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Trincado Cobos M, Tapia Salinas B, Gutiérrez Venturini A, Aragón Niño I, Del Castillo Pardo de Vera JL, Cebrián Carretero JL, Uña Orejón R. The application of three-dimensional printing in the management of a difficult airway due to Treacher Collins syndrome. Anaesth Rep 2024; 12:e12290. [PMID: 38645478 PMCID: PMC11026849 DOI: 10.1002/anr3.12290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 04/23/2024] Open
Abstract
We describe the use of three-dimensional printing to create precise airway models for a patient with Treacher Collins syndrome who presented for bimaxillary temporomandibular joint prostheses, and for whom airway management was predicted to be difficult. The model was based on pre-operative cone beam computed tomography images and printed in the 3D Lab of Hospital Universitario La Paz. Transparent models allowed clear visualisation for simulation and iterative refinement of airway management techniques and aided in risk assessment and instrument sizing. This case report emphasises the utility of this approach in complex airway scenarios.
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Affiliation(s)
| | | | | | - I. Aragón Niño
- Department of Maxillo‐facial SurgeryHospital La PazMadridSpain
| | | | | | - R. Uña Orejón
- Department of AnaesthesiologyHospital La PazMadridSpain
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Bledsoe JC, Gilleland BE, Wright AF, White EM, Crane GH, Herron CB, Locklin JJ, Ritchie BW. A Biologically Degradable and BioseniaticTM Feedstock for the High-Quality 3D Printing of Anatomical Models. J Biocommun 2023; 47:e5. [PMID: 38524908 PMCID: PMC10959741 DOI: 10.5210/jbc.v47i2.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
A Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) -based filament was evaluated as an alternative feedstock for Fused Deposition Modeling (FDM) of instructional and clinical medical specimens. PHBHHx-based prints of domestic cat vertebrae, skull bone, and an aortic arch cast were found comparable to conventional materials. PHBHHx-based filament and extrudate samples were evaluated for biological degradability, to meet the BioseniaticTM standard, defined by the University of Georgia New Materials Institute. Both samples achieved more than 90% mineralization within 32 days in industrial composting conditions.
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Zambrano-Jerez LC, Díaz-Santamaría KD, Rodríguez-Santos MA, Alarcón-Ariza DF, Meléndez-Flórez GL, Ramírez-Blanco MA. Dye-Perfused Human Placenta for Simulation in a Microsurgery Laboratory for Plastic Surgeons. Arch Plast Surg 2023; 50:627-634. [PMID: 38143834 PMCID: PMC10736195 DOI: 10.1055/a-2113-4182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/15/2023] [Indexed: 12/26/2023] Open
Abstract
In recent decades, a number of simulation models for microsurgical training have been published. The human placenta has received extensive validation in microneurosurgery and is a useful instrument to facilitate learning in microvascular repair techniques as an alternative to using live animals. This study uses a straightforward, step-by-step procedure for instructing the creation of simulators with dynamic flow to characterize the placental vascular tree and assess its relevance for plastic surgery departments. Measurements of the placental vasculature and morphological characterization of 18 placentas were made. After the model was used in a basic microsurgery training laboratory session, a survey was given to nine plastic surgery residents, two microsurgeons, and one hand surgeon. In all divisions, venous diameters were larger than arterial diameters, with minimum diameters of 0.8 and 0.6 mm, respectively. The majority of the participants considered that the model faithfully reproduces a real microsurgical scenario; the consistency of the vessels and their dissection are similar in in vivo tissue. Furthermore, all the participants considered that this model could improve their surgical technique and would propose it for microsurgical training. As some of the model's disadvantages, an abundantly thick adventitia, a thin tunica media, and higher adherence to the underlying tissue were identified. The color-perfused placenta is an excellent tool for microsurgical training in plastic surgery. It can faithfully reproduce a microsurgical scenario, offering an abundance of vasculature with varying sizes similar to tissue in vivo, enhancing technical proficiency, and lowering patient error.
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Affiliation(s)
- Laura C. Zambrano-Jerez
- Division of Plastic and Reconstructive Surgery, Universidad Industrial de Santander, Hospital Universitario de Santander, Santander, Colombia
| | - Karen D. Díaz-Santamaría
- Division of Plastic and Reconstructive Surgery, Universidad Industrial de Santander, Hospital Universitario de Santander, Santander, Colombia
| | - María A. Rodríguez-Santos
- Division of Plastic and Reconstructive Surgery, Universidad Industrial de Santander, Hospital Universitario de Santander, Santander, Colombia
| | - Diego F. Alarcón-Ariza
- Division of Plastic and Reconstructive Surgery, Universidad Industrial de Santander, Hospital Internacional de Colombia, Santander, Colombia
| | - Genny L. Meléndez-Flórez
- Division of Plastic and Reconstructive Surgery, Universidad Industrial de Santander, Hospital Universitario de Santander, Santander, Colombia
| | - Mónica A. Ramírez-Blanco
- Division of Plastic and Reconstructive Surgery, Universidad Industrial de Santander, Hospital Internacional de Colombia, Santander, Colombia
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Yang MY, Tseng HC, Liu CH, Tsai SY, Chen JH, Chu YH, Li ST, Lee JJ, Liao WC. Effects of the individual three-dimensional printed craniofacial bones with a quick response code on the skull spatial knowledge of undergraduate medical students. Anat Sci Educ 2023; 16:858-869. [PMID: 36905326 DOI: 10.1002/ase.2269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
Understanding the three-dimensional (3D) structure of the human skull is imperative for medical courses. However, medical students are overwhelmed by the spatial complexity of the skull. Separated polyvinyl chloride (PVC) bone models have advantages as learning tools, but they are fragile and expensive. This study aimed to reconstruct 3D-printed skull bone models (3D-PSBs) using polylactic acid (PLA) with anatomical characteristics for spatial recognition of the skull. Student responses to 3D-PSB application were investigated through a questionnaire and tests to understand the requirement of these models as a learning tool. The students were randomly divided into 3D-PSB (n = 63) and skull (n = 67) groups to analyze pre- and post-test scores. Their knowledge was improved, with the gain scores of the 3D-PSB group (50.0 ± 3.0) higher than that of the skull group (37.3 ± 5.2). Most students agreed that using 3D-PSBs with quick response codes could improve immediate feedback on teaching (88%; 4.41 ± 0.75), while 85.9% of the students agreed that individual 3D-PSBs clarified the structures hidden within the skull (4.41 ± 0.75). The ball drop test revealed that the mechanical strength of the cement/PLA model was significantly greater than that of the cement or PLA model. The prices of the PVC, cement, and cement/PLA models were 234, 1.9, and 10 times higher than that of the 3D-PSB model, respectively. These findings imply that low-cost 3D-PSB models could revolutionize skull anatomical education by incorporating digital technologies like the QR system into the anatomical teaching repertoire.
