Abstract
BackgroundTraining in medical education depends on the availability of standardized materials that can reliably mimic the human anatomy and physiology. One alternative to using cadavers or animal bodies is to employ phantoms or mimicking devices. Styrene-ethylene/butylene-styrene (SEBS) gels are biologically inert and present tunable properties, including mechanical properties that resemble the soft tissue. Therefore, SEBS is an alternative to develop a patient-specific phantom, that provides real visual and morphological experience during simulation-based neurosurgical training.ResultsA 3D model was reconstructed and printed based on patient-specific magnetic resonance images. The fused deposition of polyactic acid (PLA) filament and selective laser sintering of polyamid were used for 3D printing. Silicone and SEBS materials were employed to mimic soft tissues. A neuronavigation protocol was performed on the 3D-printed models scaled to three different sizes, 100%, 50%, and 25% of the original dimensions. A neurosurgery team (17 individuals) evaluated the phantom realism as “very good” and “perfect” in 49% and 31% of the cases, respectively, and rated phantom utility as “very good” and “perfect” in 61% and 32% of the cases, respectively. Models in original size (100%) and scaled to 50% provided a quantitative and realistic visual analysis of the patient’s cortical anatomy without distortion. However, reduction to one quarter of the original size (25%) hindered visualization of surface details and identification of anatomical landmarks.ConclusionsA patient-specific phantom was developed with anatomically and spatially accurate shapes, that can be used as an alternative for surgical planning. Printed models scaled to sizes that avoided quality loss might save time and reduce medical training costs.
Highlights
Training in medical education depends on the availability of standardized materials that can reliably mimic the human anatomy and physiology
Patient-specific phantom The magnetic resonance imaging (MRI) scan of a three-year-old boy diagnosed with Sturge-Weber Syndrome [27] was acquired using a 3DT1 gradient echo sequence (TR = 4.8 ms; TE = 3.4 ms; acquisition matrix = 129 × 164 × 169 mm; slice thickness = 1 mm; pixel size = 1 × 1 mm) in a scanner Achieva 3 T (Philips, The Netherlands)
The molds were filled with molten SEBS gel (Kraton Polymers, Houston, EUA), which was manufactured by mixing the SEBS copolymer with mineral oil at a concentration of 10% w/w; as described by Cabrelli et al [23]
Summary
Training in medical education depends on the availability of standardized materials that can reliably mimic the human anatomy and physiology. One alternative to using cadavers or animal bodies is to employ phantoms or mimicking devices. SEBS is an alternative to develop a patient-specific phantom, that provides real visual and morphological experience during simulationbased neurosurgical training. Grillo et al 3D Printing in Medicine (2018) 4:3 Medical training is another method to minimize medical errors and to make procedures more accurate. The classical approach to anatomy and surgery teaching and learning is based on the use of human cadavers [10] and animals. This strategy is becoming less common due to the high cost and ethical and/or logistic issues involved in collecting cadavers and in maintaining live animals prior to sacrifice. Computational simulation [11, 13,14,15] and phantoms [16] are alternative tools for training purposes
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