The first 3D printed multiple sclerosis brain: Towards a 3D era in medicine

Conventional magnetic resonance imaging (MRI) studies depict disease of the human brain in 2D but the reconstruction of a patient’s brain stricken with multiple sclerosis (MS) in 3D using 2D images has not been attempted. Using 3D reconstruction algorithms, we built a 3D printed patient-specific brain model to scale. It is a first of its kind model that depicts the total white matter lesion (WML) load using T2 FLAIR images in an MS patient. The patient’s images in Digital Imaging and Communications in Medicine (DICOM) format were imported into Mimics inPrint 2.0 (Materialise NV, Leuven, Belgium) a dedicated medical image processing software designed for the purposes of image segmentation and 3D modeling. The imported axial images were automatically formatted to display coronal and sagittal slices within the software. The imaging data were then segmented into regions and surface rendering was done to achieve 3D virtual printable files of the desired structures of interest. Rendering brain tumor(s) in 3D has been attempted with the specific intent of extending the options available to a surgeon but no study to our knowledge has attempted to quantify brain disease in MS that has, for all practical purposes, no surgical options. The purpose of our study was to demonstrate that 3D depiction of chronic neurological diseases is possible in a printable model while serving a fundamental need for patient education. Medical teaching is moored in 2D graphics and it is time to evolve into 3D models that can be life-like and deliver instant impact.

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The first 3D printed multiple sclerosis brain: Towards a 3D era in medicine

F1000Research ◽

10.12688/f1000research.12336.4 ◽

2018 ◽

Vol 6 ◽

pp. 1603

Author(s):

Jagannadha Avasarala ◽

Todd Pietila

Keyword(s):

Multiple Sclerosis ◽

Neurological Diseases ◽

3D Models ◽

Patient Specific ◽

Surface Rendering ◽

Reconstruction Algorithms ◽

Imaging Data ◽

Surgical Options ◽

3D Printed ◽

Magnetic Resonance Imaging Mri

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The first 3D printed multiple sclerosis brain: Towards a 3D era in medicine

F1000Research ◽

10.12688/f1000research.12336.1 ◽

2017 ◽

Vol 6 ◽

pp. 1603

Author(s):

Jagannadha Avasarala ◽

Todd Pietila

Keyword(s):

Multiple Sclerosis ◽

Medical Image ◽

White Matter Lesion ◽

Imaging Study ◽

Patient Specific ◽

Reconstruction Algorithms ◽

Resonance Imaging ◽

Surgical Options ◽

3D Printed ◽

Magnetic Resonance Imaging Mri

Conventional magnetic resonance imaging (MRI) studies depict disease of the human brain in 2D but the reconstruction of a patient’s brain stricken with multiple sclerosis (MS) in 3D using 2D images has not been attempted. Using 3D reconstruction algorithms, we built a 3D printed patient-specific brain model to scale. It is a first of its kind model that depicts the total white matter lesion (WML) load using T2 FLAIR images in an MS patient. The patient images in Digital Imaging and Communications in Medicine (DICOM) format were imported into Mimics inPrint 2.0 (Materialise NV, Leuven, Belgium) a dedicated medical image processing software for the purposes of image segmentation and 3D modeling. The imported axial images were automatically formatted to display coronal and sagittal slices within the software. The imaging study was then segmented into regions and surface rendered to achieve 3D virtual printable files of the desired structures of interest. Rendering brain tumor(s) in 3D has been attempted with the specific intent of extending the options available to a surgeon but no study to our knowledge has attempted to quantify brain disease in MS that has, for all practical purposes, no surgical options.

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The first 3D printed multiple sclerosis brain: Towards a 3D era in medicine

F1000Research ◽

10.12688/f1000research.12336.2 ◽

2017 ◽

Vol 6 ◽

pp. 1603

Author(s):

Jagannadha Avasarala ◽

Todd Pietila

Keyword(s):

Multiple Sclerosis ◽

Medical Image ◽

White Matter Lesion ◽

Imaging Study ◽

Patient Specific ◽

Reconstruction Algorithms ◽

Resonance Imaging ◽

Surgical Options ◽

3D Printed ◽

Magnetic Resonance Imaging Mri

Conventional magnetic resonance imaging (MRI) studies depict disease of the human brain in 2D but the reconstruction of a patient’s brain stricken with multiple sclerosis (MS) in 3D using 2D images has not been attempted. Using 3D reconstruction algorithms, we built a 3D printed patient-specific brain model to scale. It is a first of its kind model that depicts the total white matter lesion (WML) load using T2 FLAIR images in an MS patient. The patient images in Digital Imaging and Communications in Medicine (DICOM) format were imported into Mimics inPrint 2.0 (Materialise NV, Leuven, Belgium) a dedicated medical image processing software for the purposes of image segmentation and 3D modeling. The imported axial images were automatically formatted to display coronal and sagittal slices within the software. The imaging study was then segmented into regions and surface rendered to achieve 3D virtual printable files of the desired structures of interest. Rendering brain tumor(s) in 3D has been attempted with the specific intent of extending the options available to a surgeon but no study to our knowledge has attempted to quantify brain disease in MS that has, for all practical purposes, no surgical options.