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Affiliation(s)
- Mao-Yi Yang
- Department of Medical Education, Changhua Christian Hospital, Changhua City, Taiwan
- Department of Orthopedic Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Hsien-Chun Tseng
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Department of Radiation Oncology, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chiung-Hui Liu
- Ph.D. Program in Tissue Engineering and Regenerative Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Shao-Yu Tsai
- Department of Anatomy, Faculty of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jyun-Hsiung Chen
- Department of Anatomy, Faculty of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yin-Hung Chu
- Ph.D. Program in Tissue Engineering and Regenerative Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Shao-Ti Li
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jian-Jr Lee
- Faculty of Medicine, School of Medicine, China Medical University, Taichung, Taiwan
- Department of Plastic & Reconstruction Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Chieh Liao
- Ph.D. Program in Tissue Engineering and Regenerative Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
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Patel P, Dhal K, Gupta R, Tappa K, Rybicki FJ, Ravi P. Medical 3D Printing Using Desktop Inverted Vat Photopolymerization: Background, Clinical Applications, and Challenges. Bioengineering (Basel) 2023; 10:782. [PMID: 37508810 PMCID: PMC10376892 DOI: 10.3390/bioengineering10070782] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Medical 3D printing is a complex, highly interdisciplinary, and revolutionary technology that is positively transforming the care of patients. The technology is being increasingly adopted at the Point of Care (PoC) as a consequence of the strong value offered to medical practitioners. One of the key technologies within the medical 3D printing portfolio enabling this transition is desktop inverted Vat Photopolymerization (VP) owing to its accessibility, high quality, and versatility of materials. Several reports in the peer-reviewed literature have detailed the medical impact of 3D printing technologies as a whole. This review focuses on the multitude of clinical applications of desktop inverted VP 3D printing which have grown substantially in the last decade. The principles, advantages, and challenges of this technology are reviewed from a medical standpoint. This review serves as a primer for the continually growing exciting applications of desktop-inverted VP 3D printing in healthcare.
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Affiliation(s)
- Parimal Patel
- Department of Mechanical & Aerospace Engineering, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Kashish Dhal
- Department of Mechanical & Aerospace Engineering, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Rajul Gupta
- Department of Orthopedic Surgery, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Karthik Tappa
- Department of Breast Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Prashanth Ravi
- Department of Radiology, University of Cincinnati, Cincinnati, OH 45219, USA
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Yang JX, DeYoung V, Xue Y, Nehru A, Hildebrand A, Brewer-Deluce D, Wainman B. Size matters! Investigating the effects of model size on anatomy learning. Anat Sci Educ 2023; 16:415-427. [PMID: 36457242 DOI: 10.1002/ase.2233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 05/11/2023]
Abstract
Three-dimensional (3D) scanning and printing technology has allowed for the production of anatomical replicas at virtually any size. But what size optimizes the educational potential of 3D printing models? This study systematically investigates the effect of model size on nominal anatomy learning. The study population of 380 undergraduate students, without prior anatomical knowledge, were randomized to learn from two of four bone models (either vertebra and pelvic bone [os coxae], or scapula and sphenoid bone), each model 3D printed at 50%, 100%, 200%, and either 300% or 400% of normal size. Participants were then tested on nominal anatomy recall on the respective bone specimens. Mental rotation ability and working memory were also assessed, and opinions regarding learning with the various models were solicited. The diameter of the rotational bounding sphere for the object ("longest diameter") had a small, but significant effect on test score (F(2,707) = 17.15, p < 0.05, R2 = 0.046). Participants who studied from models with a longest diameter greater than 10 cm scored significantly better than those who used models less than 10 cm, with the exception of the scapula model, on which performance was equivalent across all sizes. These results suggest that models with a longest diameter beyond 10 cm are unlikely to incur a greater size-related benefit in learning nominal anatomy. Qualitative feedback suggests that there also appear to be inherent features of bones besides longest diameter that facilitate learning.
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Affiliation(s)
- Jack X Yang
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Schulich School of Medicine - Windsor Campus, Western University, Windsor, Ontario, Canada
| | - Veronica DeYoung
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Yuanxin Xue
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amit Nehru
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Hildebrand
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Danielle Brewer-Deluce
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Bruce Wainman
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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Miaskowski A, Gas P. Numerical Estimation of SAR and Temperature Distributions inside Differently Shaped Female Breast Tumors during Radio-Frequency Ablation. Materials (Basel) 2022; 16:223. [PMID: 36614561 PMCID: PMC9821952 DOI: 10.3390/ma16010223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Radio-frequency (RF) ablation is a reliable technique for the treatment of deep-seated malignant tumors, including breast carcinoma, using high ablative temperatures. The paper aims at a comparative analysis of the specific absorption rate and temperature distribution during RF ablation with regard to different female breast tumors. In the study, four tumor models equivalent to an irregular tumor were considered, i.e., an equivalent sphere and ellipsoid with the same surfaces and volumes as the irregular tumor and an equivalent sphere and ellipsoid inscribed in the irregular tumor. An RF applicator with a specific voltage, operating at 100 kHz inserted into the anatomically correct female breast, was applied as a source of electromagnetically induced heat. A conjugated Laplace equation with the modified Pennes equation was used to obtain the appropriate temperature gradient in the treated area. The levels of power dissipation in terms of the specific absorption rate (SAR) inside the naturalistically shaped tumor, together with the temperature profiles of the four simplified tumor models equivalent to the irregular one, were determined. It was suggested that the equivalent tumor models might successfully replace a real, irregularly shaped tumor, and the presented numeric methodology may play an important role in the complex therapeutic RF ablation process of irregularly shaped female breast tumors.
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Affiliation(s)
- Arkadiusz Miaskowski
- Department of Applied Mathematics and Computer Sciences, Faculty of Production Engineering, University of Life Sciences in Lublin, Akademicka 13 Street, 20-950 Lublin, Poland
| | - Piotr Gas
- Department of Electrical and Power Engineering, Faculty of Electrical Engineering, Automatics, Computer Science and Biomedical Engineering, AGH University of Science and Technology, Mickiewicza 30 Avenue, 30-059 Krakow, Poland
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Borghese G, Coppola F, Raimondo D, Raffone A, Travaglino A, Bortolani B, Lo Monaco S, Cercenelli L, Maletta M, Cattabriga A, Casadio P, Mollo A, Golfieri R, Paradisi R, Marcelli E, Seracchioli R. 3D Patient-Specific Virtual Models for Presurgical Planning in Patients with Recto-Sigmoid Endometriosis Nodules: A Pilot Study. Medicina (Kaunas) 2022; 58:medicina58010086. [PMID: 35056394 PMCID: PMC8777715 DOI: 10.3390/medicina58010086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/26/2021] [Accepted: 01/04/2022] [Indexed: 11/29/2022]
Abstract
Background and Objective: In recent years, 3D printing has been used to support surgical planning or to guide intraoperative procedures in various surgical specialties. An improvement in surgical planning for recto-sigmoid endometriosis (RSE) excision might reduce the high complication rate related to this challenging surgery. The aim of this study was to build novel presurgical 3D models of RSE nodules from magnetic resonance imaging (MRI) and compare them with intraoperative findings. Materials and Methods: A single-center, observational, prospective, cohort, pilot study was performed by enrolling consecutive symptomatic women scheduled for minimally invasive surgery for RSE between November 2019 and June 2020 at our institution. Preoperative MRI were used for building 3D models of RSE nodules and surrounding pelvic organs. 3D models were examined during multi-disciplinary preoperative planning, focusing especially on three domains: degree of bowel stenosis, nodule’s circumferential extension, and bowel angulation induced by the RSE nodule. After surgery, the surgeon was asked to subjectively evaluate the correlation of the 3D model with the intra-operative findings and to express his evaluation as “no correlation”, “low correlation”, or “high correlation” referring to the three described domains. Results: seven women were enrolled and 3D anatomical virtual models of RSE nodules and surrounding pelvic organs were generated. In all cases, surgeons reported a subjective “high correlation” with the surgical findings. Conclusion: Presurgical 3D models could be a feasible and useful tool to support surgical planning in women with recto-sigmoidal endometriotic involvement, appearing closely related to intraoperative findings.
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Affiliation(s)
- Giulia Borghese
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, 40138 Bologna, Italy; (G.B.); (M.M.); (P.C.); (R.P.); (R.S.)
| | - Francesca Coppola
- Department of Radiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (S.L.M.); (A.C.); (R.G.)
| | - Diego Raimondo
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, 40138 Bologna, Italy; (G.B.); (M.M.); (P.C.); (R.P.); (R.S.)
