering, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam-si 13135, Republic of Korea
| |
Collapse
|
6
|
Chen JR, Morris J, Wentworth A, Sears V, Duit A, Erie E, McGee K, Leng S. Three-dimensional printing accuracy analysis for medical applications across a wide variety of printers. J Med Imaging (Bellingham) 2023; 10:026501. [PMID: 37020530 PMCID: PMC10068246 DOI: 10.1117/1.jmi.10.2.026501] [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: 09/16/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
Purpose Three-dimensional (3D) printing has had a significant impact on patient care. However, there is a lack of standardization in quality assurance (QA) to ensure printing accuracy and precision given multiple printing technologies, variability across vendors, and inter-printer reliability issues. We investigated printing accuracy on a diverse selection of 3D printers commonly used in the medical field. Approach A specially designed 3D printing QA phantom was periodically printed on 16 printers used in our practice, covering five distinct printing technologies and eight different vendors. Longitudinal data were acquired over six months by printing the QA phantom monthly on each printer. Qualitative assessment and quantitative measurements were obtained for each printed phantom. Accuracy and precision were assessed by comparing quantitative measurements with reference values of the phantom. Data were then compared among printer models, vendors, and printing technologies; longitudinal trends were also analyzed. Results Differences in 3D printing accuracy across printers were observed. Material jetting and vat photopolymerization printers were found to be the most accurate. Printers using the same 3D printing technology but from different vendors also showed differences in accuracy, most notably between vat photopolymerization printers from two different vendors. Furthermore, differences in accuracy were found between printers from the same vendor using the same printing technology, but different models/generations. Conclusions These results show how factors such as printing technology, vendor, and printer model can impact 3D printing accuracy, which should be appropriately considered in practice to avoid potential medical or surgical errors.
Collapse
Affiliation(s)
- Joshua Ray Chen
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Jonathan Morris
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Adam Wentworth
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Victoria Sears
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Andrew Duit
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Eric Erie
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Kiaran McGee
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| | - Shuai Leng
- Mayo Clinic, Department of Radiology, Rochester, Minnesota, United States
| |
Collapse
|
7
|
Nguyen P, Stanislaus I, McGahon C, Pattabathula K, Bryant S, Pinto N, Jenkins J, Meinert C. Quality assurance in 3D-printing: A dimensional accuracy study of patient-specific 3D-printed vascular anatomical models. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1097850. [PMID: 36824261 PMCID: PMC9941637 DOI: 10.3389/fmedt.2023.1097850] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/03/2023] [Indexed: 02/10/2023] Open
Abstract
3D printing enables the rapid manufacture of patient-specific anatomical models that substantially improve patient consultation and offer unprecedented opportunities for surgical planning and training. However, the multistep preparation process may inadvertently lead to inaccurate anatomical representations which may impact clinical decision making detrimentally. Here, we investigated the dimensional accuracy of patient-specific vascular anatomical models manufactured via digital anatomical segmentation and Fused-Deposition Modelling (FDM), Stereolithography (SLA), Selective Laser Sintering (SLS), and PolyJet 3D printing, respectively. All printing modalities reliably produced hand-held patient-specific models of high quality. Quantitative assessment revealed an overall dimensional error of 0.20 ± 3.23%, 0.53 ± 3.16%, -0.11 ± 2.81% and -0.72 ± 2.72% for FDM, SLA, PolyJet and SLS printed models, respectively, compared to unmodified Computed Tomography Angiograms (CTAs) data. Comparison of digital 3D models to CTA data revealed an average relative dimensional error of -0.83 ± 2.13% resulting from digital anatomical segmentation and processing. Therefore, dimensional error resulting from the print modality alone were 0.76 ± 2.88%, + 0.90 ± 2.26%, + 1.62 ± 2.20% and +0.88 ± 1.97%, for FDM, SLA, PolyJet and SLS printed models, respectively. Impact on absolute measurements of feature size were minimal and assessment of relative error showed a propensity for models to be marginally underestimated. This study revealed a high level of dimensional accuracy of 3D-printed patient-specific vascular anatomical models, suggesting they meet the requirements to be used as medical devices for clinical applications.
Collapse
Affiliation(s)
- Philip Nguyen
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Ivan Stanislaus
- Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Clover McGahon
- Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Krishna Pattabathula
- Vascular Surgery Department, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, QLD, Australia,Vascular Biofabrication Program, Herston Biofabrication Institute, Metro North Hospital and Health Services, Brisbane, QLD, Australia
| | - Samuel Bryant
- Vascular Surgery Department, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, QLD, Australia,Vascular Biofabrication Program, Herston Biofabrication Institute, Metro North Hospital and Health Services, Brisbane, QLD, Australia
| | - Nigel Pinto
- Vascular Surgery Department, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, QLD, Australia,Vascular Biofabrication Program, Herston Biofabrication Institute, Metro North Hospital and Health Services, Brisbane, QLD, Australia
| | - Jason Jenkins
- Vascular Surgery Department, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Services, Brisbane, QLD, Australia,Vascular Biofabrication Program, Herston Biofabrication Institute, Metro North Hospital and Health Services, Brisbane, QLD, Australia
| | - Christoph Meinert
- Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia,Vascular Biofabrication Program, Herston Biofabrication Institute, Metro North Hospital and Health Services, Brisbane, QLD, Australia,Faculty of Engineering, Architecture and Information Technology, University of Queensland, Brisbane, QLD, Australia,Correspondence: Christoph Meinert
| |
Collapse
|
8
|
Jusufbegović M, Pandžić A, Busuladžić M, Čiva LM, Gazibegović-Busuladžić A, Šehić A, Vegar-Zubović S, Jašić R, Beganović A. Utilisation of 3D Printing in the Manufacturing of an Anthropomorphic Paediatric Head Phantom for the Optimisation of Scanning Parameters in CT. Diagnostics (Basel) 2023; 13:328. [PMID: 36673137 PMCID: PMC9858362 DOI: 10.3390/diagnostics13020328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/27/2022] [Accepted: 11/29/2022] [Indexed: 01/18/2023] Open
Abstract
Computed tomography (CT) is a diagnostic imaging process that uses ionising radiation to obtain information about the interior anatomic structure of the human body. Considering that the medical use of ionising radiation implies exposing patients to radiation that may lead to unwanted stochastic effects and that those effects are less probable at lower doses, optimising imaging protocols is of great importance. In this paper, we used an assembled 3D-printed infant head phantom and matched its image quality parameters with those obtained for a commercially available adult head phantom using the imaging protocol dedicated for adult patients. In accordance with the results, an optimised scanning protocol was designed which resulted in dose reductions for paediatric patients while keeping image quality at an adequate level.
Collapse
Affiliation(s)
- Merim Jusufbegović
- Radiology Clinic, Sarajevo University Clinical Center, 71000 Sarajevo, Bosnia and Herzegovina
- Department of Radiological Technologies, Faculty of Health Studies, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Adi Pandžić
- Department of Mechanical Production Engineering, Faculty of Mechanical Engineering Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Mustafa Busuladžić
- Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Lejla M. Čiva
- Sarajevo Medical School, University Sarajevo School of Science and Technology, 71210 Ilidža, Bosnia and Herzegovina
| | | | - Adnan Šehić
- Department of Radiological Technologies, Faculty of Health Studies, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Sandra Vegar-Zubović
- Radiology Clinic, Sarajevo University Clinical Center, 71000 Sarajevo, Bosnia and Herzegovina
- Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Rahima Jašić
- Department of Radiation Protection and Medical Physics, Sarajevo University Clinical Center, 71000 Sarajevo, Bosnia and Herzegovina
| | - Adnan Beganović
- Faculty of Science, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
- Department of Radiation Protection and Medical Physics, Sarajevo University Clinical Center, 71000 Sarajevo, Bosnia and Herzegovina
| |
Collapse
|
9
|
Chai Y, Simic R, Smith PN, Valter K, Limaye A, Li RW. Comparison of 2 open-sourced 3-dimensional modeling techniques for orthopaedic application. OTA Int 2022; 5:e213. [PMID: 36569106 PMCID: PMC9782327 DOI: 10.1097/oi9.0000000000000213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/08/2022] [Indexed: 12/27/2022]
Abstract
Objectives: Although 3-dimensional (3D) printing is becoming more widely adopted for clinical applications, it is yet to be accepted as part of standard practice. One of the key applications of this technology is orthopaedic surgical planning for urgent trauma cases. Anatomically accurate replicas of patients' fracture models can be produced to guide intervention. These high-quality models facilitate the design and printing of patient-specific implants and surgical devices. Therefore, a fast and accurate workflow will help orthopaedic surgeons to generate high-quality 3D printable models of complex fractures. Currently, there is a lack of access to an uncomplicated and inexpensive workflow. Methods: Using patient DICOM data sets (n = 13), we devised a novel, simple, open-source, and rapid modeling process using Drishti software and compared its efficacy and data storage with the 3D Slicer image computing platform. We imported the computed tomography image directory acquired from patients into the software to isolate the model of bone surface from surrounding soft tissue using the minimum functions. One pelvic fracture case was further integrated into the customized implant design practice to demonstrate the compatibility of the 3D models generated from Drishti. Results: The data sizes of the generated 3D models and the processing files that represent the original DICOM of Drishti are on average 27% and 12% smaller than that of 3D Slicer, respectively (both P < 0.05). The time frame needed to reach the stage of viewing the 3D bone model and the exporting of the data of Drishti is 39% and 38% faster than that of 3D Slicer, respectively (both P < 0.05). We also constructed a virtual model using third-party software to trial the implant design. Conclusions: Drishti is more suitable for urgent trauma cases that require fast and efficient 3D bone reconstruction with less hardware requirement. 3D Slicer performs better at quantitative preoperative planning and multilayer segmentation. Both software platforms are compatible with third-party programs used to produce customized implants that could be useful for surgical training. Level of Evidence: Level V.
