Production of patient-specific electron beam aperture cut-outs using a low-cost, multi-purpose 3D printer

OBJECT Commercially available, preformed patient-specific cranioplasty implants are anatomically accurate but costly. Acrylic bone cement is a commonly used alternative. However, the manual shaping of the bone cement is difficult and may not lead to a satisfactory implant in some cases. The object of this study was to determine the feasibility of fabricating molds using a commercial low-cost 3D printer for the purpose of producing patient-specific acrylic cranioplasty implants. METHODS Using data from a high-resolution brain CT scan of a patient with a calvarial defect posthemicraniectomy, a skull phantom and a mold were generated with computer software and fabricated with the 3D printer using the fused deposition modeling method. The mold was used as a template to shape the acrylic implant, which was formed via a polymerization reaction. The resulting implant was fitted to the skull phantom and the cranial index of symmetry was determined. RESULTS The skull phantom and mold were successfully fabricated with the 3D printer. The application of acrylic bone cement to the mold was simple and straightforward. The resulting implant did not require further adjustment or drilling prior to being fitted to the skull phantom. The cranial index of symmetry was 96.2% (the cranial index of symmetry is 100% for a perfectly symmetrical skull). CONCLUSIONS This study showed that it is feasible to produce patient-specific acrylic cranioplasty implants with a low-cost 3D printer. Further studies are required to determine applicability in the clinical setting. This promising technique has the potential to bring personalized medicine to more patients around the world.

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A feasibility study for using ABS plastic and a low-cost 3D printer for patient-specific brachytherapy mould design

Australasian Physical & Engineering Sciences in Medicine ◽

10.1007/s13246-015-0356-3 ◽

2015 ◽

Vol 38 (3) ◽

pp. 399-412 ◽

Cited By ~ 22

Author(s):

Benjamin D. Harris ◽

Sanna Nilsson ◽

Christopher M. Poole

Keyword(s):

Feasibility Study ◽

Low Cost ◽

Patient Specific ◽

3D Printer ◽

Mould Design

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Three-dimensional printing versus conventional machining in the creation of a meatal urethral dilator: a cost and mechanical strength analysis

10.21203/rs.2.21033/v1 ◽

2020 ◽

Author(s):

Michael Yue-Cheng Chen ◽

Jacob Skewes ◽

Ryan Daley ◽

Maria Ann Woodruff ◽

Nicholas John Rukin

Keyword(s):

3D Printing ◽

Low Cost ◽

Three Dimensional ◽

Patient Specific ◽

Strength Analysis ◽

3D Printer ◽

Fused Deposition ◽

3D Printed ◽

The Cost ◽

Conventional Machining

Abstract Background Three-dimensional (3D) printing is a promising technology in medicine. Low-cost 3D printing options are accessible but the limitations are often poorly understood. We aim to compare fused deposition modelling (FDM), the most common and low cost 3D printing technique, with selective laser sintering (SLS) and conventional machining techniques in manufacturing meatal urethral dilators which were recently removed from the Australian market.Methods A meatal urethral dilator was designed using computer-aided design (CAD). The dilator was 3D printed vertically orientated on a low cost FDM 3D printer in polylactic acid (PLA) and acrylonitrile butadiene styrene (ABS). It was also 3D printed horizontally orientated in ABS on a high-end FDM 3D printer with soluble support material, as well as on a SLS 3D printer in medical nylon. The dilator was also machined in medical stainless steel using a lathe. All dilators were tested mechanically in a custom rig by hanging calibrated weights from the handle until the dilator snapped.Results The horizontally printed ABS dilator experienced failure at a greater load than the vertically printed PLA and ABS dilators respectively (503g vs 283g vs 163g, p < 0.001). The SLS nylon dilator did not fail but began to bend and deformed at around 5,000g of pressure. The steel dilator did not bend even at 10,000g of pressure. The cost per dilator is highest for the steel dilator if assuming a low quantity of five at 98 USD, but this decreases to 30 USD for a quantity of 1000. In contrast, the cost for the SLS dilator is 33 USD for a quantity of five but relatively unchanged at 27 for a quantity of 1000.Conclusions SLS and conventional machining created clinically functional meatal dilators but low-cost FDM printing could not. We suggest that at the current time 3D printing is not a replacement for conventional manufacturing techniques which are still the most reliable way to produce large quantities of parts with a simple geometry such as the meatal dilator. 3D printing is best used for patient-specific parts, prototyping or manufacturing complex parts that have additional functionality that cannot be achieved with conventional machining methods.