- Correspondence: (D.R.); (A.R.)
| | - Antonio Raffone
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, 40138 Bologna, Italy; (G.B.); (M.M.); (P.C.); (R.P.); (R.S.)
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80138 Naples, Italy
- Correspondence: (D.R.); (A.R.)
| | - Antonio Travaglino
- Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, 80138 Naples, Italy;
| | - Barbara Bortolani
- eDIMES Lab-Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40126 Bologna, Italy; (B.B.); (L.C.); (E.M.)
| | - Silvia Lo Monaco
- Department of Radiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (S.L.M.); (A.C.); (R.G.)
| | - Laura Cercenelli
- eDIMES Lab-Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40126 Bologna, Italy; (B.B.); (L.C.); (E.M.)
| | - Manuela Maletta
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, 40138 Bologna, Italy; (G.B.); (M.M.); (P.C.); (R.P.); (R.S.)
| | - Arrigo Cattabriga
- Department of Radiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (S.L.M.); (A.C.); (R.G.)
| | - Paolo Casadio
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, 40138 Bologna, Italy; (G.B.); (M.M.); (P.C.); (R.P.); (R.S.)
| | - Antonio Mollo
- Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, 84081 Baronissi, Italy;
| | - Rita Golfieri
- Department of Radiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (F.C.); (S.L.M.); (A.C.); (R.G.)
| | - Roberto Paradisi
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, 40138 Bologna, Italy; (G.B.); (M.M.); (P.C.); (R.P.); (R.S.)
| | - Emanuela Marcelli
- eDIMES Lab-Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40126 Bologna, Italy; (B.B.); (L.C.); (E.M.)
| | - Renato Seracchioli
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, 40138 Bologna, Italy; (G.B.); (M.M.); (P.C.); (R.P.); (R.S.)
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Tanoğlu O, Subaşı İÖ, Gökgöz MB, Arıcan G. Is Proximal Tibia Sufficient for Accurate Measurement of Tibial Slope Angles on Three-dimensional Tomography-based Anatomical Models? Curr Med Imaging 2021; 17:1419-1424. [PMID: 34365952 DOI: 10.2174/1573405617666210806150938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/11/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Tibial slope measurements performed using only the proximal part of tibia ignore the native tibial anatomical axis. Our first aim is to measure the native medial, lateral and total tibial slope angles of gender groups using the whole tibial anatomical axis on computerized tomography-based three-dimensional anatomical models. The second aim is to determine the correlation between proximal and whole tibial anatomical axis for measurement of medial, lateral, and total tibial slope angles. METHODS We randomly selected 100 females and 100 males between 18-60 years of age. Three-dimensional anatomical models of right and left tibia were created. The gender-specific differences of medial, lateral, and total tibial slope angles according to proximal and whole tibial anatomical axis were measured. Correlation coefficients (r) of medial, lateral, and total tibial slope angles measured with proximal and whole tibial anatomical axis were calculated. RESULTS The mean age was 47.1 years. A statistically significant difference was observed between female (7.1 ± 3) and male (8.2 ± 2.5) groups in terms of mean lateral tibial slope angles according to the whole tibial anatomical axis (p=0.008). A strong correlation between proximal and whole tibial anatomical axis for all tibial slope angle measurements was detected. CONCLUSION The method we determined for 3D measurement of medial, lateral and total tibial slope angles using proximal tibial anatomical axis has a strong correlation with slope angles measured in accordance with the whole tibial anatomical axis. Our 3D tibial slope angle measurement method on the proximal tibia has high reliability and could be used in the daily practice.
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Affiliation(s)
- Oğuzhan Tanoğlu
- Erzincan Binali Yıldırım University, Department of Orthopedics and Traumatology. Turkey
| | - İzzet Özay Subaşı
- Erzincan Binali Yıldırım University, Department of Orthopedics and Traumatology. Turkey
| | | | - Gökhun Arıcan
- Sivas Numune Hospital, Department of Orthopedics and Traumatology. Turkey
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Roh TH, Oh JW, Jang CK, Choi S, Kim EH, Hong CK, Kim SH. Virtual dissection of the real brain: integration of photographic 3D models into virtual reality and its effect on neurosurgical resident education. Neurosurg Focus 2021; 51:E16. [PMID: 34333482 DOI: 10.3171/2021.5.focus21193] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/14/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Virtual reality (VR) is increasingly being used for education and surgical simulation in neurosurgery. So far, the 3D sources for VR simulation have been derived from medical images, which lack real color. The authors made photographic 3D models from dissected cadavers and integrated them into the VR platform. This study aimed to introduce a method of developing a photograph-integrated VR and to evaluate the educational effect of these models. METHODS A silicone-injected cadaver head was prepared. A CT scan of the specimen was taken, and the soft tissue and skull were segmented to 3D objects. The cadaver was dissected layer by layer, and each layer was 3D scanned by a photogrammetric method. The objects were imported to a free VR application and layered. Using the head-mounted display and controllers, the various neurosurgical approaches were demonstrated to neurosurgical residents. After performing hands-on virtual surgery with photographic 3D models, a feedback survey was collected from 31 participants. RESULTS Photographic 3D models were seamlessly integrated into the VR platform. Various skull base approaches were successfully performed with photograph-integrated VR. During virtual dissection, the landmark anatomical structures were identified based on their color and shape. Respondents rated a higher score for photographic 3D models than for conventional 3D models (4.3 ± 0.8 vs 3.2 ± 1.1, respectively; p = 0.001). They responded that performing virtual surgery with photographic 3D models would help to improve their surgical skills and to develop and study new surgical approaches. CONCLUSIONS The authors introduced photographic 3D models to the virtual surgery platform for the first time. Integrating photographs with the 3D model and layering technique enhanced the educational effect of the 3D models. In the future, as computer technology advances, more realistic simulations will be possible.
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Affiliation(s)
- Tae Hoon Roh
- 1Department of Neurosurgery, Ajou University Hospital, Ajou University School of Medicine, Suwon
| | - Ji Woong Oh
- 2Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul
| | - Chang Ki Jang
- 2Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul
| | - Seonah Choi
- 2Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul
| | - Eui Hyun Kim
- 2Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul
| | - Chang-Ki Hong
- 3Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul; and.,4Department of Neurosurgery, Asan Medical Center, Ulsan University School of Medicine, Seoul, Republic of Korea
| | - Se-Hyuk Kim
- 1Department of Neurosurgery, Ajou University Hospital, Ajou University School of Medicine, Suwon
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11
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Segaran N, Saini G, Mayer JL, Naidu S, Patel I, Alzubaidi S, Oklu R. Application of 3D Printing in Preoperative Planning. J Clin Med 2021; 10:jcm10050917. [PMID: 33652844 PMCID: PMC7956651 DOI: 10.3390/jcm10050917] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/07/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022] Open
Abstract
Preoperative planning is critical for success in the surgical suite. Current techniques for surgical planning are limited; clinicians often rely on prior experience and medical imaging to guide the decision-making process. Furthermore, two-dimensional (2D) presentations of anatomical structures may not accurately portray their three-dimensional (3D) complexity, often leaving physicians ill-equipped for the procedure. Although 3D postprocessed images are an improvement on traditional 2D image sets, they are often inadequate for surgical simulation. Medical 3D printing is a rapidly expanding field and could provide an innovative solution to current constraints of preoperative planning. As 3D printing becomes more prevalent in medical settings, it is important that clinicians develop an understanding of the technologies, as well as its uses. Here, we review the fundamentals of 3D printing and key aspects of its workflow. The many applications of 3D printing for preoperative planning are discussed, along with their challenges.