Collapse
Affiliation(s)
- Yuan Chai
- Trauma and Orthopaedic Research Laboratory, Department of Surgery, The Medical School, The Australian National University, Canberra, ACT, Australia
| | - Robert Simic
- Trauma and Orthopaedic Research Laboratory, Department of Surgery, The Medical School, The Australian National University, Canberra, ACT, Australia
| | - Paul N. Smith
- Trauma and Orthopaedic Research Unit, Clinical Orthopaedic Surgery, The Canberra Hospital, Garran, ACT, Australia
| | - Krisztina Valter
- The Medical School, and John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - Ajay Limaye
- National Computational Infrastructure, The Australian National University, Canberra, ACT, Australia; and
| | - Rachel W. Li
- The Medical School, and John Curtin School of Medical Research, The Australian National University, Acton, ACT, Australia
| |
Collapse
|
10
|
Ganapathy A, Chen D, Elumalai A, Albers B, Tappa K, Jammalamadaka U, Hoegger MJ, Ballard DH. Guide for starting or optimizing a 3D printing clinical service. Methods 2022; 206:41-52. [PMID: 35964862 DOI: 10.1016/j.ymeth.2022.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 10/15/2022] Open
Abstract
Three-dimensional (3D) printing has applications in many fields and has gained substantial traction in medicine as a modality to transform two-dimensional scans into three-dimensional renderings. Patient-specific 3D printed models have direct patient care uses in surgical and procedural specialties, allowing for increased precision and accuracy in developing treatment plans and guiding surgeries. Medical applications include surgical planning, surgical guides, patient and trainee education, and implant fabrication. 3D printing workflow for a laboratory or clinical service that produces anatomic models and guides includes optimizing imaging acquisition and post-processing, segmenting the imaging, and printing the model. Quality assurance considerations include supervising medical imaging expert radiologists' guidance and self-implementing in-house quality control programs. The purpose of this review is to provide a workflow and guide for starting or optimizing laboratories and clinical services that 3D-print anatomic models or guides for clinical use.
Collapse
Affiliation(s)
- Aravinda Ganapathy
- School of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| | - David Chen
- School of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| | - Anusha Elumalai
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Brian Albers
- 3D Printing Center, Barnes Jewish Hospital, St. Louis, MO, USA.
| | - Karthik Tappa
- Anatomic 3D Printing and Visualization Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | | | - Mark J Hoegger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
| | - David H Ballard
- School of Medicine, Washington University School of Medicine, St. Louis, MO, USA.
| |
Collapse
|
11
|
Ravi P, Chepelev LL, Stichweh GV, Jones BS, Rybicki FJ. Medical 3D Printing Dimensional Accuracy for Multi-pathological Anatomical Models 3D Printed Using Material Extrusion. J Digit Imaging 2022; 35:613-622. [PMID: 35237891 PMCID: PMC9156585 DOI: 10.1007/s10278-022-00614-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/15/2022] Open
Abstract
Medical 3D printing of anatomical models is being increasingly applied in healthcare facilities. The accuracy of such 3D-printed anatomical models is an important aspect of their overall quality control. The purpose of this research was to test whether the accuracy of a variety of anatomical models 3D printed using Material Extrusion (MEX) lies within a reasonable tolerance level, defined as less than 1-mm dimensional error. Six medical models spanning across anatomical regions (musculoskeletal, neurological, abdominal, cardiovascular) and sizes (model volumes ranging from ~ 4 to 203 cc) were chosen for the primary study. Three measurement landing blocks were strategically designed within each of the six medical models to allow high-resolution caliper measurements. An 8-cc reference cube was printed as the 7th model in the primary study. In the secondary study, the effect of model rotation and scale was assessed using two of the models from the first study. All models were 3D printed using an Ultimaker 3 printer in triplicates. All absolute measurement errors were found to be less than 1 mm with a maximum error of 0.89 mm. The maximum relative error was 2.78%. The average absolute error was 0.26 mm, and the average relative error was 0.71% in the primary study, and the results were similar in the secondary study with an average absolute error of 0.30 mm and an average relative error of 0.60%. The relative errors demonstrated certain patterns in the data, which were explained based on the mechanics of MEX 3D printing. Results indicate that the MEX process, when carefully assessed on a case-by-case basis, could be suitable for the 3D printing of multi-pathological anatomical models for surgical planning if an accuracy level of 1 mm is deemed sufficient for the application.
Collapse
Affiliation(s)
- Prashanth Ravi
- Department of Radiology, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH, 45219, USA.
| | - Leonid L Chepelev
- Department of Radiology, Stanford University, 300 Pasteur Dr, Stanford, CA, 94305, USA
| | - Gabrielle V Stichweh
- 1819 Innovation Hub Makerspace, University of Cincinnati, 2900 Reading Rd, Cincinnati, OH, 45206, USA
| | - Benjamin S Jones
- 1819 Innovation Hub Makerspace, University of Cincinnati, 2900 Reading Rd, Cincinnati, OH, 45206, USA
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH, 45219, USA
| |
Collapse
|
12
|
Pelvic Endoprosthesis after Hemipelvectomy Using a 3D-Printed Osteotomy Guide for Infiltrative Osteoma in a Cat. Vet Sci 2022; 9:vetsci9050237. [PMID: 35622765 PMCID: PMC9143148 DOI: 10.3390/vetsci9050237] [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: 04/04/2022] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 11/17/2022] Open
Abstract
With the development of 3D printing and surgical techniques, various defect reconstruction methods after tumor resection have been applied not only in humans but also in veterinary medicine. This report describes a case of reconstruction after hemipelvectomy for an osteoma in a cat using a 3D-printed pelvic endoprosthesis and micro total hip replacement (mTHR). A 5-year-old spayed female Turkish Angora cat was referred for a 1-month history of constipation and intermittent weight-bearing lameness in the left hindlimb. An osteoma in the pelvis measuring 4.5 × 3 × 5.4 cm was identified based on diagnostic examinations. A left mid-to-caudal partial and right caudal partial hemipelvectomy, and a left femoral head and neck osteotomy, were planned to remove the mass. Reconstruction of the bone defect using 3D-printed metal endoprosthesis and mTHR in the left hindlimb was intended. During right caudal partial hemipelvectomy, right femoral head and neck osteotomy was performed because there was infiltration in the medial wall of the acetabulum. Histopathological examination confirmed the diagnosis of an osteoma. Two weeks post-surgery, surgical debridement and femoral stem removal were performed because of delayed wound healing and sciatic neurapraxia, leading to femoral stem dislocation from the cup. The delayed wound healing and sciatic neurapraxia were appropriately addressed. The cat regained normal weight and defecation 4 weeks post-operatively. Two years post-surgery, the patient recovered with an almost normal gait. Hemipelvectomy with 3D-printed endoprosthesis provides a safe surgical option with favorable outcomes for neoplasms in the pelvis of cats.
Collapse
|
13
|
Zhang N, Singh S, Liu S, Zbijewski W, Grayson WL. A robust, autonomous, volumetric quality assurance method for 3D printed porous scaffolds. 3D Print Med 2022; 8:9. [PMID: 35384521 PMCID: PMC8988331 DOI: 10.1186/s41205-022-00135-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/12/2022] [Indexed: 12/03/2022] Open
Abstract
Bone tissue engineering strategies aimed at treating critical-sized craniofacial defects often utilize novel biomaterials and scaffolding. Rapid manufacturing of defect-matching geometries using 3D-printing strategies is a promising strategy to treat craniofacial bone loss to improve aesthetic and regenerative outcomes. To validate manufacturing quality, a robust, three-dimensional quality assurance pipeline is needed to provide an objective, quantitative metric of print quality if porous scaffolds are to be translated from laboratory to clinical settings. Previously published methods of assessing scaffold print quality utilized one- and two-dimensional measurements (e.g., strut widths, pore widths, and pore area) or, in some cases, the print quality of a single phantom is assumed to be representative of the quality of all subsequent prints. More robust volume correlation between anatomic shapes has been accomplished; however, it requires manual user correction in challenging cases such as porous objects like bone scaffolds. Here, we designed porous, anatomically-shaped scaffolds with homogenous or heterogenous porous structures. We 3D-printed the designs with acrylonitrile butadiene styrene (ABS) and used cone-beam computed tomography (CBCT) to obtain 3D image reconstructions. We applied the iterative closest point algorithm to superimpose the computational scaffold designs with the CBCT images to obtain a 3D volumetric overlap. In order to avoid false convergences while using an autonomous workflow for volumetric correlation, we developed an independent iterative closest point (I-ICP10) algorithm using MATLAB®, which applied ten initial conditions for the spatial orientation of the CBCT images relative to the original design. Following successful correlation, scaffold quality can be quantified and visualized on a sub-voxel scale for any part of the volume.
Collapse
Affiliation(s)
- Nicholas Zhang
- Department of Biomedical Engineering, Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA.,Translational Tissue Engineering Center, Johns Hopkins University, Baltimore, MD, USA
| | - Srujan Singh
- Translational Tissue Engineering Center, Johns Hopkins University, Baltimore, MD, USA.,Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Stephen Liu
- Department of Biomedical Engineering, Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA
| | - Wojciech Zbijewski
- Department of Biomedical Engineering, Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA
| | - Warren L Grayson
- Department of Biomedical Engineering, Translational Tissue Engineering Center, Johns Hopkins University, 400 North Broadway, Smith Building 5023, Baltimore, MD, 21231, USA. .,Translational Tissue Engineering Center, Johns Hopkins University, Baltimore, MD, USA. .,Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA. .,Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, MD, USA. .,Institute for Nanobiotechnology, Johns Hopkins University, Baltimore, MD, USA.
| |
Collapse
|
14
|
Meyer-Szary J, Luis MS, Mikulski S, Patel A, Schulz F, Tretiakow D, Fercho J, Jaguszewska K, Frankiewicz M, Pawłowska E, Targoński R, Szarpak Ł, Dądela K, Sabiniewicz R, Kwiatkowska J. The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals-Cross-Sectional Multispecialty Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3331. [PMID: 35329016 PMCID: PMC8953417 DOI: 10.3390/ijerph19063331] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/18/2022] [Accepted: 03/05/2022] [Indexed: 12/19/2022]
Abstract
Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and education, development of surgical guides and other tools, patient-specific implants, bioprinted organs or structures, and counseling of patients. It was evident that pre-procedural planning and rehearsing of unusual or difficult procedures and training of medical professionals in these procedures are extremely useful and transformative.
