3D Printed Patient Specific Models Research Articles

Multidisciplinary Advanced Surgical Planning for Slide Tracheoplasty Using 3D-Printed Models.

The objective of this study was to develop and assess multidisciplinary advanced surgical planning (ASP) sessions using three dimensional (3D) printed models for cervicothoracic slide tracheoplasty (CST). We hypothesized that these sessions would improve surgeon confidence, streamline intraoperative planning, and highlight the utility of 3D modeling. 3D-printed patient-specific trachea models were used in pre-operative ASP sessions consisting of a multidisciplinary case discussion and hands-on slide tracheoplasty simulation. Participants completed a survey rating realism, utility, impact on the final surgical plan, and pre- and post-session confidence. Statistical analysis was performed via Wilcoxon and Kruskal-Wallis tests. Forty-eight surveys were collected across nine sessions and 27 different physicians. On a 5-point Likert scale, models were rated as "very realistic", "very useful" (both median of 4, IQR 3-4 and 4-5, respectively). Overall confidence increased by 1.4 points (+/- 0.7, p < 0.0001), with the largest change seen in those with minimal prior slide tracheoplasty experience (p = 0.005). Participants felt that the sessions "strongly" impacted their surgical plan or anticipated performance (median 4, IQR 4-5), regardless of training level or experience. 3D-printed patient-specific models were successfully implemented in ASP sessions for CST. Models were deemed very realistic and very useful by surgeons across multiple specialties and training levels. Surgical planning sessions also strongly impacted the final surgical plan and increased surgeon confidence for CST. IV Laryngoscope, 2024.

Cardiovascular Computed Tomography in the Diagnosis of Cardiovascular Disease: Beyond Lumen Assessment.

Cardiovascular CT is being widely used in the diagnosis of cardiovascular disease due to the rapid technological advancements in CT scanning techniques. These advancements include the development of multi-slice CT, from early generation to the latest models, which has the capability of acquiring images with high spatial and temporal resolution. The recent emergence of photon-counting CT has further enhanced CT performance in clinical applications, providing improved spatial and contrast resolution. CT-derived fractional flow reserve is superior to standard CT-based anatomical assessment for the detection of lesion-specific myocardial ischemia. CT-derived 3D-printed patient-specific models are also superior to standard CT, offering advantages in terms of educational value, surgical planning, and the simulation of cardiovascular disease treatment, as well as enhancing doctor-patient communication. Three-dimensional visualization tools including virtual reality, augmented reality, and mixed reality are further advancing the clinical value of cardiovascular CT in cardiovascular disease. With the widespread use of artificial intelligence, machine learning, and deep learning in cardiovascular disease, the diagnostic performance of cardiovascular CT has significantly improved, with promising results being presented in terms of both disease diagnosis and prediction. This review article provides an overview of the applications of cardiovascular CT, covering its performance from the perspective of its diagnostic value based on traditional lumen assessment to the identification of vulnerable lesions for the prediction of disease outcomes with the use of these advanced technologies. The limitations and future prospects of these technologies are also discussed.

Patient-specific 3D printed models for enhanced learning of immediate implant procedures and provisionalization.

This study aimed to describe the fabrication, implementation and evaluation of 3D-printed patient-specific models for unskilled students to enhance learning in immediate implant procedures and provisionalization. The individualized simulation models were designed and processed based on CT and digital intraoral scanning of a patient. Thirty students performed simulation implant surgery and provisionalized the implant sites on the models and answered questionnaires to assess their perceptions before and after the training. The scores of the questionnaires were analysed using the Wilcoxon signed-rank test. Significant differences before and after training were found in the students' responses. Students reported better results in understanding of surgical procedures, knowledge in prosthetically driven implantology, understanding of minimally invasive tooth extraction, confirming the accuracy of surgical template, usage of the guide rings and usage of the surgical cassette after simulation training. The overall expenditure on the simulation training involving 30 students amounted to 342.5 USD. The patient-specific and cost-efficient 3D printed models are helpful for students to improve theoretical knowledge and practical skills. Such individualized simulation models have promising application prospects.

The role of 3-D printed models in planning and resection of heterotopic ossification around the elbow: A case series

BACKGROUND: Heterotopic ossification (HO) is a concern after elbow trauma and is associated with significant limitation of movement. Although complete restoration of elbow movement is seldom possible even by surgical resection, it improves functional range of movement and quality of life. Surgical excision of HO requires meticulous preoperative planning to minimize complications such as inadequate resection, and neurovascular complications. Life size models printed with three-dimensional (3D) printing technology help in understanding the complex HO mass and its relation to neurovascular structures, thereby helping in better preoperative planning. AIM: The aim is to study the usefulness of 3D-printed patient-specific models in resection of heterotrophic ossification around elbow MATERIALS AND METHODS: The 3D models are printed using computed tomography scans by FDM technology. Surgical approaches were planned based on the dimensions and extent of the HO mass in the 3D model. Resection was performed as planned and the sterilized 3D model was also used during surgery as anatomical reference. All patients had a minimum follow-up of 1 year. They were evaluated for improvement in elbow range of motion and complications. RESULTS: Six patients underwent surgical excision of HO of the elbow, with preoperative planning using 3D-printed models. A functional range of movement was achieved in all patients. There were neurovascular complications in this case series. CONCLUSION: 3D-printed models are accurate and provide a replica of the patient-specific abnormal heterotopic ossification. 3D models provide excellent anatomical reference in planning excision by providing good orientation of the mass, dimensions, extent, and relation to neurovascular structures.