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Affiliation(s)
- Nicole Segaran
- Minimally Invasive Therapeutics Laboratory, Department of Vascular and Interventional Radiology, Mayo Clinic, Phoenix, AZ 85054, USA; (N.S.); (G.S.)
| | - Gia Saini
- Minimally Invasive Therapeutics Laboratory, Department of Vascular and Interventional Radiology, Mayo Clinic, Phoenix, AZ 85054, USA; (N.S.); (G.S.)
| | - Joseph L. Mayer
- 3D Innovations Laboratory, Mayo Clinic Arizona, 5711 E. Mayo Blvd. Support Services Building, Phoenix, AZ 85054, USA;
| | - Sailen Naidu
- Department of Radiology, Mayo Clinic, Phoenix, AZ 85054, USA; (S.N.); (I.P.); (S.A.)
| | - Indravadan Patel
- Department of Radiology, Mayo Clinic, Phoenix, AZ 85054, USA; (S.N.); (I.P.); (S.A.)
| | - Sadeer Alzubaidi
- Department of Radiology, Mayo Clinic, Phoenix, AZ 85054, USA; (S.N.); (I.P.); (S.A.)
| | - Rahmi Oklu
- Minimally Invasive Therapeutics Laboratory, Department of Vascular and Interventional Radiology, Mayo Clinic, Phoenix, AZ 85054, USA; (N.S.); (G.S.)
- 3D Innovations Laboratory, Mayo Clinic Arizona, 5711 E. Mayo Blvd. Support Services Building, Phoenix, AZ 85054, USA;
- Department of Radiology, Mayo Clinic, Phoenix, AZ 85054, USA; (S.N.); (I.P.); (S.A.)
- Correspondence: ; Tel.: +1-480-342-5664
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12
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Arens S, Dierckx H, Panfilov AV. GEMS: A Fully Integrated PETSc-Based Solver for Coupled Cardiac Electromechanics and Bidomain Simulations. Front Physiol 2018; 9:1431. [PMID: 30386252 PMCID: PMC6198176 DOI: 10.3389/fphys.2018.01431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 09/20/2018] [Indexed: 01/23/2023] Open
Abstract
Cardiac contraction is coordinated by a wave of electrical excitation which propagates through the heart. Combined modeling of electrical and mechanical function of the heart provides the most comprehensive description of cardiac function and is one of the latest trends in cardiac research. The effective numerical modeling of cardiac electromechanics remains a challenge, due to the stiffness of the electrical equations and the global coupling in the mechanical problem. Here we present a short review of the inherent assumptions made when deriving the electromechanical equations, including a general representation for deformation-dependent conduction tensors obeying orthotropic symmetry, and then present an implicit-explicit time-stepping approach that is tailored to solving the cardiac mono- or bidomain equations coupled to electromechanics of the cardiac wall. Our approach allows to find numerical solutions of the electromechanics equations using stable and higher order time integration. Our methods are implemented in a monolithic finite element code GEMS (Ghent Electromechanics Solver) using the PETSc library that is inherently parallelized for use on high-performance computing infrastructure. We tested GEMS on standard benchmark computations and discuss further development of our software.
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Affiliation(s)
- Sander Arens
- Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Hans Dierckx
- Department of Physics and Astronomy, Ghent University, Ghent, Belgium
| | - Alexander V Panfilov
- Department of Physics and Astronomy, Ghent University, Ghent, Belgium.,Laboratory of Computational Biology and Medicine, Ural Federal University, Ekaterinburg, Russia
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13
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Revoredo ECV, Galembeck A, Ponzi EAC, Leão JC, Arcoverde LS, Araújo LC, Leite SP. Palatal obturator designed by 3-dimensional prototyping for a patient with a large ameloblastoma: a case report. Gen Dent 2018; 66:e12-e17. [PMID: 30188865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of the present report was to detail the advantages of using 3-dimensional (3D) prototyping in the planning, modeling, and manufacturing of an immediate palatal obturator for a 62-year-old man who underwent a left total maxillectomy to remove a solid, multicystic ameloblastoma. The prosthesis provided favorable restoration of stomatognathic functions, including speech, swallowing, and mastication. The use of an immediate obturator prosthesis made with 3D technology is an important aid in the treatment of patients diagnosed with tumors in the head and neck region.
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14
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Eastwood KW, Bodani VP, Haji FA, Looi T, Naguib HE, Drake JM. Development of synthetic simulators for endoscope-assisted repair of metopic and sagittal craniosynostosis. J Neurosurg Pediatr 2018; 22:128-136. [PMID: 29856293 DOI: 10.3171/2018.2.peds18121] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Endoscope-assisted repair of craniosynostosis is a safe and efficacious alternative to open techniques. However, this procedure is challenging to learn, and there is significant variation in both its execution and outcomes. Surgical simulators may allow trainees to learn and practice this procedure prior to operating on an actual patient. The purpose of this study was to develop a realistic, relatively inexpensive simulator for endoscope-assisted repair of metopic and sagittal craniosynostosis and to evaluate the models' fidelity and teaching content. METHODS Two separate, 3D-printed, plastic powder-based replica skulls exhibiting metopic (age 1 month) and sagittal (age 2 months) craniosynostosis were developed. These models were made into consumable skull "cartridges" that insert into a reusable base resembling an infant's head. Each cartridge consists of a multilayer scalp (skin, subcutaneous fat, galea, and periosteum); cranial bones with accurate landmarks; and the dura mater. Data related to model construction, use, and cost were collected. Eleven novice surgeons (residents), 9 experienced surgeons (fellows), and 5 expert surgeons (attendings) performed a simulated metopic and sagittal craniosynostosis repair using a neuroendoscope, high-speed drill, rongeurs, lighted retractors, and suction/irrigation. All participants completed a 13-item questionnaire (using 5-point Likert scales) to rate the realism and utility of the models for teaching endoscope-assisted strip suturectomy. RESULTS The simulators are compact, robust, and relatively inexpensive. They can be rapidly reset for repeated use and contain a minimal amount of consumable material while providing a realistic simulation experience. More than 80% of participants agreed or strongly agreed that the models' anatomical features, including surface anatomy, subgaleal and subperiosteal tissue planes, anterior fontanelle, and epidural spaces, were realistic and contained appropriate detail. More than 90% of participants indicated that handling the endoscope and the instruments was realistic, and also that the steps required to perform the procedure were representative of the steps required in real life. CONCLUSIONS Both the metopic and sagittal craniosynostosis simulators were developed using low-cost methods and were successfully designed to be reusable. The simulators were found to realistically represent the surgical procedure and can be used to develop the technical skills required for performing an endoscope-assisted craniosynostosis repair.