Collapse
Affiliation(s)
- Jarosław Meyer-Szary
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Marlon Souza Luis
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- First Doctoral School, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Szymon Mikulski
- Department of Head and Neck Surgery, Singapore General Hospital, Singapore 169608, Singapore
| | - Agastya Patel
- First Doctoral School, Medical University of Gdańsk, 80-211 Gdańsk, Poland
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Finn Schulz
- University Clinical Centre in Gdańsk, 80-952 Gdańsk, Poland
| | - Dmitry Tretiakow
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Justyna Fercho
- Neurosurgery Department, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Kinga Jaguszewska
- Department of Gynecology, Obstetrics and Neonatology, Division of Gynecology and Obstetrics, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Mikołaj Frankiewicz
- Department of Urology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Ewa Pawłowska
- Department of Oncology and Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Radosław Targoński
- 1st Department of Cardiology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Łukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, Poland
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Katarzyna Dądela
- Department of Pediatric Cardiology, University Children's Hospital, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Robert Sabiniewicz
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Joanna Kwiatkowska
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| |
Collapse
|
15
|
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.
Collapse
|
16
|
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.
Collapse
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.)
| |
Collapse
|
17
|
Mei K, Geagan M, Roshkovan L, Litt HI, Gang GJ, Shapira N, Stayman JW, Noël PB. Three-dimensional printing of patient-specific lung phantoms for CT imaging: Emulating lung tissue with accurate attenuation profiles and textures. Med Phys 2021; 49:825-835. [PMID: 34910309 DOI: 10.1002/mp.15407] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Phantoms are a basic tool for assessing and verifying performance in CT research and clinical practice. Patient-based realistic lung phantoms accurately representing textures and densities are essential in developing and evaluating novel CT hardware and software. This study introduces PixelPrint, a 3D printing solution to create patient-based lung phantoms with accurate attenuation profiles and textures. METHODS PixelPrint, a software tool, was developed to convert patient digital imaging and communications in medicine (DICOM) images directly into FDM printer instructions (G-code). Density was modeled as the ratio of filament to voxel volume to emulate attenuation profiles for each voxel, with the filament ratio controlled through continuous modification of the printing speed. A calibration phantom was designed to determine the mapping between filament line width and Hounsfield units (HU) within the range of human lungs. For evaluation of PixelPrint, a phantom based on a single human lung slice was manufactured and scanned with the same CT scanner and protocol used for the patient scan. Density and geometrical accuracy between phantom and patient CT data were evaluated for various anatomical features in the lung. RESULTS For the calibration phantom, measured mean HU show a very high level of linear correlation with respect to the utilized filament line widths, (r > 0.999). Qualitatively, the CT image of the patient-based phantom closely resembles the original CT image both in texture and contrast levels (from -800 to 0 HU), with clearly visible vascular and parenchymal structures. Regions of interest comparing attenuation illustrated differences below 15 HU. Manual size measurements performed by an experienced thoracic radiologist reveal a high degree of geometrical correlation of details between identical patient and phantom features, with differences smaller than the intrinsic spatial resolution of the scans. CONCLUSION The present study demonstrates the feasibility of 3D-printed patient-based lung phantoms with accurate organ geometry, image texture, and attenuation profiles. PixelPrint will enable applications in the research and development of CT technology, including further development in radiomics.
Collapse
Affiliation(s)
- Kai Mei
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael Geagan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Leonid Roshkovan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Harold I Litt
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Grace J Gang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nadav Shapira
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - J Webster Stayman
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Peter B Noël
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, München, Germany
| |
Collapse
|
18
|
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.
Collapse
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.
| |
Collapse
|
19
|
Wake N, Rosenkrantz AB, Huang WC, Wysock JS, Taneja SS, Sodickson DK, Chandarana H. A workflow to generate patient-specific three-dimensional augmented reality models from medical imaging data and example applications in urologic oncology. 3D Print Med 2021; 7:34. [PMID: 34709482 PMCID: PMC8554989 DOI: 10.1186/s41205-021-00125-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/03/2021] [Indexed: 01/12/2023] Open
Abstract
Augmented reality (AR) and virtual reality (VR) are burgeoning technologies that have the potential to greatly enhance patient care. Visualizing patient-specific three-dimensional (3D) imaging data in these enhanced virtual environments may improve surgeons' understanding of anatomy and surgical pathology, thereby allowing for improved surgical planning, superior intra-operative guidance, and ultimately improved patient care. It is important that radiologists are familiar with these technologies, especially since the number of institutions utilizing VR and AR is increasing. This article gives an overview of AR and VR and describes the workflow required to create anatomical 3D models for use in AR using the Microsoft HoloLens device. Case examples in urologic oncology (prostate cancer and renal cancer) are provided which depict how AR has been used to guide surgery at our institution.
Collapse
Affiliation(s)
- Nicole Wake
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. .,Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA.
| | - Andrew B Rosenkrantz
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - William C Huang
- Department of Urology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - James S Wysock
- Department of Urology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Samir S Taneja
- Department of Urology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Daniel K Sodickson
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Hersh Chandarana
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| |
Collapse
|
20
|
Kairn T, Talkhani S, Charles PH, Chua B, Lin CY, Livingstone AG, Maxwell SK, Poroa T, Simpson-Page E, Spelleken E, Vo M, Crowe SB. Determining tolerance levels for quality assurance of 3D printed bolus for modulated arc radiotherapy of the nose. Phys Eng Sci Med 2021; 44:1187-1199. [PMID: 34529247 DOI: 10.1007/s13246-021-01054-7] [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] [Received: 04/27/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
Given the existing literature on the subject, there is obviously a need for specific advice on quality assurance (QA) tolerances for departments using or implementing 3D printed bolus for radiotherapy treatments. With a view to providing initial suggested QA tolerances for 3D printed bolus, this study evaluated the dosimetric effects of changes in bolus geometry and density, for a particularly common and challenging clinical situation: specifically, volumetric modulated arc therapy (VMAT) treatment of the nose. Film-based dose verification measurements demonstrated that both the AAA and the AXB algorithms used by the Varian Eclipse treatment planning system (Varian Medical Systems, Palo Alto, USA) were capable of providing sufficiently accurate dose calculations to allow this planning system to be used to evaluate the effects of bolus errors on dose distributions from VMAT treatments of the nose. Thereafter, the AAA and AXB algorithms were used to calculate the dosimetric effects of applying a range of simulated errors to the design of a virtual bolus, to identify QA tolerances that could be used to avoid clinically significant effects from common printing errors. Results were generally consistent, whether the treatment target was superficial and treated with counter-rotating coplanar arcs or more-penetrating and treated with noncoplanar arcs, and whether the dose was calculated using the AAA algorithm or the AXB algorithm. The results of this study suggest the following QA tolerances are advisable, when 3D printed bolus is fabricated for use in photon VMAT treatments of the nose: bolus relative electron density variation within [Formula: see text] (although an action level at [Formula: see text] may be permissible); bolus thickness variation within [Formula: see text] mm (or 0.5 mm variation on opposite sides); and air gap between bolus and skin [Formula: see text] mm. These tolerances should be investigated for validity with respect to other treatment modalities and anatomical sites. This study provides a set of baselines for future comparisons and a useful method for identifying additional or alternative 3D printed bolus QA tolerances.
Collapse
Affiliation(s)
- T Kairn
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. .,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia. .,School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, QLD, Australia. .,School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD, Australia.
| | - S Talkhani
- School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD, Australia
| | - P H Charles
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia.,School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, QLD, Australia.,School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD, Australia
| | - B Chua
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - C Y Lin
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - A G Livingstone
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - S K Maxwell
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - T Poroa
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - E Simpson-Page
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - E Spelleken
- GenesisCare Rockhampton, Rockhampton Hospital, Rockhampton, QLD, Australia
| | - M Vo
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - S B Crowe
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia.,School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, QLD, Australia.,School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD, Australia
| |
Collapse
|
21
|
Menshutina N, Abramov A, Tsygankov P, Lovskaya D. Extrusion-Based 3D Printing for Highly Porous Alginate Materials Production. Gels 2021; 7:gels7030092. [PMID: 34287289 PMCID: PMC8293155 DOI: 10.3390/gels7030092] [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: 05/24/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 12/21/2022] Open
Abstract
Three-dimensional (3D) printing is a promising technology for solving a wide range of problems: regenerative medicine, tissue engineering, chemistry, etc. One of the potential applications of additive technologies is the production of highly porous structures with complex geometries, while printing is carried out using gel-like materials. However, the implementation of precise gel printing is a difficult task due to the high requirements for “ink”. In this paper, we propose the use of gel-like materials based on sodium alginate as “ink” for the implementation of the developed technology of extrusion-based 3D printing. Rheological studies were carried out for the developed alginate ink compositions. The optimal rheological properties are gel-like materials based on 2 wt% sodium alginate and 0.2 wt% calcium chloride. The 3D-printed structures with complex geometry were successfully dried using supercritical drying. The resulting aerogels have a high specific surface area (from 350 to 422 m2/g) and a high pore volume (from 3 to 3.78 cm3/g).
Collapse
|
22
|
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.