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Custom Patient-Specific Three-Dimensional Printed Mitral Valve Models for Pre-Operative Patient Education Enhance Patient Satisfaction and Understanding

Journal of Medical Devices ◽

10.1115/1.4043737 ◽

2019 ◽

Vol 13 (3) ◽

Author(s):

Kay S. Hung ◽

Michael J. Paulsen ◽

Hanjay Wang ◽

Camille Hironaka ◽

Y. Joseph Woo

Keyword(s):

Patient Education ◽

Mitral Valve ◽

Three Dimensional ◽

3D Models ◽

Patient Specific ◽

Imaging Data ◽

Anatomical Models ◽

Mitral Valves ◽

Flexible Polymer ◽

3D Printed

In recent years, advances in medical imaging and three-dimensional (3D) additive manufacturing techniques have increased the use of 3D-printed anatomical models for surgical planning, device design and testing, customization of prostheses, and medical education. Using 3D-printing technology, we generated patient-specific models of mitral valves from their pre-operative cardiac imaging data and utilized these custom models to educate patients about their anatomy, disease, and treatment. Clinical 3D transthoracic and transesophageal echocardiography images were acquired from patients referred for mitral valve repair surgery and segmented using 3D modeling software. Patient-specific mitral valves were 3D-printed using a flexible polymer material to mimic the precise geometry and tissue texture of the relevant anatomy. 3D models were presented to patients at their pre-operative clinic visit and patient education was performed using either the 3D model or the standard anatomic illustrations. Afterward, patients completed questionnaires assessing knowledge and satisfaction. Responses were calculated based on a 1–5 Likert scale and analyzed using a nonparametric Mann–Whitney test. Twelve patients were presented with a patient-specific 3D-printed mitral valve model in addition to standard education materials and twelve patients were presented with only standard educational materials. The mean survey scores were 64.2 (±1.7) and 60.1 (±5.9), respectively (p = 0.008). The use of patient-specific anatomical models positively impacts patient education and satisfaction, and is a feasible method to open new opportunities in precision medicine.

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Quality Control in 3D Printing: Accuracy Analysis of 3D-Printed Models of Patient-Specific Anatomy

Materials ◽

10.3390/ma14041021 ◽

2021 ◽

Vol 14 (4) ◽

pp. 1021

Author(s):

Bernhard Dorweiler ◽

Pia Elisabeth Baqué ◽

Rayan Chaban ◽

Ahmed Ghazy ◽

Oroa Salem

Keyword(s):

Wall Thickness ◽

Large Scale ◽

Fused Deposition Modeling ◽

Vascular Anatomy ◽

3D Models ◽

Patient Specific ◽

Stl File ◽

Fused Deposition ◽

3D Printed ◽

The Mean

As comparative data on the precision of 3D-printed anatomical models are sparse, the aim of this study was to evaluate the accuracy of 3D-printed models of vascular anatomy generated by two commonly used printing technologies. Thirty-five 3D models of large (aortic, wall thickness of 2 mm, n = 30) and small (coronary, wall thickness of 1.25 mm, n = 5) vessels printed with fused deposition modeling (FDM) (rigid, n = 20) and PolyJet (flexible, n = 15) technology were subjected to high-resolution CT scans. From the resulting DICOM (Digital Imaging and Communications in Medicine) dataset, an STL file was generated and wall thickness as well as surface congruency were compared with the original STL file using dedicated 3D engineering software. The mean wall thickness for the large-scale aortic models was 2.11 µm (+5%), and 1.26 µm (+0.8%) for the coronary models, resulting in an overall mean wall thickness of +5% for all 35 3D models when compared to the original STL file. The mean surface deviation was found to be +120 µm for all models, with +100 µm for the aortic and +180 µm for the coronary 3D models, respectively. Both printing technologies were found to conform with the currently set standards of accuracy (<1 mm), demonstrating that accurate 3D models of large and small vessel anatomy can be generated by both FDM and PolyJet printing technology using rigid and flexible polymers.