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Affiliation(s)
- Kyle W Eastwood
- 1Center for Image-Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto.,3Institute of Biomaterials and Biomedical Engineering, University of Toronto
| | - Vivek P Bodani
- 1Center for Image-Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto.,3Institute of Biomaterials and Biomedical Engineering, University of Toronto
| | - Faizal A Haji
- 4Department of Clinical Neurological Sciences, Western University, London, Ontario
| | - Thomas Looi
- 1Center for Image-Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto.,3Institute of Biomaterials and Biomedical Engineering, University of Toronto
| | - Hani E Naguib
- 3Institute of Biomaterials and Biomedical Engineering, University of Toronto.,5Department of Mechanical and Industrial Engineering, University of Toronto; and.,6Smart and Adaptive Polymer Laboratory (SAPL), University of Toronto, Ontario, Canada
| | - James M Drake
- 1Center for Image-Guided Innovation and Therapeutic Intervention, The Hospital for Sick Children, Toronto.,3Institute of Biomaterials and Biomedical Engineering, University of Toronto
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15
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Golestanirad L, Rahsepar AA, Kirsch JE, Suwa K, Collins JC, Angelone LM, Keil B, Passman RS, Bonmassar G, Serano P, Krenz P, DeLap J, Carr JC, Wald LL. Changes in the specific absorption rate (SAR) of radiofrequency energy in patients with retained cardiac leads during MRI at 1.5T and 3T. Magn Reson Med 2018; 81:653-669. [PMID: 29893997 PMCID: PMC6258273 DOI: 10.1002/mrm.27350] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 04/08/2018] [Accepted: 04/16/2018] [Indexed: 12/20/2022]
Abstract
PURPOSE To evaluate the local specific absorption rate (SAR) and heating around retained cardiac leads during MRI at 64 MHz (1.5T) and 127 MHz (3T) as a function of RF coil type and imaging landmark. METHODS Numerical models of retained cardiac leads were built from CT and X-ray images of 6 patients with retained cardiac leads. Electromagnetic simulations and bio-heat modeling were performed with MRI RF body and head coils tuned to 64 MHz and 127 MHz and positioned at 9 different imaging landmarks covering an area from the head to the lower limbs. RESULTS For all patients and at both 1.5T and 3T, local transmit head coils produced negligible temperature rise ( <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>Δ</mml:mo> <mml:mi>T</mml:mi> <mml:mo><</mml:mo> <mml:mn>0.1</mml:mn> <mml:mo>°</mml:mo> <mml:mi>C</mml:mi></mml:mrow> </mml:math> ) for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>3</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> . For body imaging with quadrature-driven coils at 1.5T, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>Δ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> during a 10-min scan remained < 3°C at all imaging landmarks for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>3</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> and <6°C for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>4</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> . For body imaging at 3T, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>Δ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> during a 10-min scan remained < 6°C at all imaging landmarks for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>2</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> . For shorter pulse sequences up to 2 min, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mo>Δ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> remained < 6°C for <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>3</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> . CONCLUSION For the models based on 6 patients studied, simulations suggest that MRI could be performed safely using a local head coil at both 1.5T and 3T, and with a body coil at 1.5T with pulses that produced <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>4</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> . MRI at 3T could be performed safely in these patients using pulses with <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:mrow><mml:mrow><mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo> <mml:mrow><mml:msubsup><mml:mi>B</mml:mi> <mml:mn>1</mml:mn> <mml:mo>+</mml:mo></mml:msubsup> </mml:mrow> <mml:mo>‖</mml:mo> <mml:mo>‖</mml:mo></mml:mrow> <mml:mo>≤</mml:mo> <mml:mn>2</mml:mn> <mml:mo> </mml:mo> <mml:mo>μ</mml:mo> <mml:mi>T</mml:mi></mml:mrow> </mml:math> .
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Affiliation(s)
- Laleh Golestanirad
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.,Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Amir Ali Rahsepar
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - John E Kirsch
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Kenichiro Suwa
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Jeremy C Collins
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Leonardo M Angelone
- Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Boris Keil
- Department of Life Science Engineering, Institute of Medical Physics and Radiation Protection, Giessen, Germany
| | - Rod S Passman
- Division of Cardiology, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Giorgio Bonmassar
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Peter Serano
- Division of Biomedical Physics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland
| | | | - Jim DeLap
- ANSYS Inc., Canonsburg, Pennsylvania
| | - James C Carr
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Lawrence L Wald
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
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16
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Akle V, Peña-Silva RA, Valencia DM, Rincón-Perez CW. Validation of clay modeling as a learning tool for the periventricular structures of the human brain. Anat Sci Educ 2018; 11:137-145. [PMID: 28759705 DOI: 10.1002/ase.1719] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 06/08/2017] [Accepted: 07/05/2017] [Indexed: 06/07/2023]
Abstract
Visualizing anatomical structures and functional processes in three dimensions (3D) are important skills for medical students. However, contemplating 3D structures mentally and interpreting biomedical images can be challenging. This study examines the impact of a new pedagogical approach to teaching neuroanatomy, specifically how building a 3D-model from oil-based modeling clay affects learners' understanding of periventricular structures of the brain among undergraduate medical students in Colombia. Students were provided with an instructional video before building the models of the structures, and thereafter took a computer-based quiz. They then brought their clay models to class where they answered questions about the structures via interactive response cards. Their knowledge of periventricular structures was assessed with a paper-based quiz. Afterward, a focus group was conducted and a survey was distributed to understand students' perceptions of the activity, as well as the impact of the intervention on their understanding of anatomical structures in 3D. Quiz scores of students that constructed the models were significantly higher than those taught the material in a more traditional manner (P < 0.05). Moreover, the modeling activity reduced time spent studying the topic and increased understanding of spatial relationships between structures in the brain. The results demonstrated a significant difference between genders in their self-perception of their ability to contemplate and rotate structures mentally (P < 0.05). The study demonstrated that the construction of 3D clay models in combination with autonomous learning activities was a valuable and efficient learning tool in the anatomy course, and that additional models could be designed to promote deeper learning of other neuroanatomy topics. Anat Sci Educ 11: 137-145. © 2017 American Association of Anatomists.
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Affiliation(s)
- Veronica Akle
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
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17
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Smith ML, Jones JFX. Dual-extrusion 3D printing of anatomical models for education. Anat Sci Educ 2018; 11:65-72. [PMID: 28906599 DOI: 10.1002/ase.1730] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/19/2017] [Accepted: 08/22/2017] [Indexed: 06/07/2023]
Abstract
Two material 3D printing is becoming increasingly popular, inexpensive and accessible. In this paper, freely available printable files and dual extrusion fused deposition modelling were combined to create a number of functional anatomical models. To represent muscle and bone FilaFlex3D flexible filament and polylactic acid (PLA) filament were extruded respectively via a single 0.4 mm nozzle using a Big Builder printer. For each filament, cubes (5 mm3 ) were printed and analyzed for X, Y, and Z accuracy. The PLA printed cubes resulted in errors averaging just 1.2% across all directions but for FilaFlex3D printed cubes the errors were statistically significantly greater (average of 3.2%). As an exemplar, a focus was placed on the muscles, bones and cartilage of upper airway and neck. The resulting single prints combined flexible and hard structures. A single print model of the vocal cords was constructed which permitted movement of the arytenoids on the cricoid cartilage and served to illustrate the action of intrinsic laryngeal muscles. As University libraries become increasingly engaged in offering inexpensive 3D printing services it may soon become common place for both student and educator to access websites, download free models or 3D body parts and only pay the costs of print consumables. Novel models can be manufactured as dissectible, functional multi-layered units and offer rich possibilities for sectional and/or reduced anatomy. This approach can liberate the anatomist from constraints of inflexible hard models or plastinated specimens and engage in the design of class specific models of the future. Anat Sci Educ 11: 65-72. © 2017 American Association of Anatomists.
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Affiliation(s)
- Michelle L Smith
- Anatomy Unit, Biomedical Section, School of Medicine, University College Dublin, Dublin, Ireland
| | - James F X Jones
- Anatomy Unit, Biomedical Section, School of Medicine, University College Dublin, Dublin, Ireland
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18
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Petriceks AH, Peterson AS, Angeles M, Brown WP, Srivastava S. Photogrammetry of Human Specimens: An Innovation in Anatomy Education. J Med Educ Curric Dev 2018; 5:2382120518799356. [PMID: 30246148 PMCID: PMC6144583 DOI: 10.1177/2382120518799356] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/13/2018] [Indexed: 05/28/2023]
Abstract
Cadaver-based anatomical education is supplemented by a wide range of pedagogical tools-from artistic diagrams, to photographs and videos, to 3-dimensional (3D) models. However, many of these supplements either simplify the true anatomy or are limited in their use and distribution. Photogrammetry, which overlaps 2-dimensional (2D) photographs to create digital 3D models, addresses such shortcomings by creating interactive, authentic digital models of cadaveric specimens. In this exploratory pilot study, we used a photogrammetric setup and rendering software developed by an outside group to produce digital 3D models of 8 dissected specimens of regional anatomy. The photogrammetrically produced anatomical models authentically and precisely represented their original specimens. These interactive models were deemed accurate and teachable by faculty at the Stanford University Division of Clinical Anatomy. Photogrammetry is, according to these results, another possible method for rendering cadaveric materials into interactive 3D models, which can be used for anatomical education. These models are more detailed than many computer-generated versions and provide more visuospatial information than 2D images. Future researchers and educators could use such technology to create institutional libraries of digital 3D anatomy for medical education.