Collapse
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.)
| |
Collapse
|
23
|
Complex Bone Tumors of the Trunk-The Role of 3D Printing and Navigation in Tumor Orthopedics: A Case Series and Review of the Literature. J Pers Med 2021; 11:jpm11060517. [PMID: 34200075 PMCID: PMC8228871 DOI: 10.3390/jpm11060517] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/28/2021] [Accepted: 06/01/2021] [Indexed: 02/07/2023] Open
Abstract
The combination of 3D printing and navigation promises improvements in surgical procedures and outcomes for complex bone tumor resection of the trunk, but its features have rarely been described in the literature. Five patients with trunk tumors were surgically treated in our institution using a combination of 3D printing and navigation. The main process includes segmentation, virtual modeling and build preparation, as well as quality assessment. Tumor resection was performed with navigated instruments. Preoperative planning supported clear margin multiplanar resections with intraoperatively adaptable real-time visualization of navigated instruments. The follow-up ranged from 2–15 months with a good functional result. The present results and the review of the current literature reflect the trend and the diverse applications of 3D printing in the medical field. 3D printing at hospital sites is often not standardized, but regulatory aspects may serve as disincentives. However, 3D printing has an increasing impact on precision medicine, and we are convinced that our process represents a valuable contribution in the context of patient-centered individual care.
Collapse
|
24
|
Haleem A, Javaid M, Suman R, Singh RP. 3D Printing Applications for Radiology: An Overview. Indian J Radiol Imaging 2021; 31:10-17. [PMID: 34316106 PMCID: PMC8299499 DOI: 10.1055/s-0041-1729129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Three-dimensional (3D) printing technologies are part of additive manufacturing processes and are used to manufacture a 3D physical model from a digital computer-aided design model as per the required shape and size. These technologies are now used for advanced radiology applications by providing all information through 3D physical model. It provides innovation in radiology for clinical applications, treatment planning, procedural simulation, medical and patient education. Radiological advancements have been made in diagnosis and communication through medical digital imaging techniques like computed tomography, magnetic resonance imaging. These images are converted into Digital Imaging and Communications in Medicine in Standard Triangulate Language file format, easily printable in 3D printing technologies. This 3D model provides in-depth information about pathologic and anatomic states. It is useful to create new opportunities related to patient care. This article discusses the potential of 3D printing technology in radiology. The steps involved in 3D printing for radiology are discussed diagrammatically, and finally identified 12 significant applications of 3D printing technology for radiology with a brief description. A radiologist can incorporate this technology to fulfil different challenges such as training, planning, guidelines, and better communications.
Collapse
Affiliation(s)
- Abid Haleem
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Rajiv Suman
- Department of Industrial and Production Engineering, G.B. Pant University of Agriculture and Technology, Pantnagar, Uttarakhand, India
| | - Ravi Pratap Singh
- Department of Industrial and Production Engineering, Dr. B. R. Ambedkar National Institute of Technology, Jalandhar, Punjab, India
| |
Collapse
|
25
|
Abstract
Magnetic resonance (MR) imaging is a crucial tool for evaluation of the skull base, enabling characterization of complex anatomy by utilizing multiple image contrasts. Recent technical MR advances have greatly enhanced radiologists' capability to diagnose skull base pathology and help direct management. In this paper, we will summarize cutting-edge clinical and emerging research MR techniques for the skull base, including high-resolution, phase-contrast, diffusion, perfusion, vascular, zero echo-time, elastography, spectroscopy, chemical exchange saturation transfer, PET/MR, ultra-high-field, and 3D visualization. For each imaging technique, we provide a high-level summary of underlying technical principles accompanied by relevant literature review and clinical imaging examples.
Collapse
Affiliation(s)
- Claudia F Kirsch
- Division Chief, Neuroradiology, Professor of Neuroradiology and Otolaryngology, Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine at Northwell, North Shore University Hospital, Manhasset, NY
| | - Mai-Lan Ho
- Associate Professor of Radiology, Director of Research, Department of Radiology, Director, Advanced Neuroimaging Core, Chair, Asian Pacific American Network, Secretary, Association for Staff and Faculty Women, Nationwide Children's Hospital and The Ohio State University, Columbus, OH; Division Chief, Neuroradiology, Professor of Neuroradiology and Otolaryngology, Department of Radiology, Northwell Health, Zucker Hofstra School of Medicine at Northwell, North Shore University Hospital, Manhasset, NY.
| |
Collapse
|
26
|
Ravi P, Chepelev L, Lawera N, Haque KMA, Chen VCP, Ali A, Rybicki FJ. A systematic evaluation of medical 3D printing accuracy of multi-pathological anatomical models for surgical planning manufactured in elastic and rigid material using desktop inverted vat photopolymerization. Med Phys 2021; 48:3223-3233. [PMID: 33733499 DOI: 10.1002/mp.14850] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/12/2021] [Accepted: 03/12/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE The dimensional accuracy of three-dimensional (3D) printed anatomical models is essential to correctly understand spatial relationships and enable safe presurgical planning. Most recent accuracy studies focused on 3D printing of a single pathology for surgical planning. This study evaluated the accuracy of medical models across multiple pathologies, using desktop inverted vat photopolymerization (VP) to 3D print anatomic models using both rigid and elastic materials. METHODS In the primary study, we 3D printed seven models (six anatomic models and one reference cube) with volumes ranging from ~2 to ~209 cc. The anatomic models spanned multiple pathologies (neurological, cardiovascular, abdominal, musculoskeletal). Two solid measurement landing blocks were strategically created around the pathology to allow high-resolution measurement using a digital micrometer and/or caliper. The physical measurements were compared to the designed dimensions, and further analysis was conducted regarding the observed patterns in accuracy. All of the models were printed in three resins: Elastic, Clear, and Grey Pro in the primary experiments. A full factorial block experimental design was employed and a total of 42 models were 3D printed in 21 print runs. In the secondary study, we 3D printed two of the anatomic models in triplicates selected from the previous six to evaluate the effect of 0.1 mm vs 0.05 mm layer height on the accuracy. RESULTS In the primary experiment, all dimensional errors were less than 1 mm. The average dimensional error across the 42 models was 0.238 ± 0.219 mm and the relative error was 1.10 ± 1.13%. Results from the secondary experiments were similar with an average dimensional error of 0.252 ± 0.213 mm and relative error of 1.52% ± 1.28% across 18 models. There was a statistically significant difference in the relative errors between the Elastic resin and Clear resin groups. We explained this difference by evaluating inverted VP 3D printing peel forces. There was a significant difference between the Solid and Hollow group of models. There was a significant difference between measurement landing blocks oriented Horizontally and Vertically. In the secondary experiments, there was no difference in accuracy between the 0.10 and 0.05 mm layer heights. CONCLUSIONS The maximum measured error was less than 1 mm across all models, and the mean error was less than 0.26mm. Therefore, inverted VP 3D printing technology is suitable for medical 3D printing if 1 mm is considered the cutoff for clinical use cases. The 0.1 mm layer height is suitable for 3D printing accurate anatomical models for presurgical planning in a majority of cases. Elastic models, models oriented horizontally, and models that are hollow tend to have relatively higher deviation as seen from experimental results and mathematical model predictions. While clinically insignificant using a 1 mm cutoff, further research is needed to better understand the complex physical interactions in VP 3D printing which influence model accuracy.
Collapse
Affiliation(s)
- Prashanth Ravi
- Department of Radiology, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH, 45219, USA
| | - Leonid Chepelev
- Department of Radiology, Stanford University, 300 Pasteur Dr, Stanford, CA, 94305, USA
| | - Nathan Lawera
- Department of Radiology, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH, 45219, USA
| | - Khan Md Ariful Haque
- Department of Industrial, Manufacturing and Systems Engineering, University of Texas at Arlington, 500 West First St, Arlington, TX, 76019, USA
| | - Victoria C P Chen
- Department of Industrial, Manufacturing and Systems Engineering, University of Texas at Arlington, 500 West First St, Arlington, TX, 76019, USA
| | - Arafat Ali
- Department of Radiology, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH, 45219, USA
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati College of Medicine, 234 Goodman St, Cincinnati, OH, 45219, USA
| |
Collapse
|
27
|
Omigbodun A, Vaishnav JY, Hsieh SS. Rapid measurement of the low contrast detectability of CT scanners. Med Phys 2021; 48:1054-1063. [PMID: 33325033 PMCID: PMC8058889 DOI: 10.1002/mp.14657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/07/2020] [Accepted: 11/30/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Low contrast detectability (LCD) is a metric of fundamental importance in computed tomography (CT) imaging. In spite of this, its measurement is challenging in the context of nonlinear data processing. We introduce a new framework for objectively characterizing LCD with a single scan of a special-purpose phantom and automated analysis software. The output of the analysis software is a "machine LCD" metric which is more representative of LCD than contrast-noise ratio (CNR). It is not intended to replace human observer or model observer studies. METHODS Following preliminary simulations, we fabricated a phantom containing hundreds of low-contrast beads. These beads are acrylic spheres (1.6 mm, net contrast ~10 HU) suspended and randomly dispersed in a background matrix of nylon pellets and isoattenuating saline. The task was to search for and localize the beads. A modified matched filter was used to automatically scan the reconstruction and select candidate bead localizations of varying confidence. These were compared to bead locations as determined from a high-dose reference scan to produce free-response ROC curves. We compared iterative reconstruction (IR) and filtered backpropagation (FBP) at multiple dose levels between 40 and 240 mAs. The scans at 60, 120, and 180 mAs were performed three times each to estimate uncertainty. RESULTS Experimental scans demonstrated the feasibility of our technique. Our metric for machine LCD was the area under the exponential transform of the FROC curve (AUC). AUC increased monotonically from 0.21 at 40 mAs to 0.84 at 240 mAs. The sample standard deviation of AUC was approximately 0.02. This measurement uncertainty in AUC corresponded to a change in tube current of 4% to 8%. Surprisingly, we found that AUCs for IR were slightly worse than AUCs for FBP. While the phantom was sufficient for these experiments, it contained small air bubbles and alternative fabrication methods will be necessary for widespread utilization. CONCLUSIONS It is feasible to measure machine LCD using a search task on a phantom with hundreds of beads and to obtain tight error bars using only a single scan. Our method could facilitate routine quality assurance or possibly enable comparisons between different protocols and scanners.