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Accessing 3D Printed Vascular Phantoms for Procedural Simulation

Frontiers in Surgery ◽

10.3389/fsurg.2020.626212 ◽

2021 ◽

Vol 7 ◽

Author(s):

Jasamine Coles-Black ◽

Damien Bolton ◽

Jason Chuen

Keyword(s):

3D Printing ◽

Endovascular Procedures ◽

Low Cost ◽

3D Models ◽

Routine Care ◽

Aortic Aneurysms ◽

Patient Specific ◽

Ct Angiogram ◽

Abdominal Aortic ◽

3D Printed

Introduction: 3D printed patient-specific vascular phantoms provide superior anatomical insights for simulating complex endovascular procedures. Currently, lack of exposure to the technology poses a barrier for adoption. We offer an accessible, low-cost guide to producing vascular anatomical models using routine CT angiography, open source software packages and a variety of 3D printing technologies.Methods: Although applicable to all vascular territories, we illustrate our methodology using Abdominal Aortic Aneurysms (AAAs) due to the strong interest in this area. CT aortograms acquired as part of routine care were converted to representative patient-specific 3D models, and then printed using a variety of 3D printing technologies to assess their material suitability as aortic phantoms. Depending on the technology, phantoms cost $20–$1,000 and were produced in 12–48 h. This technique was used to generate hollow 3D printed thoracoabdominal aortas visible under fluoroscopy.Results: 3D printed AAA phantoms were a valuable addition to standard CT angiogram reconstructions in the simulation of complex cases, such as short or very angulated necks, or for positioning fenestrations in juxtarenal aneurysms. Hollow flexible models were particularly useful for device selection and in planning of fenestrated EVAR. In addition, these models have demonstrated utility other settings, such as patient education and engagement, and trainee and anatomical education. Further study is required to establish a material with optimal cost, haptic and fluoroscopic fidelity.Conclusion: We share our experiences and methodology for developing inexpensive 3D printed vascular phantoms which despite material limitations, successfully mimic the procedural challenges encountered during live endovascular surgery. As the technology continues to improve, 3D printed vascular phantoms have the potential to disrupt how endovascular procedures are planned and taught.

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Virtual Prototyping: Computational Device Placements within Detailed Human Heart Models

Applied Sciences ◽

10.3390/app10010175 ◽

2019 ◽

Vol 10 (1) ◽

pp. 175

Author(s):

Alex J. Deakyne ◽

Tinen L. Iles ◽

Alexander R. Mattson ◽

Paul A. Iaizzo

Keyword(s):

Anatomical Study ◽

3D Models ◽

Anatomical Models ◽

Cardiac Tissues ◽

Patient Demographics ◽

Wide Range ◽

Specific Device ◽

Mri Scans ◽

3D Printed ◽

Magnetic Resonance Imaging Mri

Data relative to anatomical measurements, spatial relationships, and device–tissue interaction are invaluable to medical device designers. However, obtaining these datasets from a wide range of anatomical specimens can be difficult and time consuming, forcing designers to make decisions on the requisite shapes and sizes of a device from a restricted number of specimens. The Visible Heart® Laboratories have a unique library of over 500 perfusion-fixed human cardiac specimens from organ donors whose hearts (and or lungs) were not deemed viable for transplantation. These hearts encompass a wide variety of pathologies, patient demographics, surgical repairs, and/or interventional procedures. Further, these specimens are an important resource for anatomical study, and their utility may be augmented via generation of 3D computational anatomical models, i.e., from obtained post-fixation magnetic resonance imaging (MRI) scans. In order to optimize device designs and procedural developments, computer generated models of medical devices and delivery tools can be computationally positioned within any of the generated anatomical models. The resulting co-registered 3D models can be 3D printed and analyzed to better understand relative interfaces between a specific device and cardiac tissues within a large number of diverse cardiac specimens that would be otherwise unattainable.

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Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

Biomolecules ◽

10.3390/biom10111577 ◽

2020 ◽

Vol 10 (11) ◽

pp. 1577

Author(s):

Zhonghua Sun

Keyword(s):

Cardiovascular Disease ◽

3D Printing ◽

Current Status ◽

Patient Specific ◽

Future Research ◽

Junior Doctors ◽

Imaging Data ◽

Training Tool ◽

Complex Anatomy ◽

3D Printed

Three-dimensional (3D) printing has been increasingly used in medicine with applications in many different fields ranging from orthopaedics and tumours to cardiovascular disease. Realistic 3D models can be printed with different materials to replicate anatomical structures and pathologies with high accuracy. 3D printed models generated from medical imaging data acquired with computed tomography, magnetic resonance imaging or ultrasound augment the understanding of complex anatomy and pathology, assist preoperative planning and simulate surgical or interventional procedures to achieve precision medicine for improvement of treatment outcomes, train young or junior doctors to gain their confidence in patient management and provide medical education to medical students or healthcare professionals as an effective training tool. This article provides an overview of patient-specific 3D printed models with a focus on the applications in cardiovascular disease including: 3D printed models in congenital heart disease, coronary artery disease, pulmonary embolism, aortic aneurysm and aortic dissection, and aortic valvular disease. Clinical value of the patient-specific 3D printed models in these areas is presented based on the current literature, while limitations and future research in 3D printing including bioprinting of cardiovascular disease are highlighted.