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Low-cost endoscopic third ventriculostomy simulator with mimetic endoscope

Journal of Neurosurgery Pediatrics ◽

10.3171/2018.2.peds17671 ◽

2018 ◽

Vol 22 (2) ◽

pp. 137-146 ◽

Cited By ~ 4

Author(s):

Richard Justin Garling ◽

Xin Jin ◽

Jianzhong Yang ◽

Ahmad H. Khasawneh ◽

Carolyn Anne Harris

Keyword(s):

Open Source ◽

Open Source Software ◽

Endoscopic Third Ventriculostomy ◽

Low Cost ◽

Resident Training ◽

Patient Specific ◽

Third Ventriculostomy ◽

3D Printer ◽

Specific Subset ◽

The Brain

OBJECTIVEHydrocephalus affects approximately 1 in 500 people in the US, yet ventricular shunting, the gold standard of treatment, has a nearly 85% failure rate. Endoscopic third ventriculostomy (ETV) is an alternative surgical approach for a specific subset of hydrocephalic patients, but can be limited by the inability of neurosurgical residents to practice prior to patient contact. The goal of this study was to create an affordable ETV model and endoscope for resident training.METHODSOpen-source software was used to isolate the skull and brain from the CT and MR images of a 2-year-old boy with hydrocephalus. A 3D printer created the skull and a 3D mold of the brain. A mixture of silicone and silicone tactile mutator was used to cast the brain mold prior to subsequent compression and shearing modulus testing. A mimetic endoscope was then created from basic supplies and a 3D printed frame. A small cohort of neurosurgical residents and attending physicians evaluated the ETV simulator with mimetic endoscope.RESULTSThe authors successfully created a mimetic endoscope and ETV simulator. After compression and shearing modulus testing, a silicone/Slacker ratio between 10:6 and 10:7 was found to be similar to that of human brain parenchyma. Eighty-seven percent of participants strongly agreed that the simulator was useful for resident training, and 93% strongly agreed that the simulator helped them understand how to orient themselves with the endoscope.CONCLUSIONSThe authors created an affordable (US$123, excluding 3D printer), easy-to-use ETV simulator with endoscope. Previous models have required expensive software and costly operative endoscopes that may not be available to most residents. Instead, this attempt takes advantage of open-source software for the manipulation and fabrication of a patient-specific mold. This model can assist with resident development, allowing them to safely practice use of the endoscope in ETV.

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An Innovative and Cost-Advantage CAD Solution for Cubitus Varus Surgical Planning in Children

Applied Sciences ◽

10.3390/app11094057 ◽

2021 ◽

Vol 11 (9) ◽

pp. 4057

Author(s):

Leonardo Frizziero ◽

Gian Maria Santi ◽

Christian Leon-Cardenas ◽

Giampiero Donnici ◽

Alfredo Liverani ◽

...

Keyword(s):

Computer Aided Design ◽

Low Cost ◽

Cost Effective ◽

Varus Deformity ◽

Patient Specific ◽

Cubitus Varus ◽

Surgical Guide ◽

Traditional Procedure ◽

Custom Made ◽

Patient Specific Instruments

The study of CAD (computer aided design) modeling, design and manufacturing techniques has undergone a rapid growth over the past decades. In medicine, this development mainly concerned the dental and maxillofacial sectors. Significant progress has also been made in orthopedics with pre-operative CAD simulations, printing of bone models and production of patient-specific instruments. However, the traditional procedure that formulates the surgical plan based exclusively on two-dimensional images and interventions performed without the aid of specific instruments for the patient and is currently the most used surgical technique. The production of custom-made tools for the patient, in fact, is often expensive and its use is limited to a few hospitals. The purpose of this study is to show an innovative and cost-effective procedure aimed at prototyping a custom-made surgical guide for address the cubitus varus deformity on a pediatric patient. The cutting guides were obtained through an additive manufacturing process that starts from the 3D digital model of the patient’s bone and allows to design specific models using Creo Parametric. The result is a tool that adheres perfectly to the patient’s bone and guides the surgeon during the osteotomy procedure. The low cost of the methodology described makes it worth noticing by any health institution.