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Affiliation(s)
- Aldis H Petriceks
- Division of Clinical Anatomy, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Miguel Angeles
- Division of Clinical Anatomy, Stanford University School of Medicine, Stanford, CA, USA
| | - W Paul Brown
- Division of Clinical Anatomy, Stanford University School of Medicine, Stanford, CA, USA
| | - Sakti Srivastava
- Division of Clinical Anatomy, Stanford University School of Medicine, Stanford, CA, USA
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19
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McGovern E, Kelleher E, Snow A, Walsh K, Gadallah B, Kutty S, Redmond JM, McMahon CJ. Clinical application of three-dimensional printing to the management of complex univentricular hearts with abnormal systemic or pulmonary venous drainage. Cardiol Young 2017; 27:1248-56. [PMID: 28162139 DOI: 10.1017/S104795111600281X] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In recent years, three-dimensional printing has demonstrated reliable reproducibility of several organs including hearts with complex congenital cardiac anomalies. This represents the next step in advanced image processing and can be used to plan surgical repair. In this study, we describe three children with complex univentricular hearts and abnormal systemic or pulmonary venous drainage, in whom three-dimensional printed models based on CT data assisted with preoperative planning. For two children, after group discussion and examination of the models, a decision was made not to proceed with surgery. We extend the current clinical experience with three-dimensional printed modelling and discuss the benefits of such models in the setting of managing complex surgical problems in children with univentricular circulation and abnormal systemic or pulmonary venous drainage.
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Sander IM, McGoldrick MT, Helms MN, Betts A, van Avermaete A, Owers E, Doney E, Liepert T, Niebur G, Liepert D, Leevy WM. Three-dimensional printing of X-ray computed tomography datasets with multiple materials using open-source data processing. Anat Sci Educ 2017; 10:383-391. [PMID: 28231405 DOI: 10.1002/ase.1682] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/22/2016] [Accepted: 12/26/2016] [Indexed: 06/06/2023]
Abstract
Advances in three-dimensional (3D) printing allow for digital files to be turned into a "printed" physical product. For example, complex anatomical models derived from clinical or pre-clinical X-ray computed tomography (CT) data of patients or research specimens can be constructed using various printable materials. Although 3D printing has the potential to advance learning, many academic programs have been slow to adopt its use in the classroom despite increased availability of the equipment and digital databases already established for educational use. Herein, a protocol is reported for the production of enlarged bone core and accurate representation of human sinus passages in a 3D printed format using entirely consumer-grade printers and a combination of free-software platforms. The comparative resolutions of three surface rendering programs were also determined using the sinuses, a human body, and a human wrist data files to compare the abilities of different software available for surface map generation of biomedical data. Data shows that 3D Slicer provided highest compatibility and surface resolution for anatomical 3D printing. Generated surface maps were then 3D printed via fused deposition modeling (FDM printing). In conclusion, a methodological approach that explains the production of anatomical models using entirely consumer-grade, fused deposition modeling machines, and a combination of free software platforms is presented in this report. The methods outlined will facilitate the incorporation of 3D printed anatomical models in the classroom. Anat Sci Educ 10: 383-391. © 2017 American Association of Anatomists.
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Affiliation(s)
- Ian M Sander
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
| | - Matthew T McGoldrick
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
| | - My N Helms
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Aislinn Betts
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
| | - Anthony van Avermaete
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
| | - Elizabeth Owers
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
| | - Evan Doney
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
| | | | - Glen Niebur
- Allied ENT Specialty Center, South Bend, Indiana
| | - Douglas Liepert
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
- Department of Aerospace and Mechanical Engineering, College of Engineering, University of Notre Dame, Notre Dame, Indiana
| | - W Matthew Leevy
- Department of Biological Sciences, College of Science, University of Notre Dame, Notre Dame, Indiana
- Mike and Josie Harper Cancer Research Institute, University of Notre Dame, Indiana University School of Medicine South Bend, South Bend, Indiana
- Notre Dame Integrated Imaging Facility, University of Notre Dame, Notre Dame, Indiana
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21
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Abstract
OBJECTIVES Three-dimensionally printed anatomical models are rapidly becoming an integral part of pre-operative planning of complex surgical cases. We have previously reported the "Black Bone" MRI technique as a non-ionizing alternative to CT. Segmentation of bone becomes possible by minimizing soft tissue contrast to enhance the bone-soft tissue boundary. The objectives of this study were to ascertain the potential of utilizing this technique to produce three-dimensional (3D) printed models. METHODS "Black Bone" MRI acquired from adult volunteers and infants with craniosynostosis were 3D rendered and 3D printed. A custom phantom provided a surrogate marker of accuracy permitting comparison between direct measurements and 3D printed models created by segmenting both CT and "Black Bone" MRI data sets using two different software packages. RESULTS "Black Bone" MRI was successfully utilized to produce 3D models of the craniofacial skeleton in both adults and an infant. Measurements of the cube phantom and 3D printed models demonstrated submillimetre discrepancy. CONCLUSIONS In this novel preliminary study exploring the potential of 3D printing from "Black Bone" MRI data, the feasibility of producing anatomical 3D models has been demonstrated, thus offering a potential non-ionizing alterative to CT for the craniofacial skeleton.
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Affiliation(s)
- Karen A Eley
- 1 Department of Radiology, Addenbrookes Hospital, Cambridge, UK.,2 Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | | | - Stephen J Golding
- 2 Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.,4 University College, University of Oxford, Oxford, UK
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Lim KHA, Loo ZY, Goldie SJ, Adams JW, McMenamin PG. Use of 3D printed models in medical education: A randomized control trial comparing 3D prints versus cadaveric materials for learning external cardiac anatomy. Anat Sci Educ 2016; 9:213-21. [PMID: 26468636 DOI: 10.1002/ase.1573] [Citation(s) in RCA: 212] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 09/06/2015] [Accepted: 09/12/2015] [Indexed: 05/11/2023]
Abstract
Three-dimensional (3D) printing is an emerging technology capable of readily producing accurate anatomical models, however, evidence for the use of 3D prints in medical education remains limited. A study was performed to assess their effectiveness against cadaveric materials for learning external cardiac anatomy. A double blind randomized controlled trial was undertaken on undergraduate medical students without prior formal cardiac anatomy teaching. Following a pre-test examining baseline external cardiac anatomy knowledge, participants were randomly assigned to three groups who underwent self-directed learning sessions using either cadaveric materials, 3D prints, or a combination of cadaveric materials/3D prints (combined materials). Participants were then subjected to a post-test written by a third party. Fifty-two participants completed the trial; 18 using cadaveric materials, 16 using 3D models, and 18 using combined materials. Age and time since completion of high school were equally distributed between groups. Pre-test scores were not significantly different (P = 0.231), however, post-test scores were significantly higher for 3D prints group compared to the cadaveric materials or combined materials groups (mean of 60.83% vs. 44.81% and 44.62%, P = 0.010, adjusted P = 0.012). A significant improvement in test scores was detected for the 3D prints group (P = 0.003) but not for the other two groups. The finding of this pilot study suggests that use of 3D prints do not disadvantage students relative to cadaveric materials; maximally, results suggest that 3D may confer certain benefits to anatomy learning and supports their use and ongoing evaluation as supplements to cadaver-based curriculums. Anat Sci Educ 9: 213-221. © 2015 American Association of Anatomists.