Collapse
Affiliation(s)
| | | | - Scott S. Hsieh
- Department of Radiological Sciences, UCLA, Los Angeles, CA 90024, USA
- Department of Radiology, Mayo Clinic, Rochester, MN 55902, USA
| |
Collapse
|
28
|
Cantré D, Langner S, Kaule S, Siewert S, Schmitz KP, Kemmling A, Weber MA. Three-dimensional imaging and three-dimensional printing for plastic preparation of medical interventions. Radiologe 2021; 60:70-79. [PMID: 32926194 DOI: 10.1007/s00117-020-00739-6] [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: 11/29/2022]
Abstract
Three-dimensional (3D) imaging has been available for nearly four decades and is regarded as state of the art for visualization of anatomy and pathology and for procedure planning in many clinical fields. Together with 3D image reconstructions in the form of rendered virtual 3D models, it has helped to better perceive complex anatomic and pathologic relations, improved preprocedural measuring and sizing of implants, and nowadays enables even photorealistic quality. However, presentation on 2D displays limits the 3D experience. Novel 3D printing technologies can transfer virtual anatomic models into true 3D space and produce both patient-specific models and medical devices constructed by computer-aided design. Individualized anatomic models hold great potential for medical and patient education, research, device development and testing, procedure training, preoperative planning, and fabrication of individualized instruments and implants. Hand in hand with 3D imaging, medical 3D printing has started to revolutionize medicine in certain fields and new applications are developed and introduced regularly. The demand for medical 3D printing will likely continue to rise, as it is a promising tool for plastic preparation of medical interventions. However, there is ongoing debate on the appropriateness of medical 3D printing and further research on its efficiency is needed. As experts in 3D imaging, radiologists are not only capable of advising on adequate imaging parameters, but should also become adept in 3D printing to participate in on-site 3D printing facilities and randomized controlled trials on the topic, thus contributing to improving patient outcomes via personalized medicine through patient-specific preparation of medical interventions.
Collapse
Affiliation(s)
- Daniel Cantré
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Ernst-Heydemann-Str. 6, 18057, Rostock, Mecklenburg Western Pomerania, Germany.
| | - Sönke Langner
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Ernst-Heydemann-Str. 6, 18057, Rostock, Mecklenburg Western Pomerania, Germany
| | - Sebastian Kaule
- Institute for Implant Technology and Biomaterials e. V., associated Institution of the University of Rostock, Friedrich-Barnewitz-Straße 4, 18119, Rostock-Warnemünde, Germany
| | - Stefan Siewert
- Institute for Implant Technology and Biomaterials e. V., associated Institution of the University of Rostock, Friedrich-Barnewitz-Straße 4, 18119, Rostock-Warnemünde, Germany
| | - Klaus-Peter Schmitz
- Institute for Implant Technology and Biomaterials e. V., associated Institution of the University of Rostock, Friedrich-Barnewitz-Straße 4, 18119, Rostock-Warnemünde, Germany.,Institute for Biomedical Engineering, Rostock University Medical Center, Friedrich-Barnewitz-Straße 4, 18119, Rostock-Warnemünde, Germany
| | - André Kemmling
- Institute of Neuroradiology, University Hospital Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Ernst-Heydemann-Str. 6, 18057, Rostock, Mecklenburg Western Pomerania, Germany
| |
Collapse
|
29
|
Xiao M, Zhang M, Lei M, Hu X, Wang Q, Chen Y, Ye J, Xu R, Chen J. Application of ultra-low-dose CT in 3D printing of distal radial fractures. Eur J Radiol 2020; 135:109488. [PMID: 33385624 DOI: 10.1016/j.ejrad.2020.109488] [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] [Received: 09/21/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To explore the effect of ultra-low-dose computed tomography (CT) on three-dimensional (3D) printing models and the diagnosis of wrist fractures. METHOD This study enrolled 76 patients with distal radial fractures (DRFs). All patients underwent 320-row detector CT and were divided randomly into two groups. In Group A, 38 patients were scanned with the standard-dose protocol using a tube voltage of 120 kV and current of 100 mA. In Group B, 38 patients were scanned with the ultra-low-dose protocol using a tube voltage of 80 kV and current of 10 mA. For objective image quality assessment, the noise, CT number, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured. Subjectively, two experienced orthopaedic surgeons blinded to the scan parameters evaluated the clarity of the 3D printing model and fracture line using a 3-point scale (the diagnosis was considered acceptable with scores ≥2). The mean radiation dose was calculated. The diagnostic performances for the fractures between the two groups were compared. RESULTS The effective radiation dose was significantly reduced by 97.1 % in Group B, compared to Group A (0.28 ± 0.05vs. 9.75 ± 2.23 μSv, respectively). Quantitative objective image quality parameters (e.g., CNR, SNR, and CT numbers) were higher in the standard-dose group (p < 0.001). However, there was no difference in subjective scoring of the 3D printing model. Although the fracture line score was higher in Group A (2.92±0.27 vs. 2.16 ± 0.37; p < 0.001), the diagnostic performance of the two groups was consistent (all scores ≥2). There were no statistically significant differences in the sensitivity, specificity or accuracy between standard-dose group and ultra-low-dose group. CONCLUSIONS The ultra-low-dose protocol effectively reduced the radiation dose by 97.1 %, while maintaining the image quality for diagnosis of DRFs. Therefore, this protocol can meet the needs of 3D printing models for preoperative assessments.
Collapse
Affiliation(s)
- Mengqiang Xiao
- Department of Radiology, Zhuhai Hospital, Guangdong Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China.
| | - Meng Zhang
- Department of Radiology, Zhuhai Hospital, Guangdong Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China.
| | - Ming Lei
- Department of Radiology, Zhuhai Hospital, Guangdong Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China.
| | - Xiaolu Hu
- Department of Radiology, Zhuhai Hospital, Guangdong Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China.
| | - Qingshan Wang
- Department of Radiology, Zhuhai Hospital, Guangdong Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China.
| | - Yanxia Chen
- Department of Radiology, Zhuhai Hospital, Guangdong Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China.
| | - Jingzhi Ye
- Department of Radiology, Zhuhai Hospital, Guangdong Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China.
| | - Rulin Xu
- Radiology Group, Canon Medical Systems(China) Co., LTD, Rm 2906, R&F Centre, No.10 Huaxia Road, Guangzhou City, Guangdong Province, China.
| | - Jun Chen
- Department of Radiology, Zhuhai Hospital, Guangdong Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China.
| |
Collapse
|
30
|
Hsu CP, Lin CS, Fan CH, Chiang NY, Tsai CW, Chang CM, Liu IL. Geometric accuracy of an acrylonitrile butadiene styrene canine tibia model fabricated using fused deposition modelling and the effects of hydrogen peroxide gas plasma sterilisation. BMC Vet Res 2020; 16:478. [PMID: 33298063 PMCID: PMC7724725 DOI: 10.1186/s12917-020-02691-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/23/2020] [Indexed: 12/03/2022] Open
Abstract
Background Three-dimensional (3D) printing techniques have been used to produce anatomical models and surgical guiding instruments in orthopaedic surgery. The geometric accuracy of the 3D printed replica may affect surgical planning. This study assessed the geometric accuracy of an acrylonitrile butadiene styrene (ABS) canine tibia model printed using fused deposition modelling (FDM) and evaluated its morphological change after hydrogen peroxide (H2O2) gas plasma sterilisation. The tibias of six canine cadavers underwent computed tomography for 3D reconstruction. Tibia models were fabricated from ABS on a 3D printer through FDM. Reverse-engineering technology was used to compare morphological errors (root mean square; RMS) between the 3D-FDM models and virtual models segmented from original tibia images (3D-CT) and between the models sterilised with H2O2 gas plasma (3D-GAS) and 3D-FDM models on tibia surface and in cross-sections at: 5, 15, 25, 50, 75, 85, and 95% of the tibia length. Results The RMS mean ± standard deviation and average positive and negative deviation values for all specimens in EFDM-CT (3D-FDM vs. 3D-CT) were significantly higher than those in EGAS-FDM (3D-GAS vs. 3D-FDM; P < 0.0001). Mean RMS values for EFDM-CT at 5% bone length (proximal tibia) were significantly higher than those at the other six cross-sections (P < 0.0001). Mean RMS differences for EGAS-FDM at all seven cross-sections were nonsignificant. Conclusions The tibia models fabricated on an FDM printer had high geometric accuracy with a low RMS value. The surface deviation in EFDM-CT indicated that larger errors occurred during manufacturing than during sterilisation. Therefore, the model may be used for surgical rehearsal and further clinically relevant applications in bone surgery. Graphical abstract ![]()
Collapse
Affiliation(s)
- Chi-Pin Hsu
- High Speed 3D Printing Research Center, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Chen-Si Lin
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Chun-Hao Fan
- Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Nai-Yuan Chiang
- National Applied Research Laboratories, Taiwan Instrument Research Institute, Hsinchu, Taiwan
| | - Ching-Wen Tsai
- National Applied Research Laboratories, Taiwan Instrument Research Institute, Hsinchu, Taiwan
| | - Chun-Ming Chang
- National Applied Research Laboratories, Taiwan Instrument Research Institute, Hsinchu, Taiwan
| | - I-Li Liu
- Department and Graduate Institute of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan. .,Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
31
|
Kamio T, Suzuki M, Asaumi R, Kawai T. DICOM segmentation and STL creation for 3D printing: a process and software package comparison for osseous anatomy. 3D Print Med 2020; 6:17. [PMID: 32737703 PMCID: PMC7393875 DOI: 10.1186/s41205-020-00069-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/10/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Extracting and three-dimensional (3D) printing an organ in a region of interest in DICOM images typically calls for segmentation as a first step in support of 3D printing. The DICOM images are not exported to STL data immediately, but segmentation masks are exported to STL models. After primary and secondary processing, including noise removal and hole correction, the STL data can be 3D printed. The quality of the 3D model is directly related to the quality of the STL data. This study focuses and reports on the DICOM to STL segmentation performance for nine software packages. METHODS Multidetector row CT scanning was performed on a dry human mandible with two 10-mm-diameter bearing balls as a phantom. The DICOM image file was then segmented and exported to an STL file using nine different commercial/open-source software packages. Once the STL models were created, the data (file) properties and the size and volume of each file were measured, and differences across the software packages were noted. Additionally, to evaluate differences between the shapes of the STL models by software package, each pair of STL models was superimposed, with the observed differences between their shapes characterized as the shape error. RESULTS The data (file) size of the STL file and the number of triangles that constitute each STL model were different across all software packages, but no statistically significant differences were found across software packages. The created ball STL model expanded in the X-, Y-, and Z-axis directions, with the length in the Z-axis direction (body axis direction) being slightly longer than that in the other directions. The mean shape error between software packages of the mandibular STL model was 0.11 mm, but there was no statistically significant difference between them. CONCLUSIONS Our results revealed that there are some differences between the software packages that perform the segmentation and STL creation of the DICOM image data. In particular, the features of each software package appeared in the fine and thin areas of the osseous structures. When using these software packages, it is necessary to understand the characteristics of each.