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Accuracy Verification of an Anatomical Model Manufactured Using Low-Cost Additive Production

Applied Sciences ◽

10.3390/app11020594 ◽

2021 ◽

Vol 11 (2) ◽

pp. 594

Author(s):

Teodor Tóth ◽

Patrik Varga ◽

Branko Štefanovič ◽

Lucia Bednarčíková ◽

Marek Schnitzer ◽

...

Keyword(s):

Surface Coverage ◽

Reference Model ◽

Low Cost ◽

Cervical Vertebra ◽

3D Printer ◽

3D Scanner ◽

Entire Surface ◽

Additive Production ◽

The Third ◽

And Training

The paper deals with the separation of the third cervical vertebra using the software VGStudio MAX, Mimics, and inVesalius. During the separation, various parameters of the threshold were used to determine the effect. The comparison of models from Mimics and inVesalius to VGStudio MAX showed that the cumulative variance distribution for 95% surface coverage is less than 0.935 mm. When comparing medically oriented software, Mimics and inVesalius, the deviation was less than 0.356 mm. The model was made of polylactic acid (PLA) material on a low-cost 3D printer, Prusa i3 MK2.5 MMU1. The printed model was scanned by four scanners: Artec Eva, 3Shape D700, Steinbichler Comet L3D, and Creaform EXAscan. The outputs from the scanners were compared to the reference model (standard tessellation language (STL) model for 3D printing) as well as to the scanner with the best accuracy (3Shape). Compared to the publications below, the analysis of deviations was evaluated on the entire surface of the model and not on selected dimensions. The cumulative variance distribution for comparing the output from the 3D scanner with the reference model, as well as comparing the scanners, shows that the deviation for 95% of the surface coverage is at the level of 0.300 mm. Since the model of the vertebra is planned for education and training, the used software and technologies are suitable for use in the design and the production process.

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Hybrid Spine Simulator Prototype for X-ray Free Pedicle Screws Fixation Training

Applied Sciences ◽

10.3390/app11031038 ◽

2021 ◽

Vol 11 (3) ◽

pp. 1038

Author(s):

Sara Condino ◽

Giuseppe Turini ◽

Virginia Mamone ◽

Paolo Domenico Parchi ◽

Vincenzo Ferrari

Keyword(s):

Augmented Reality ◽

Low Cost ◽

Lumbar Vertebrae ◽

Pedicle Screws ◽

Simulation Software ◽

Patient Specific ◽

Innovative Strategy ◽

X Ray ◽

3D Printed ◽

Harmful Radiation

Simulation for surgical training is increasingly being considered a valuable addition to traditional teaching methods. 3D-printed physical simulators can be used for preoperative planning and rehearsal in spine surgery to improve surgical workflows and postoperative patient outcomes. This paper proposes an innovative strategy to build a hybrid simulation platform for training of pedicle screws fixation: the proposed method combines 3D-printed patient-specific spine models with augmented reality functionalities and virtual X-ray visualization, thus avoiding any exposure to harmful radiation during the simulation. Software functionalities are implemented by using a low-cost tracking strategy based on fiducial marker detection. Quantitative tests demonstrate the accuracy of the method to track the vertebral model and surgical tools, and to coherently visualize them in either the augmented reality or virtual fluoroscopic modalities. The obtained results encourage further research and clinical validation towards the use of the simulator as an effective tool for training in pedicle screws insertion in lumbar vertebrae.

