Medical Phantom Research Articles

Hydrogel System with Independent Tailoring of Mechanics, CT, and US Contrasts for Affordable Medical Phantoms.

Medical phantoms mimic aspects of procedures like computed tomography (CT), ultrasound (US) imaging, and surgical practices. However, the materials for current commercial phantoms are expensive and the fabrication with these is complex and lacks versatility. Therefore, existing material solutions are not suitable for creating patient-specific phantoms. We present a novel and cost-effective material system (utilizing ubiquitous sodium alginate hydrogel and coconut fat) with independently and accurately tailorable CT, US, and mechanical properties. By varying the concentration of alginate, cross-linker, and coconut fat, the radiological parameters and the elastic modulus were adjusted independently in a wide range. The independence was demonstrated by creating phantoms with features hidden in US, while visible in CT imaging and vice versa. This system is particularly beneficial in resource-scarce areas since the materials are cheap (<$ 1 USD/kg) and easy to obtain, offering realistic and versatile phantoms to practice surgeries and ultimately enhance patient care.

Requirement analysis in medical phantom development: a survey tool approach with an illustrative example of a multimodal deformable pelvic phantom

Requirement analysis in medical phantom development: a survey tool approach with an illustrative example of a multimodal deformable pelvic phantom

Customization of Computed Tomography Radio-Opacity in 3D-Printed Contrast-Injectable Tumor Phantoms.

Medical Imaging Phantoms (MIPs) calibrate imaging devices, train medical professionals, and can help procedural planning. Traditional MIPs are costly and limited in customization. Additive manufacturing allows for customizable, patient-specific phantoms. This study examines the CT attenuation characteristics of contrast-injectable, chambered 3D-printed phantoms to optimize tissue-mimicking capabilities. A MIP was constructed from a CT of a complex pelvic tumor near the iliac bifurcation. A 3D reconstruction of these structures composed of three chambers (aorta, inferior vena cava, tumor) with ports for contrast injection was 3D printed. Desired attenuations were 200 HU (arterial I), 150 HU (venous I), 40 HU (tumor I), 150 HU (arterial II), 90 HU (venous II), and 400 HU (tumor II). Solutions of Optiray 350 and water were injected, and the phantom was scanned on CT. Attenuations were measured using ROIs. Mean attenuation for the six phases was as follows: 37.49 HU for tumor I, 200.50 HU for venous I, 227.92 HU for arterial I, 326.20 HU for tumor II, 91.32 HU for venous II, and 132.08 HU for arterial II. Although the percent differences between observed and goal attenuation were high, the observed relative HU differences between phases were similar to goal HU differences. The observed attenuations reflected the relative concentrations of contrast solutions used, exhibiting a strong positive correlation with contrast concentration. The contrast-injectable tumor phantom exhibited a useful physiologic range of attenuation values, enabling the modification of tissue-mimicking 3D-printed phantoms even after the manufacturing process.

Medical phantom of the knee joint for computed tomography studies

Medical phantom of the knee joint for computed tomography studies

On the gamma radiation response of commercially available 3D printing materials for medical dosimetry

3D printing technology has rapidly spread for decades, allowing the fabrication of medical implants and human phantoms and revolutionizing healthcare. The objective of this study is to evaluate some radiological properties of commercially available 3D printing materials as potential tissue mimicking materials. Among fifteen materials, we compared their properties with nine human tissues. In all materials and tissues, exposure and energy absorption buildup factors were calculated for photon energies between 0.015 and 15 MeV and penetration depths up to 40 mean free path. Furthermore, the Geant4 Monte Carlo toolkit (version 10.5) was used to simulate their percentage depth dose distributions. In addition, equivalent atomic numbers, effective atomic numbers, attenuation coefficients, and CT numbers have been examined. All parameters were considered in calculating the average relative error (σ), which was used as a statistical comparison tool. With σ between 6 and 7, we found that Polylactic Acid (PLA) was capable of simulating eye lenses, blood, soft tissue, lung, muscle, and brain tissues. Moreover, Polymethacrylic Acid (PMAA) material has a σ value of 4 when modeling adipose and breast tissues, respectively. Aside from that, variations in 3D printing materials’ infilling percentage can affect their CT numbers. We therefore suggest the PLA for mimicking soft tissue, muscle, brain, eye lens, lung and blood tissues, with an infill of between 92.7 and 94.3 percent. We also suggest an 89 percent infill when simulating breast tissue. Furthermore, with a 96.7 percent infill, the PMAA faithfully replicates adipose tissue. Additionally, we found that a 59 percent infill of Fe-PLA material is comparable to cortical bone. Due to the benefits of creating individualized medical phantoms and equipment, the results might be seen as an added value for both patients and clinicians.