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Affiliation(s)
- Kah Heng Alexander Lim
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Zhou Yaw Loo
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Stephen J Goldie
- Department of Medicine, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton Campus, Victoria, Australia
| | - Justin W Adams
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Paul G McMenamin
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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23
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Abstract
OBJECT Endoscopic third ventriculostomy (ETV) is an effective but technically demanding procedure with significant risk. Current simulators, including human cadavers, animal models, and virtual reality systems, are expensive, relatively inaccessible, and can lack realistic sensory feedback. The purpose of this study was to construct a realistic, low-cost, reusable brain simulator for ETV and evaluate its fidelity. METHODS A brain silicone replica mimicking normal mechanical properties of a 4-month-old child with hydrocephalus was constructed, encased in the replicated skull, and immersed in water. Realistic intraventricular landmarks included the choroid plexus, veins, mammillary bodies, infundibular recess, and basilar artery. The thinned-out third ventricle floor, which dissects appropriately, is quickly replaceable. Standard neuroendoscopic equipment including irrigation is used. Bleeding scenarios are also incorporated. A total of 16 neurosurgical trainees (Postgraduate Years 1-6) and 9 pediatric and adult neurosurgeons tested the simulator. All participants filled out questionnaires (5-point Likert-type items) to rate the simulator for face and content validity. RESULTS The simulator is portable, robust, and sets up in minutes. More than 95% of participants agreed or strongly agreed that the simulator's anatomical features, tissue properties, and bleeding scenarios were a realistic representation of that seen during an ETV. Participants stated that the simulator helped develop the required hand-eye coordination and camera skills, and the training exercise was valuable. CONCLUSIONS A low-cost, reusable, silicone-based ETV simulator realistically represents the surgical procedure to trainees and neurosurgeons. It can help them develop the technical and cognitive skills for ETV including dealing with complications.
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Affiliation(s)
- Gerben E Breimer
- Centre for Image-Guided Innovation and Therapeutic Intervention and
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McMenamin PG, Quayle MR, McHenry CR, Adams JW. The production of anatomical teaching resources using three-dimensional (3D) printing technology. Anat Sci Educ 2014. [PMID: 24976019 DOI: 10.1002/ase.v7.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The teaching of anatomy has consistently been the subject of societal controversy, especially in the context of employing cadaveric materials in professional medical and allied health professional training. The reduction in dissection-based teaching in medical and allied health professional training programs has been in part due to the financial considerations involved in maintaining bequest programs, accessing human cadavers and concerns with health and safety considerations for students and staff exposed to formalin-containing embalming fluids. This report details how additive manufacturing or three-dimensional (3D) printing allows the creation of reproductions of prosected human cadaver and other anatomical specimens that obviates many of the above issues. These 3D prints are high resolution, accurate color reproductions of prosections based on data acquired by surface scanning or CT imaging. The application of 3D printing to produce models of negative spaces, contrast CT radiographic data using segmentation software is illustrated. The accuracy of printed specimens is compared with original specimens. This alternative approach to producing anatomically accurate reproductions offers many advantages over plastination as it allows rapid production of multiple copies of any dissected specimen, at any size scale and should be suitable for any teaching facility in any country, thereby avoiding some of the cultural and ethical issues associated with cadaver specimens either in an embalmed or plastinated form.
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Affiliation(s)
- Paul G McMenamin
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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McMenamin PG, Quayle MR, McHenry CR, Adams JW. The production of anatomical teaching resources using three-dimensional (3D) printing technology. Anat Sci Educ 2014; 7:479-86. [PMID: 24976019 DOI: 10.1002/ase.1475] [Citation(s) in RCA: 311] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 05/14/2014] [Accepted: 06/12/2014] [Indexed: 05/11/2023]
Abstract
The teaching of anatomy has consistently been the subject of societal controversy, especially in the context of employing cadaveric materials in professional medical and allied health professional training. The reduction in dissection-based teaching in medical and allied health professional training programs has been in part due to the financial considerations involved in maintaining bequest programs, accessing human cadavers and concerns with health and safety considerations for students and staff exposed to formalin-containing embalming fluids. This report details how additive manufacturing or three-dimensional (3D) printing allows the creation of reproductions of prosected human cadaver and other anatomical specimens that obviates many of the above issues. These 3D prints are high resolution, accurate color reproductions of prosections based on data acquired by surface scanning or CT imaging. The application of 3D printing to produce models of negative spaces, contrast CT radiographic data using segmentation software is illustrated. The accuracy of printed specimens is compared with original specimens. This alternative approach to producing anatomically accurate reproductions offers many advantages over plastination as it allows rapid production of multiple copies of any dissected specimen, at any size scale and should be suitable for any teaching facility in any country, thereby avoiding some of the cultural and ethical issues associated with cadaver specimens either in an embalmed or plastinated form.
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Affiliation(s)
- Paul G McMenamin
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, School of Biomedical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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26
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Serrat MA, Dom AM, Buchanan JT, Williams AR, Efaw ML, Richardson LL. Independent learning modules enhance student performance and understanding of anatomy. Anat Sci Educ 2014; 7:406-416. [PMID: 24616425 DOI: 10.1002/ase.1438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 12/18/2013] [Accepted: 02/03/2014] [Indexed: 06/03/2023]
Abstract
Didactic lessons are only one part of the multimodal teaching strategies used in gross anatomy courses today. Increased emphasis is placed on providing more opportunities for students to develop lifelong learning and critical thinking skills during medical training. In a pilot program designed to promote more engaged and independent learning in anatomy, self-study modules were introduced to supplement human gross anatomy instruction at Joan C. Edwards School of Medicine at Marshall University. Modules use three-dimensional constructs to help students understand complex anatomical regions. Resources are self-contained in portable bins and are accessible at any time. Students use modules individually or in groups in a structured self-study format that augments material presented in lecture and laboratory. Pilot outcome data, measured by feedback surveys and examination performance statistics, suggest that the activity may be improving learning in gross anatomy. Positive feedback on both pre- and post-examination surveys showed that students felt the activity helped to increase their understanding of the topic. In concordance with student perception, average examination scores on module-related laboratory and lecture questions were higher in the two years of the pilot program compared with the year before its initiation. Modules can be fabricated on a modest budget using minimal resources, making implementation practical for smaller institutions. Upper level medical students assist in module design and upkeep, enabling continuous opportunities for vertical integration across the curriculum. This resource offers a feasible mechanism for enhancing independent and lifelong learning competencies, which could be a valuable complement to any gross anatomy curriculum.
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Affiliation(s)
- Maria A Serrat
- Department of Anatomy and Pathology, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
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27
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Abstract
Heart shape and function are major determinants of disease severity and predictors of future morbidity and mortality. Many studies now rely on non-invasive cardiac imaging techniques to quantify structural and functional changes. Statistical anatomical modeling of heart shape and motion provides a new tool for the quantification and evaluation of heart disease. This review surveys recent progress in the evaluation of statistical shape measures across populations and sub-cohorts, and highlights collaborative efforts to facilitate data sharing and atlas-based shape analysis.