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Low-Cost Customized Cranioplasty with Polymethyl Methacrylate Using 3D Printer Generated Mold: An Institutional Experience and Review of Literature

Indian Journal of Neurotrauma ◽

10.1055/s-0041-1729679 ◽

2021 ◽

Author(s):

Ankit Chaudhary ◽

Virendra Deo Sinha ◽

Sanjeev Chopra ◽

Jitendra Shekhawat ◽

Gaurav Jain

Keyword(s):

Polymethyl Methacrylate ◽

Bone Fractures ◽

Low Cost ◽

Operating Time ◽

Three Dimensional ◽

Wound Dehiscence ◽

3D Printer ◽

Skull Defects ◽

Aesthetic Appearance ◽

The Mean

Abstract Background Cranioplasty is performed to repair skull defects and to restore normal skull anatomy. Optimal reconstruction remains a topic of debate. Autologous bone flap is the standard option but it may not be available due to traumatic bone fractures, bone infection, and resorption. The authors present their experience with prefabrication of precise and low-cost polymethyl methacrylate (PMMA) mold using three-dimensional (3D) digital printing. Methods A total of 30 patients underwent cranioplasty between March 2017 and September 2019 at Sawai Man Singh Medical College Jaipur, India. Preoperative data included diagnosis for which decompressive craniectomy was done and Glasgow coma scale score. Intraoperative data included operating time. Postoperative data included cosmetic outcome in the form of cranial contour and margins, complications such as infection, seroma, implant failure, wound dehiscence, and hematoma. Results Patient age at cranioplasty ranged from 12 to 63 years with a mean age of 36.7 years. The mean operating time was 151.6 minutes (range 130–190 minutes). The mean follow-up period was 8 months (range 6–13 months). Postoperative wound dehiscence developed in one case (3.3%). Cranial contour and approximation of the margins were excellent and aesthetic appearance improved in all patients. Conclusion Low-cost PMMA implant made by digital 3D printer mold is associated with reconstruction of the deformed skull contour giving satisfactory results to the patient and his family members, at a low cost compared with other commercially available implants. This technique could be a breakthrough in cranioplasty.

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Performance of Low-Cost 3D Printer in Medical Application

Volume 1: Additive Manufacturing; Advanced Materials Manufacturing; Biomanufacturing; Life Cycle Engineering; Manufacturing Equipment and Automation ◽

10.1115/msec2021-63208 ◽

2021 ◽

Author(s):

Nor Aiman Sukindar ◽

Azib Azhari Awang Dahan ◽

Sharifah Imihezri Syed Shaharuddin ◽

Nor Farah Huda Abd Halim

Keyword(s):

Low Cost ◽

Medical Application ◽

Fused Deposition Modelling ◽

3D Printer ◽

Layer By Layer ◽

Total Deformation ◽

Element Analysis ◽

Porosity Level ◽

Fused Deposition ◽

Printing Parameters

Abstract Fused Deposition Modelling (FDM) is an additive manufacturing (AM) process that produces a physical object directly from a CAD design using layer-by-layer deposition of the filament material that is extruded via a nozzle. In industry, FDM has become one of the most used AM processes for the production of low batch quantity and functional prototypes, due to its safety, efficiency, reliability, low cost, and ability to process manufacturing-grade engineering thermoplastic. Recently, the market is flooded with the availability of low-cost printers produced by numerous companies. This research aims to investigate the effect of different porosity levels on a scaffold structure produced using a low-cost 3D printer. Comparisons of these porous structures were made in terms of Von-Mises strain, total deformation, as well as compressive stress. Various porosity levels were created by varying printing parameters, including layer height, infill density, and shell thickness by slicing the initial solid CAD file using Repetier Host 3D printing software. Finite Element Analysis (FEA) simulation was then performed on the created scaffold structures by using Ansys Workbench 19.2. The simulation result indicates that the greater porosity level will result in higher total deformation of the structure. Meanwhile, the compression test shows that the minimum strength value obtained was favourable at 22 MPa and had exceeded that of the trabecular femur (15 MPa). However, its porosity level (maximum at 52%) was still below that of the minimum threshold of porosity level of 70 percent. However, the printing parameters currently used can be adjusted in the future. Therefore, it was deduced that the low-cost 3D printer offers promising potential to fabricate different porosity structures with multiple outcomes.

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