In-hospital 3D Printing to Aid Maxillofacial Surgery during the COVID-19 Pandemic.

Surgeons around the world share the same goal: providing the best care to their patients. In recent years, the complexity of procedures has increased, and so has the need for enhanced planning, training, and education. A growing number of interventionists and surgeons are using 3D-printed patient-specific models in their practice to prepare for procedures with more confidence. In 2018 we considered to implement 3D printing in our hospital, and we have created a virtual planning and 3D printing LAB within the maxillofacial surgery department at Città della Salute e della Scienza Hospital, University of Torino, Italy. (See Video [online], which displays the planning, printing and intraoperative cutting guides.) The laboratory is equipped with a CAD station and two 3D printers (Ultimaker 3 Extended and Formlabs Form 3). {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 1.","caption":"Video 1 from “In-Hospital 3d Printing in Maxillofacial Surgery during the Covid-19 Pandemic”","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_wgikhelf"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} Fig. 1.: Protective visor 3D model to print.3D-printing and advanced visualization techniques have been proved to assist clinicians develop tailored surgical approaches for patients. Hospitals, clinicians, and patients can all benefit from 3D printing regardless of whether the process is handled in-hospital or outsourced. Nevertheless, having a dedicated facility in-house can cut days off the process, support innovation initiatives, and lower the overall costs incurred by the hospital. From the beginning of 2019 until the period before the start of the COVID-19 pandemic, the laboratory within the department worked at full capacity for the virtual planning of selected cases and for the printing of models. According to Jacobs and Lin,1 3D-printing technologies in cranio-maxillofacial surgery were divided into 4 categories: Type 1 contour models, Type 2 guides, Type 3 splints, and Type 4 implants. In the period between January 2019 and the start of the pandemic, we printed a total of 331 models. In 79 cases, only type 1 models were printed; in 68 cases, type 1 models were printed together with type 2 and 3 models.2 At the start of the lockdown, elective surgical activity was drastically reduced, as well as hospital resources. Surgical activity was therefore limited only to handling trauma and tumors. However, the activity of the 3D laboratory has not suffered a limitation: in addition to the planning and realization of the surgical models, the production of protective visors has been started to support the surgical departments of the entire hospital (Fig. 1). During the period of the lockdown, 650 pieces of personal protective equipment were produced in our 3D laboratory at the Division of Maxillofacial Surgery. The creation of an in-hospital 3D lab has been shown to be an effective tool both for routine surgery and during the pandemic. The ability to customize devices and surgeries proved to be a possibility for the immediate production of emergency devices within the department.

Biomodex patient-specific brain aneurysm models: the value of simulation for first in-human experiences using new devices and robotics

BackgroundWith the recent advent of advanced technologies in the field, treatment of neurovascular diseases using endovascular techniques is rapidly evolving. Here we describe our experience with pre-surgical simulation using the...

3D Printed Patient Specific Models from Medical Imaging - A General Workflow

Abstract Scanning Technologies such as the Computer Topography (CT) or Magnetic Resonance Imaging (MRI) gather three-dimensional data (3D) that can be viewed on 2D Screens. However, actual 3D models allow a better interaction with real objects. Developments in image partition algorithms and improved accessibility of three-dimensional (3D) printers has resulted in manufacturing cost effective patient-specific models without proficient knowledge. In this paper, a general workflow is executed to transform the medical image such as Computer Tomography (CT) to 3D printable physical model. The process is split into four stages: image acquisition, image partition, mesh adjustment and 3D printing. The efficacy of this streamlined workflow has been demonstrated by producing heart, kidneys, liver and lungs using Stratasys Object260 Connex 3D printer. This paper concludes with a general method to convert a medical image to 3D printable solid model and it works for the extensive array of organs and anatomical regions of interest. Also provided an outline of open-source software’s which can be used for medical image partition by end users who are not specialized in image processing.

Optimizing the Quality of 4D-DSA Temporal Information.

Quantification of blood flow using a 4D-DSA would be useful in the diagnosis and treatment of cerebrovascular diseases. A protocol optimizing identification of density variations in the time-density curves of a 4D-DSA has not been defined. Our purpose was to determine the contrast injection protocol most likely to result in the optimal pulsatility signal strength. Two 3D-printed patient-specific models were used and connected to a pulsatile pump and flow system, which delivered 250-260 mL/min to the model. Contrast medium (Isovue, 370 mg I/mL, 75% dilution) was injected through a 6F catheter positioned upstream from the inlet of the model. 4D-DSA acquisitions were performed for the following injection rates: 1.5, 2.0, 2.5, 3.0 and 3.5 mL/s for 8 seconds. To determine pulsatility, we analyzed the time-density curve at the inlets using the oscillation amplitude and a previously described numeric metric, the sideband ratio. Vascular geometry from 4D-DSA reconstructions was compared with ground truth and micro-CT measurements of the model. Dimensionless numbers that characterize hemodynamics, Reynolds and Craya-Curtet, were calculated for each injection rate. The strongest pulsatility signal occurred with the 2.5 mL/s injections. The largest oscillation amplitudes were found with 2.0- and 2.5-mL/s injections. Geometric accuracy was best preserved with injection rates of >1.5 mL/s. An injection rate of 2.5 mL/s provided the strongest pulsatility signal in the 4D-DSA time-density curve. Geometric accuracy was best preserved with injection rates above 1.5 mL/s. These results may be useful in future in vivo studies of blood flow quantification.