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Personalized Three-Dimensional Printed Models in Congenital Heart Disease

Journal of Clinical Medicine ◽

10.3390/jcm8040522 ◽

2019 ◽

Vol 8 (4) ◽

pp. 522 ◽

Cited By ~ 13

Author(s):

Sun ◽

Lau ◽

Wong ◽

Yeong

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Three Dimensional ◽

Patient Specific ◽

Future Research ◽

Imaging Data ◽

Doctor Patient Communication ◽

Medical Education And Training ◽

3D Printed

Patient-specific three-dimensional (3D) printed models have been increasingly used in cardiology and cardiac surgery, in particular, showing great value in the domain of congenital heart disease (CHD). CHD is characterized by complex cardiac anomalies with disease variations between individuals; thus, it is difficult to obtain comprehensive spatial conceptualization of the cardiac structures based on the current imaging visualizations. 3D printed models derived from patient’s cardiac imaging data overcome this limitation by creating personalized 3D heart models, which not only improve spatial visualization, but also assist preoperative planning and simulation of cardiac procedures, serve as a useful tool in medical education and training, and improve doctor–patient communication. This review article provides an overall view of the clinical applications and usefulness of 3D printed models in CHD. Current limitations and future research directions of 3D printed heart models are highlighted.

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Beneath the Skin: Emulating human physiology using a novel bitmap-based “voxel” 3D-printing workflow.

10.26686/wgtn.17151335 ◽

2021 ◽

Author(s):

◽

Ana Morris

Keyword(s):

Medical Education ◽

3D Printing ◽

Biomedical Imaging ◽

Human Anatomy ◽

Patient Specific ◽

Imaging Data ◽

Anatomical Models ◽

Medical Communication ◽

Medical Models ◽

3D Printed

<p>Novel technologies that produce medical models which are synthetic equivalents to human tissue may forever change the way human anatomy and medicine are explored. Medical modelling using a bitmap-based additive manufacturing workflow offers exciting opportunities for medical education, informed consent practices, skills acquisition, pre-operative planning and surgical simulation. Moving medical data from the 2D-world to tactile, highly detailed 3D-printed anatomical models may significantly change how we comprehend the body; revamping everything – from medical education to clinical practice. Research Problem The existing workflow for producing patient-specific anatomical models from biomedical imaging data involves image thresholding and iso-surface extraction techniques that result in surface meshes (also known as objects or parts). This process restricts shape specification to one colour and density, limiting material blending and resulting in anatomically inequivalent medical models. So, how can the use of 3D-printing go beyond static anatomical replication? Imagine pulling back the layers of tissue to reveal the complexity of a procedure, allowing a family to understand and discuss their diagnosis. Overcoming the disadvantages of static medical models could be a breakthrough in the areas of medical communication and simulation. Currently, patient specific models are either rigid or mesh-based and, therefore, are not equivalents of physiology. Research Aim The aim of this research is to create tangible and visually compelling patient-specific prototypes of human anatomy, offering an insight into the capabilities of new bitmap-based 3D-printing technology. It proposes that full colour, multi-property, voxel-based 3D-printing can emulate physiology, creating a new format of visual and physical medical communication. Data Collection and Procedure For this study, biomedical imaging data was converted into multi-property 3D-printed synthetic anatomy by bypassing the conversion steps of traditional segmentation. Bitmap-based 3D-printing allows for the precise control over every 14-micron material droplet or “voxel”. Control over each voxel involves a process of sending bitmap images to a high-resolution and multi-property 3D-printer. Bitmap-based 3D-printed synthetic medical models – which mimicked the colour and density of human anatomy – were successfully produced. Findings This research presented a novel and streamlined bitmap-based medical modelling workflow with the potential to save manufacturing time and labour cost. Moreover, this workflow produced highly accurate models with graduated densities, translucency, colour and flexion – overcoming complexities that arise due to our body’s opaqueness. The presented workflow may serve as an incentive for others to investigate bitmap-based 3D-printing workflows for different manufacturing applications.</p>

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