Collapse
Affiliation(s)
- Takashi Kamio
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University, 1-9-20 Fujimi-cho, Chiyoda-ku, Tokyo, 102-8159 Japan
| | - Madoka Suzuki
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University, 1-9-20 Fujimi-cho, Chiyoda-ku, Tokyo, 102-8159 Japan
| | - Rieko Asaumi
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University, 1-9-20 Fujimi-cho, Chiyoda-ku, Tokyo, 102-8159 Japan
| | - Taisuke Kawai
- Department of Oral and Maxillofacial Radiology, The Nippon Dental University, 1-9-20 Fujimi-cho, Chiyoda-ku, Tokyo, 102-8159 Japan
| |
Collapse
|
32
|
Rivero Belenchón I, Congregado Ruíz CB, Gómez Ciriza G, Gómez Dos Santos V, Rivas González JA, Gálvez García C, González Gordaliza MC, Osmán García I, Conde Sánchez JM, Burgos Revilla FJ, Medina López RA. How to obtain a 3D printed model of renal cell carcinoma (RCC) with venous tumor thrombus extension (VTE) for surgical simulation (phase I NCT03738488). Updates Surg 2020; 72:1237-1246. [DOI: 10.1007/s13304-020-00806-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 05/18/2020] [Indexed: 11/28/2022]
|
33
|
Sharma N, Cao S, Msallem B, Kunz C, Brantner P, Honigmann P, Thieringer FM. Effects of Steam Sterilization on 3D Printed Biocompatible Resin Materials for Surgical Guides-An Accuracy Assessment Study. J Clin Med 2020; 9:jcm9051506. [PMID: 32429549 PMCID: PMC7291001 DOI: 10.3390/jcm9051506] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/07/2020] [Accepted: 05/14/2020] [Indexed: 12/13/2022] Open
Abstract
Computer-assisted surgery with three-dimensional (3D) printed surgical guides provides more accurate results than free-hand surgery. Steam sterilization could be one of the factors that affect the dimensions of surgical guide resin materials, leading to inaccuracies during surgeries. The purpose of this study was to evaluate the effects of steam sterilization on the dimensional accuracy of indication-specific hollow cube test bodies, manufactured in-house using Class IIa biocompatible resin materials (proprietary and third-party). To evaluate the pre- and post-sterilization dimensional accuracy, root mean square (RMS) values were calculated. The results indicate that, in all the groups, steam sterilization resulted in an overall linear expansion of the photopolymeric resin material, with an increase in outer dimensions and a decrease in inner dimensions. The effects on the dimensional accuracy of test bodies were not statistically significant in all the groups, except PolyJet Glossy (p > 0.05). The overall pre- and post-sterilization RMS values were below 100 and 200 µm, respectively. The highest accuracies were seen in proprietary resin materials, i.e., PolyJet Glossy and SLA-LT, in pre- and post-sterilization measurements, respectively. The dimensional accuracy of third-party resin materials, i.e., SLA-Luxa and SLA-NextDent, were within a comparable range as proprietary materials and can serve as an economical alternative.
Collapse
Affiliation(s)
- Neha Sharma
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland; (N.S.); (S.C.); (B.M.); (C.K.)
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 16, 4123 Allschwil, Switzerland; (P.B.); (P.H.)
| | - Shuaishuai Cao
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland; (N.S.); (S.C.); (B.M.); (C.K.)
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 16, 4123 Allschwil, Switzerland; (P.B.); (P.H.)
| | - Bilal Msallem
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland; (N.S.); (S.C.); (B.M.); (C.K.)
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 16, 4123 Allschwil, Switzerland; (P.B.); (P.H.)
| | - Christoph Kunz
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland; (N.S.); (S.C.); (B.M.); (C.K.)
| | - Philipp Brantner
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 16, 4123 Allschwil, Switzerland; (P.B.); (P.H.)
- Radiology Department, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland
| | - Philipp Honigmann
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 16, 4123 Allschwil, Switzerland; (P.B.); (P.H.)
- Hand Surgery, Cantonal Hospital Basel-land, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Florian M. Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland; (N.S.); (S.C.); (B.M.); (C.K.)
- Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Gewerbestrasse 16, 4123 Allschwil, Switzerland; (P.B.); (P.H.)
- Correspondence:
| |
Collapse
|
34
|
Weadock WJ. Quality Control in Medical 3D Printing. Acad Radiol 2020; 27:661-662. [PMID: 31879161 DOI: 10.1016/j.acra.2019.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Affiliation(s)
- W J Weadock
- Department of Radiology, University of Michigan Medical School, B1 D502C UMHS, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5030.
| |
Collapse
|
35
|
Galvez M, Montoya CE, Fuentes J, Rojas GM, Asahi T, Currie W, Kuflik M, Chahin A. Error Measurement Between Anatomical Porcine Spine, CT Images, and 3D Printing. Acad Radiol 2020; 27:651-660. [PMID: 31326309 DOI: 10.1016/j.acra.2019.06.016] [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: 02/20/2019] [Revised: 06/27/2019] [Accepted: 06/27/2019] [Indexed: 01/25/2023]
Abstract
RATIONALE AND OBJECTIVES 3D printers are increasingly used in medical applications such as surgical planning, creation of implants and prostheses, and medical education. For the creation of reliable 3D printed models of the vertebral column, processing must be performed on CT images. This processing must be assessed and validated so that any error of the printed model can be recognized and minimized. MATERIAL AND METHODS In order to perform this validation, 10 CT scans of porcine lumbar spinal vertebra were used, which were then dissected and scanned again. CT image processing was performed to obtain a mesh and perform 3D printing. RESULTS There was no statistical difference among the four different levels of vertebrae measurements (first CT images, second CT images, anatomical piece of porcine bone and 3D printing of porcine bone; One Way repeated measure ANOVA, F < F_crit, p value > α = 0.05). The Intraclass Correlation also revealed a mean intraclass correlation coefficient (3,1) = 0.9553, which describes the reliability of all four levels in addition to the reliability of the data between porcine samples subjected to different levels of measurement. This shows that the average error is less than 1 mm. CONCLUSIONS The measurements of models created with 3D printers using the pipeline described in this paper have an average error of 0.60 mm with CT images and 0.73 mm with anatomical piece. Thus, 3D printed models accurately reflect in vivo bones and provide accurate 3D impressions to assist in surgical planning.
Collapse
|
36
|
Replicating Skull Base Anatomy With 3D Technologies: A Comparative Study Using 3D-scanned and 3D-printed Models of the Temporal Bone. Otol Neurotol 2020; 41:e392-e403. [DOI: 10.1097/mao.0000000000002524] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
37
|
Clifton W, Damon A. The three‐dimensional printing renaissance of individualized anatomical modeling: Are we repeating history? Clin Anat 2020; 33:428-430. [DOI: 10.1002/ca.23545] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 12/12/2019] [Indexed: 12/12/2022]
Affiliation(s)
- William Clifton
- Department of Neurological SurgeryMayo Clinic Florida Jacksonville Florida
| | - Aaron Damon
- Department of Neurological SurgeryMayo Clinic Florida Jacksonville Florida
| |
Collapse
|
38
|
Day AL, Barger JB, Resuehr D. A Versatile, Low-Cost, Three-Dimensional-Printed Ultrasound Procedural Training Phantom of the Human Knee. EUROPEAN MEDICAL JOURNAL 2019. [DOI: 10.33590/emj/10310891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The use of musculoskeletal ultrasound is expanding in many medical disciplines, and simulation trainers have been successfully employed to help practitioners learn various ultrasound techniques. While there are fewer commercial trainers in musculoskeletal ultrasound than other ultrasound modalities, the ones that do exist can be prohibitively expensive. Several less expensive phantom trainers have been described in the literature, including those made of ballistic gelatine. The authors present a three-dimensional printed knee phantom that was overlaid with ballistic gelatine as a viable option for training.