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Affiliation(s)
- Pau Medrano-Gracia
- Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand
| | - Brett R Cowan
- Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand
| | - Avan Suinesiaputra
- Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand
| | - Alistair A Young
- Department of Anatomy with Radiology, University of Auckland, Auckland, New Zealand
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28
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Neufeld E, Szczerba D, Chavannes N, Kuster N. A novel medical image data-based multi-physics simulation platform for computational life sciences. Interface Focus 2014; 3:20120058. [PMID: 24427518 DOI: 10.1098/rsfs.2012.0058] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Simulating and modelling complex biological systems in computational life sciences requires specialized software tools that can perform medical image data-based modelling, jointly visualize the data and computational results, and handle large, complex, realistic and often noisy anatomical models. The required novel solvers must provide the power to model the physics, biology and physiology of living tissue within the full complexity of the human anatomy (e.g. neuronal activity, perfusion and ultrasound propagation). A multi-physics simulation platform satisfying these requirements has been developed for applications including device development and optimization, safety assessment, basic research, and treatment planning. This simulation platform consists of detailed, parametrized anatomical models, a segmentation and meshing tool, a wide range of solvers and optimizers, a framework for the rapid development of specialized and parallelized finite element method solvers, a visualization toolkit-based visualization engine, a Python scripting interface for customized applications, a coupling framework, and more. Core components are cross-platform compatible and use open formats. Several examples of applications are presented: hyperthermia cancer treatment planning, tumour growth modelling, evaluating the magneto-haemodynamic effect as a biomarker and physics-based morphing of anatomical models.
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Affiliation(s)
- Esra Neufeld
- Foundation for Research on Information Technologies in Society (IT'IS) , Zeughausstr. 43, 8004 Zürich , Switzerland
| | - Dominik Szczerba
- Foundation for Research on Information Technologies in Society (IT'IS) , Zeughausstr. 43, 8004 Zürich , Switzerland
| | - Nicolas Chavannes
- Foundation for Research on Information Technologies in Society (IT'IS) , Zeughausstr. 43, 8004 Zürich , Switzerland
| | - Niels Kuster
- Foundation for Research on Information Technologies in Society (IT'IS) , Zeughausstr. 43, 8004 Zürich , Switzerland ; Swiss Federal Institute of Technology (ETH) Zürich , 8092 Zürich , Switzerland
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Ntsinjana HN, Biglino G, Capelli C, Tann O, Giardini A, Derrick G, Schievano S, Taylor AM. Aortic arch shape is not associated with hypertensive response to exercise in patients with repaired congenital heart diseases. J Cardiovasc Magn Reson 2013; 15:101. [PMID: 24219806 PMCID: PMC3833644 DOI: 10.1186/1532-429x-15-101] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 11/05/2013] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Aortic arch geometry is linked to abnormal blood pressure (BP) response to maximum exercise. This study aims to quantitatively assess whether aortic arch geometry plays a role in blood pressure (BP) response to exercise. METHODS 60 age- and BSA-matched subjects--20 post-aortic coarctation (CoA) repair, 20 transposition of great arteries post arterial switch operation (ASO) and 20 healthy controls--had a three-dimensional (3D), whole heart magnetic resonance angiography (MRA) at 1.5 Tesla, 3D geometric reconstructions created from the MRA. All subjects underwent cardiopulmonary exercise test on the same day as MRA using an ergometer cycle with manual BP measurements. Geometric analysis and their correlation with BP at peak exercise were assessed. RESULTS Arch curvature was similarly acute in both the post-CoA and ASO cases [0.05 ± 0.01 vs. 0.05 ± 0.01 (1/mm/m²); p = 1.0] and significantly different to that of normal healthy controls [0.05 ± 0.01 vs. 0.03 ± 0.01 (1/mm/m²), p < 0.001]. Indexed transverse arch cross sectional area were significantly abnormal in the post-CoA cases compared to the ASO cases (117.8 ± 47.7 vs. 221.3 ± 44.6; p < 0.001) and controls (117.8 ± 47.7 vs. 157.5 ± 27.2 mm²; p = 0.003). BP response to peak exercise did not correlate with arch curvature (r = 0.203, p = 0.120), but showed inverse correlation with indexed minimum cross sectional area of transverse arch and isthmus (r = -0.364, p = 0.004), and ratios of minimum arch area/ descending diameter (r = -0.491, p < 0.001). CONCLUSION Transverse arch and isthmus hypoplasia, rather than acute arch angulation plays a role in the pathophysiology of BP response to peak exercise following CoA repair.
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Affiliation(s)
- Hopewell N Ntsinjana
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK
| | - Giovanni Biglino
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK
| | - Claudio Capelli
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK
| | - Oliver Tann
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK
| | - Alessandro Giardini
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK
| | - Graham Derrick
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK
| | - Silvia Schievano
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK
| | - Andrew M Taylor
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK
- Cardiorespiratory Unit, Level 7, Nurses Home, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK
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Kooloos JGM, Vorstenbosch MATM. A tool for teaching three-dimensional dermatomes combined with distribution of cutaneous nerves on the limbs. Anat Sci Educ 2013; 6:277-280. [PMID: 23508989 DOI: 10.1002/ase.1354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 12/07/2012] [Accepted: 01/10/2013] [Indexed: 06/01/2023]
Abstract
A teaching tool that facilitates student understanding of a three-dimensional (3D) integration of dermatomes with peripheral cutaneous nerve field distributions is described. This model is inspired by the confusion in novice learners between dermatome maps and nerve field distribution maps. This confusion leads to the misconception that these two distribution maps fully overlap, and may stem from three sources: (1) the differences in dermatome maps in anatomical textbooks, (2) the limited views in the figures of dermatome maps and cutaneous nerve field maps, hampering the acquisition of a 3D picture, and (3) the lack of figures showing both maps together. To clarify this concept, the learning process can be facilitated by transforming the 2D drawings in textbooks to a 3D hands-on model and by merging the information from the separate maps. Commercially available models were covered with white cotton pantyhose, and borders between dermatomes were marked using the drawings from the students' required study material. Distribution maps of selected peripheral nerves were cut out from color transparencies. Both the model and the cut-out nerve fields were then at the students' disposal during a laboratory exercise. The students were instructed to affix the transparencies in the right place according to the textbook's figures. This model facilitates integrating the spatial relationships of the two types of nerve distributions. By highlighting the spatial relationship and aiming to provoke student enthusiasm, this model follows the advantages of other low-fidelity models.
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Affiliation(s)
- Jan G M Kooloos
- Department of Anatomy, Radboud University Nijmegen Medical Centre, The Netherlands.
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31
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Khot Z, Quinlan K, Norman GR, Wainman B. The relative effectiveness of computer-based and traditional resources for education in anatomy. Anat Sci Educ 2013; 6:211-215. [PMID: 23509000 DOI: 10.1002/ase.1355] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 01/10/2013] [Accepted: 01/10/2013] [Indexed: 05/28/2023]
Abstract
There is increasing use of computer-based resources to teach anatomy, although no study has compared computer-based learning to traditional. In this study, we examine the effectiveness of three formats of anatomy learning: (1) a virtual reality (VR) computer-based module, (2) a static computer-based module providing Key Views (KV), (3) a plastic model. We conducted a controlled trial in which 60 undergraduate students had ten minutes to study the names of 20 different pelvic structures. The outcome measure was a 25 item short answer test consisting of 15 nominal and 10 functional questions, based on a cadaveric pelvis. All subjects also took a brief mental rotations test (MRT) as a measure of spatial ability, used as a covariate in the analysis. Data were analyzed with repeated measures ANOVA. The group learning from the model performed significantly better than the other two groups on the nominal questions (Model 67%; KV 40%; VR 41%, Effect size 1.19 and 1.29, respectively). There was no difference between the KV and VR groups. There was no difference between the groups on the functional questions (Model 28%; KV, 23%, VR 25%). Computer-based learning resources appear to have significant disadvantages compared to traditional specimens in learning nominal anatomy. Consistent with previous research, virtual reality shows no advantage over static presentation of key views.
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Affiliation(s)
- Zaid Khot
- Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada
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