Abstract
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.
Highlights
Multiple sclerosis (MS) is a chronic, white and gray matter disease of the central nervous system
Development of computational models for patient-specific requirements based on human pathophysiology individualized to patient-specific data is needed as we move forward with advanced techniques such as 3D printing in medicine
Our work will trigger research into the study of regional/global atrophy, focal/total cortical thickness assessment and deep gray matter changes in 3D, a field that is increasingly coming to light in conventional studies using Structural Image Evaluation Using Normalization of Atrophy software and statistical parametric mapping analysis (Pagani et al, 2005)
Summary
Multiple sclerosis (MS) is a chronic, white and gray matter disease of the central nervous system. Data acquisition and segmentation We obtained routine MRI images of the brain from a young Caucasian woman in her early 20s who came to our neurology clinic for the first time following a hospital visit for headache, mild gait problems and visual impairment in her right eye that she had developed over the two days prior to presentation. The MRI images showed typical white matter lesions that raised concern for MS; her diagnosis was established after ruling out mimics Since her brain contained an unusually high lesion load, we opted to print a 3D model to fully ascertain the extent of white matter involvement by total lesion volume. The brain cortex was printed using transparent material, with blue representing the ventricles and lesions as depicted in pink (Figure 2)
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