Collapse
Affiliation(s)
- Alvin Lee Day
- Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - John Bradley Barger
- Department of Cell, Developmental and Integrative Biology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David Resuehr
- Department of Cell, Developmental and Integrative Biology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
39
|
Bose S, Traxel KD, Vu AA, Bandyopadhyay A. Clinical significance of three-dimensional printed biomaterials and biomedical devices. MRS BULLETIN 2019; 44:494-504. [PMID: 31371848 PMCID: PMC6675023 DOI: 10.1557/mrs.2019.121] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Three-dimensional printing (3DP) is becoming a standard manufacturing practice for a variety of biomaterials and biomedical devices. This layer-by-layer methodology provides the ability to fabricate parts from computer-aided design files without the need for part-specific tooling. Three-dimensional printed medical components have transformed the field of medicine through on-demand patient care with specialized treatment such as local, strategically timed drug delivery, and replacement of once-functioning body parts. Not only can 3DP technology provide individualized components, it also allows for advanced medical care, including surgical planning models to aid in training and provide temporary guides during surgical procedures for reinforced clinical success. Despite the advancement in 3DP technology, many challenges remain for forward progress, including sterilization concerns, reliability, and reproducibility. This article offers an overview of biomaterials and biomedical devices derived from metals, ceramics, polymers, and composites that can be three-dimensionally printed, as well as other techniques related to 3DP in medicine, including surgical planning, bioprinting, and drug delivery.
Collapse
Affiliation(s)
- Susmita Bose
- W.M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, USA
| | - Kellen D Traxel
- W.M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, USA
| | - Ashley A Vu
- W.M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, USA
| | - Amit Bandyopadhyay
- W.M. Keck Biomedical Materials Research Laboratory, School of Mechanical and Materials Engineering, Washington State University, USA
| |
Collapse
|
40
|
Park JM, Son J, An HJ, Kim JH, Wu HG, Kim JI. Bio-compatible patient-specific elastic bolus for clinical implementation. ACTA ACUST UNITED AC 2019; 64:105006. [DOI: 10.1088/1361-6560/ab1c93] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
41
|
Clifton W, Nottmeier E, Damon A, Dove C, Pichelmann M. The Future of Biomechanical Spine Research: Conception and Design of a Dynamic 3D Printed Cervical Myelography Phantom. Cureus 2019; 11:e4591. [PMID: 31309016 PMCID: PMC6609301 DOI: 10.7759/cureus.4591] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Three-dimensional (3D) printing is a growing practice in the medical community for patient care and trainee education as well as production of equipment and devices. The development of functional models to replicate physiologic systems of human tissue has also been explored, although to a lesser degree. Specifically, the design of 3D printed phantoms that possess comparable biomechanical properties to human cervical vertebrae is an underdeveloped area of spine research. In order to investigate the functional uses of cervical 3D printed models for replicating the complex physiologic and biomechanical properties of the human subaxial cervical spine, our institution has created a prototype that accurately reflects these properties and provides a novel method of assessing spinal canal dimensions using simulated myelography. To our knowledge, this is the first 3D printed phantom created to study these parameters. Materials and methods A de-identified cervical spine computed tomography imaging file was segmented using threshold modulation in 3D Slicer software. The subaxial vertebrae (C3-C7) of the scan were individualized by separating the facet joint spaces and uncovertebral joints within the software in order to create individual stereolithography (STL) files. Each individual vertebra was printed on an Ultimaker S5 dual-extrusion printer using white “tough” polylactic acid filament. A human cadaveric subaxial cervical spine was harvested to provide a control for our experiment. Both models were assessed and compared in flexion and extension dynamic motion grossly and fluoroscopically. The maximum angles of deformation on X-ray imaging were recorded using DICOM (Digital Imaging and Communications in Medicine) viewing software. In order to compare the ability to assess canal dimensions of the models using fluoroscopic imaging, a myelography simulation was designed. Results The cervical phantom demonstrated excellent ability to resist deformation in flexion and extension positions, attributed to the high quality of initial segmentation. The gross and fluoroscopic dynamic movement of the phantom was analogous to the cadaver model. The myelography simulator adequately demonstrated the canal dimensions in static and dynamic positions for both models. Pertinent anatomic landmarks were able to be effectively visualized for assessment of canal measurements for sagittal and transverse dimensions. Conclusions By utilizing the latest technologies in DICOM segmentation and 3D printing, our institution has created the first cervical myelography phantom for biomechanical evaluation and trainee instruction. By combining new technologies with anatomical knowledge, quality 3D printing shows great promise in becoming a standard player in the future of spinal biomechanical research.
Collapse
Affiliation(s)
| | | | - Aaron Damon
- Neurosurgery, Mayo Clinic, Jacksonville, USA
| | | | | |
Collapse
|
42
|
Odeh M, Levin D, Inziello J, Lobo Fenoglietto F, Mathur M, Hermsen J, Stubbs J, Ripley B. Methods for verification of 3D printed anatomic model accuracy using cardiac models as an example. 3D Print Med 2019; 5:6. [PMID: 30923948 PMCID: PMC6743141 DOI: 10.1186/s41205-019-0043-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/12/2019] [Indexed: 12/26/2022] Open
Abstract
Background Medical 3D printing has brought the manufacturing world closer to the patient’s bedside than ever before. This requires hospitals and their personnel to update their quality assurance program to more appropriately accommodate the 3D printing fabrication process and the challenges that come along with it. Results In this paper, we explored different methods for verifying the accuracy of a 3D printed anatomical model. Methods included physical measurements, digital photographic measurements, surface scanning, photogrammetry, and computed tomography (CT) scans. The details of each verification method, as well as their benefits and challenges, are discussed. Conclusion There are multiple methods for model verification, each with benefits and drawbacks. The choice of which method to adopt into a quality assurance program is multifactorial and will depend on the type of 3D printed models being created, the training of personnel, and what resources are available within a 3D printed laboratory.
Collapse
Affiliation(s)
- Mohammad Odeh
- Institute for Simulation and Training, University of Central Florida, Orlando, FL, USA
| | - Dmitry Levin
- Department of Medicine, Division of Cardiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Jim Inziello
- Institute for Simulation and Training, University of Central Florida, Orlando, FL, USA
| | | | - Moses Mathur
- Structural Interventional Cardiology, Virginia Mason Hospital, Edmonds, WA, USA
| | - Joshua Hermsen
- Department of Surgery, Division of Cardiothoracic Surgery, University of Wisconsin School of Medicine, Madison, WI, USA
| | - Jack Stubbs
- Institute for Simulation and Training, University of Central Florida, Orlando, FL, USA
| | - Beth Ripley
- VA Puget Sound Health Care System, Seattle, WA, USA. .,Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA.
| |
Collapse
|
43
|
Comrie ML, Monteith G, Zur Linden A, Oblak M, Phillips J, James FMK, on behalf of the Ontario Veterinary College Rapid Prototyping of Patient-specific Implants for Dogs (RaPPID) group. The accuracy of computed tomography scans for rapid prototyping of canine skulls. PLoS One 2019; 14:e0214123. [PMID: 30908536 PMCID: PMC6433237 DOI: 10.1371/journal.pone.0214123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 03/08/2019] [Indexed: 12/27/2022] Open
Abstract
This study’s objective was to determine the accuracy of using current computed tomography (CT) scan and software techniques for rapid prototyping by quantifying the margin of error between CT models and laser scans of canine skull specimens. Twenty canine skulls of varying morphology were selected from an anatomy collection at a veterinary school. CT scans (bone and standard algorithms) were performed for each skull, and data segmented (testing two lower threshold settings of 226HU and -650HU) into 3-D CT models. Laser scans were then performed on each skull. The CT models were compared to the corresponding laser scan to determine the error generated from the different types of CT model parameters. This error was then compared between the different types of CT models to determine the most accurate parameters. The mean errors for the 226HU CT models, both bone and standard algorithms, were not significant from zero error (p = 0.1076 and p = 0.0580, respectively). The mean errors for both -650HU CT models were significant from zero error (p < 0.001). Significant differences were detected between CT models for 3 CT model comparisons: Bone (p < 0.0001); Standard (p < 0.0001); and -650HU (p < 0.0001). For 226HU CT models, a significant difference was not detected between CT models (p = 0.2268). Independent of the parameters tested, the 3-D models derived from CT imaging accurately represent the real skull dimensions, with CT models differing less than 0.42 mm from the real skull dimensions. The 226HU threshold was more accurate than the -650HU threshold. For the 226HU CT models, accuracy was not dependent on the CT algorithm. For the -650 CT models, bone was more accurate than standard algorithms. Knowing the inherent error of this procedure is important for use in 3-D printing for surgical planning and medical education.
Collapse
Affiliation(s)
- Michaela L. Comrie
- Department Human Health and Nutritional Science, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Gabrielle Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Alex Zur Linden
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Michelle Oblak
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - John Phillips
- Centre for Advanced Manufacturing and Design Technologies, Sheridan College, Brampton, Ontario, Canada
| | - Fiona M. K. James
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
- * E-mail:
| | | |
Collapse
|
44
|
Luzon JA, Andersen BT, Stimec BV, Fasel JHD, Bakka AO, Kazaryan AM, Ignjatovic D. Implementation of 3D printed superior mesenteric vascular models for surgical planning and/or navigation in right colectomy with extended D3 mesenterectomy: comparison of virtual and physical models to the anatomy found at surgery. Surg Endosc 2019; 33:567-575. [PMID: 30014328 DOI: 10.1007/s00464-018-6332-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/06/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Three-dimensional (3D) printing technology has recently been well approved as an emerging technology in various fields of medical education and practice; e.g., there are numerous studies evaluating 3D printouts of solid organs. Complex surgery such as extended mesenterectomy imposes a need to analyze also the accuracy of 3D printouts of more mobile and complex structures like the diversity of vascular arborization within the central mesentery. The objective of this study was to evaluate the linear dimensional anatomy landmark differences of the superior mesenteric artery and vein between (1) 3D virtual models, (2) 3D printouts, and (3) peroperative measurements. METHODS The study included 22 patients from the ongoing prospective multicenter trial "Safe Radical D3 Right Hemicolectomy for Cancer through Preoperative Biphasic MDCT Angiography," with preoperative CT and peroperative measurements. The patients were operated in Norway between January 2016 and 2017. Their CT datasets underwent 3D volume rendering and segmentation, and the virtual 3D model produced was then exported for stereolithography 3D printing. RESULTS Four parameters were measured: distance between the origins of the ileocolic and the middle colic artery, distance between the termination of the gastrocolic trunk and the ileocolic vein, and the calibers of the middle colic and ileocolic arteries. The inter-arterial distance has proven a strong correlation between all the three modalities implied (Pearson's coefficient 0.968, 0.956, 0.779, respectively), while inter-venous distances showed a weak correlation between peroperative measurements and both virtual and physical models. CONCLUSION This study showed acceptable dimensional inter-arterial correlations between 3D printed models, 3D virtual models and authentic soft tissue anatomy of the central mesenteric vessels, and weaker inter-venous correlations between all the models, reflecting the highly variable nature of veins in situ.
Collapse
Affiliation(s)
- Javier A Luzon
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Surgery, Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Bjarte T Andersen
- Department of Gastroenterological Surgery, Østfold Hospital Trust, Sarpsborg, Norway
| | - Bojan V Stimec
- Anatomy Sector, Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jean H D Fasel
- Anatomy Sector, Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Arne O Bakka
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Surgery, Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
| | - Airazat M Kazaryan
- Division of Surgery, Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
- Department of Surgery №1, Yerevan State Medical University After M. Heratsi, Yerevan, Armenia
| | - Dejan Ignjatovic
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
- Division of Surgery, Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway.
| |
Collapse
|
45
|
Hernandez-Giron I, den Harder JM, Streekstra GJ, Geleijns J, Veldkamp WJ. Development of a 3D printed anthropomorphic lung phantom for image quality assessment in CT. Phys Med 2019; 57:47-57. [DOI: 10.1016/j.ejmp.2018.11.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/31/2018] [Accepted: 11/21/2018] [Indexed: 11/26/2022] Open
|
46
|
Using 3D models in orthopedic oncology: presenting personalized advantages in surgical planning and intraoperative outcomes. 3D Print Med 2018; 4:12. [PMID: 30649645 PMCID: PMC6261090 DOI: 10.1186/s41205-018-0035-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 11/16/2018] [Indexed: 11/21/2022] Open
Abstract
Background Three Dimensional (3D) printed models can aid in effective pre-operative planning by defining the geometry of tumor mass, bone loss, and nearby vessels to help determine the most accurate osteotomy site and the most appropriate prosthesis, especially in the case of complex acetabular deficiency, resulting in decreased operative time and decreased blood loss. Methods Four complicated cases were selected, reconstructed and printed. These 4 cases were divided in 3 groups of 3D printed models. Group 1 consisted of anatomical models with major vascular considerations during surgery. Group 2 consisted of an anatomical model showing a bone defect, which was intended to be used for substantial instrumentation, pre-operatively. Group 3 consisted of an extra-compartmental bone tumor which displayed a deteriorated cortical outline; thus, using CT and MRI fused images to reconstruct the model accurately. An orthopedic surgeon created the 3D models of groups 1 and 2 using standard segmentation techniques. Because group 3 required complex techniques, an engineer assisted during digital model construction. Results These models helped to guide the orthopedic surgeon in creating a personalized pre-operative plan and a physical simulation. The models proved to be beneficial and assisted with all 4 cases, by decreasing blood loss, operative time and surgical incision length, and helped to select the appropriate acetabular supporting ring in complex acetabular deficiency, pre-operatively. Conclusion Qualitatively, using 3D printing in tumor cases, provides personalized advantages regarding the various characteristics of each skeletal tumor.
Collapse
|
47
|
Chepelev L, Wake N, Ryan J, Althobaity W, Gupta A, Arribas E, Santiago L, Ballard DH, Wang KC, Weadock W, Ionita CN, Mitsouras D, Morris J, Matsumoto J, Christensen A, Liacouras P, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios. 3D Print Med 2018; 4:11. [PMID: 30649688 PMCID: PMC6251945 DOI: 10.1186/s41205-018-0030-y] [Citation(s) in RCA: 144] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/19/2018] [Indexed: 02/08/2023] Open
Abstract
Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.
Collapse
Affiliation(s)
- Leonid Chepelev
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Nicole Wake
- Center for Advanced Imaging Innovation and Research (CAI2R), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY USA
- Sackler Institute of Graduate Biomedical Sciences, NYU School of Medicine, New York, NY USA
| | | | - Waleed Althobaity
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Ashish Gupta
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Elsa Arribas
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lumarie Santiago
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO USA
| | - Kenneth C Wang
- Baltimore VA Medical Center, University of Maryland Medical Center, Baltimore, MD USA
| | - William Weadock
- Department of Radiology and Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI USA
| | - Ciprian N Ionita
- Department of Neurosurgery, State University of New York Buffalo, Buffalo, NY USA
| | - Dimitrios Mitsouras
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | | | | | - Andy Christensen
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Peter Liacouras
- 3D Medical Applications Center, Walter Reed National Military Medical Center, Washington, DC, USA
| | - Frank J Rybicki
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| |
Collapse
|
48
|
Mohammed Ali A, Hogg P, Johansen S, England A. Construction and validation of a low cost paediatric pelvis phantom. Eur J Radiol 2018; 108:84-91. [PMID: 30396676 DOI: 10.1016/j.ejrad.2018.09.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE Imaging phantoms can be cost prohibitive, therefore a need exists to produce low cost alternatives which are fit for purpose. This paper describes the development and validation of a low cost paediatric pelvis phantom based on the anatomy of a 5-year-old child. METHODS Tissue equivalent materials representing paediatric bone (Plaster of Paris; PoP) and soft tissue (Poly methyl methacrylate; PMMA) were used. PMMA was machined to match the bony anatomy identified from a CT scan of a 5-year-old child and cavities were created for infusing the PoP. Phantom validation comprised physical and visual measures. Physical included CT density comparison between a CT scan of a 5-year old child and the phantom and Signal to Noise Ratio (SNR) comparative analysis of anteroposterior phantom X-ray images against a commercial anthropomorphic phantom. Visual analysis using a psychometric image quality scale (face validity). RESULTS CT density, the percentage difference between cortical bone, soft tissue and their equivalent tissue substitutes were -4.7 to -4.1% and -23.4%, respectively. For SNR, (mAs response) there was a strong positive correlation between the two phantoms (r > 0.95 for all kVps). For kVp response, there was a strong positive correlation between 1 and 8 mAs (r = 0.85), this then decreased as mAs increased (r = -0.21 at 20 mAs). Psychometric scale results produced a Cronbach's Alpha of almost 0.8. CONCLUSIONS Physical and visual measures suggest our low-cost phantom has suitable anatomical characteristics for X-ray imaging. Our phantom could have utility in dose and image quality optimisation studies.
Collapse
Affiliation(s)
- Ali Mohammed Ali
- School of Health Sciences, University of Salford, Salford, M6 6PU, United Kingdom.
| | - Peter Hogg
- School of Health Sciences, University of Salford, Salford, M6 6PU, United Kingdom.
| | - Safora Johansen
- Oslo Metropolitan University, Faculty of Health Sciences, Norway; Department of Oncology, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
| | - Andrew England
- School of Health Sciences, University of Salford, Salford, M6 6PU, United Kingdom.
| |
Collapse
|
49
|
Chen SA, Ong CS, Malguria N, Vricella LA, Garcia JR, Hibino N. Digital Design and 3D Printing of Aortic Arch Reconstruction in HLHS for Surgical Simulation and Training. World J Pediatr Congenit Heart Surg 2018; 9:454-458. [PMID: 29945510 DOI: 10.1177/2150135118771323] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Patients with hypoplastic left heart syndrome (HLHS) present a diverse spectrum of aortic arch morphology. Suboptimal geometry of the reconstructed aortic arch may result from inappropriate size and shape of an implanted patch and may be associated with poor outcomes. Meanwhile, advances in diagnostic imaging, computer-aided design, and three-dimensional (3D) printing technology have enabled the creation of 3D models. The purpose of this study is to create a surgical simulation and training model for aortic arch reconstruction. DESCRIPTION Specialized segmentation software was used to isolate aortic arch anatomy from HLHS computed tomography scan images to create digital 3D models. Three-dimensional modeling software was used to modify the exported segmented models and digitally design printable customized patches that were optimally sized for arch reconstruction. EVALUATION Life-sized models of HLHS aortic arch anatomy and a digitally derived customized patch were 3D printed to allow simulation of surgical suturing and reconstruction. The patient-specific customized patch was successfully used for surgical simulation. CONCLUSIONS Feasibility of digital design and 3D printing of patient-specific patches for aortic arch reconstruction has been demonstrated. The technology facilitates surgical simulation. Surgical training that leads to an understanding of optimal aortic patch geometry is one element that may potentially influence outcomes for patients with HLHS.
Collapse
Affiliation(s)
- Sarah A Chen
- 1 Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.,2 Department of Art as Applied to Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.,3 University of California Davis School of Medicine, Sacramento, CA, USA
| | - Chin Siang Ong
- 1 Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Nagina Malguria
- 4 Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Luca A Vricella
- 1 Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Juan R Garcia
- 2 Department of Art as Applied to Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Narutoshi Hibino
- 1 Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, MD, USA
| |
Collapse
|
50
|
Principles of three-dimensional printing and clinical applications within the abdomen and pelvis. Abdom Radiol (NY) 2018; 43:2809-2822. [PMID: 29619525 DOI: 10.1007/s00261-018-1554-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Improvements in technology and reduction in costs have led to widespread interest in three-dimensional (3D) printing. 3D-printed anatomical models contribute to personalized medicine, surgical planning, and education across medical specialties, and these models are rapidly changing the landscape of clinical practice. A physical object that can be held in one's hands allows for significant advantages over standard two-dimensional (2D) or even 3D computer-based virtual models. Radiologists have the potential to play a significant role as consultants and educators across all specialties by providing 3D-printed models that enhance clinical care. This article reviews the basics of 3D printing, including how models are created from imaging data, clinical applications of 3D printing within the abdomen and pelvis, implications for education and training, limitations, and future directions.
Collapse
|