Evaluation of radiation attenuation properties of breast equivalent phantom material made of gelatin material in mammographic X-ray energies

The work discusses the development of a novel breast phantom material using local gelatin for medical imaging and patient-specific quality assurance. Various gelatin samples were fabricated, differing in hardness (200, 240, and 250 Bloom values) and gelatin-to-water ratios (15%, 20%, and 25%). These samples were evaluated for density, which ranged from 1.04 to 1.08 g/cm³, and for mechanical properties, revealing that higher hardness and gelatin-to-water ratios led to increased stress-strain values. The study also measured the linear and mass attenuation coefficients (μ, μm) of these samples under different X-ray energies (20–40 kV), finding that samples S7, S8, and S9 exhibited the highest μ values across all energies. The properties of these gelatin samples were compared with data on human breast tissue of different ages from the XCOM database. Samples S1 to S6 closely matched the breast tissue of the young age group, with a minimal difference of less than 0.33. Fitness tests (χ2) indicated that samples with 20% and 25% gelatin content were particularly effective in mimicking young breast tissue. This research suggests the potential of using gelatin samples with at least 20% gelatin powder as a promising material for mimicking young breast tissue in medical phantoms.

Computed Tomography Attenuation of Three-Dimensional (3D) Printing Materials-Depository to Aid in Constructing 3D-Printed Phantoms.

Three-dimensionally printed phantoms are increasingly used in medical imaging and research due to their cost-effectiveness and customizability, offering valuable alternatives to commercial phantoms. The purpose of this study was to assess the computed tomography (CT) attenuation characteristics of 27 resin materials from Formlabs, a 3D printing equipment and materials manufacturer. Cube phantoms (both solid and hollow constructions) produced with each resin were subjected to CT scanning under varying tube current-time products with attenuation measurements recorded in Hounsfield units (HU). The resins exhibited a wide range of attenuation values (-3.33 to 2666.27 HU), closely mimicking a range of human tissues, from fluids to dense bone structures. The resins also demonstrated consistent attenuation regardless of changes in the tube current. The CT attenuation analysis of FormLabs resins produced an archive of radiological imaging characteristics of photopolymers that can be utilized to construct more accurate tissue mimicking medical phantoms and improve the evaluation of imaging device performance.

Demonstration of medical imaging using flexible polymer ultrasound technology

We present a novel ultrasound transducer technology based on piezo polymers. Its fabrication process (PillarWaveTM), based on creating hexagonal micro-structured PVDF-TrFE pillars. This makes it fully flexible and allows scaling to large apertures (&amp;gt;15 × 15 cm2). Large area flexible transducers enable to select relevant field of view in automated post-processing. This can alleviate the need for a skilled sonographer and enable applications of echography outside clinics. To demonstrate its performance, a 128 element 8 MHz linear array is designed and manufactured. Its total thickness is 0.1 mm. Its acoustic characteristics are determined demonstrating 5.2 kPa/V transmit efficiency and 150 mV/Pa sensitivity. The receive bandwidth at -6dB is larger than 100%. A peak pressure in excess of 1 MPa at 4 cm from the array is measured in water. The transducer array is connected to a Verasonics Vantage research medical ultrasound system. The imaging performance of the array is demonstrated experimentally. Real-time imaging of an in vitro- medical phantom using plane wave compounding and delay-and-sum beamforming is demonstrated at 15 frames per second, with point spread functions at -20 dB of 1.3 and 0.92 mm in the lateral and depth directions, respectively. Finally, imaging of a human carotid in vivo is demonstrated.

Iterative reconstruction of medical phantoms on the computing cluster of eagle

Now one of the most important tasks is development and adaptation of iterative methods for the solution of the superbig rarefied systems of the algebraic equations. The problem of iterative parallel reconstruction of three-dimensional images of industrial facilities leads to such computing tasks. The fact that iterative methods of the solution of computing problems of big dimension are implemented on parallel structures much more effectively, than direct methods of their decision is important.

Custom-made flow phantoms for quantitative ultrasound microvessel imaging

Morphologically realistic flow phantoms are essential experimental tools for quantitative ultrasound-based microvessel imaging. As new quantitative flow imaging tools are developed, the need for more complex vessel-mimicking phantoms is indisputable. In this article, we propose a method for fabricating phantoms with sub-millimeter channels consisting of branches and curvatures in various shapes and sizes suitable for quantifying vessel morphological features. We used different tissue-mimicking materials (TMMs) compatible with ultrasound imaging as the base and metal wires of different diameters (0.15–1.25 mm) to create wall-less channels. The TMMs used are silicone rubber, plastisol, conventional gelatin, and medical gelatin. Mother channels in these phantoms were made in diameters of 1.25 mm or 0.3 mm and the daughter channels in diameters 0.3 mm or 0.15 mm. Bifurcations were created by soldering wires together at branch points. Quantitative parameters were assessed, and accuracy of measurements from the ground truth were determined. Channel diameters were seen to have increased (76–270%) compared to the initial state in the power Doppler images, partly due to blood mimicking fluid pressure. Amongst the microflow phantoms made from the different TMMs, the medical gelatin phantom was selected as the best option for microflow imaging, fulfilling the objective of being easy to fabricate with high transmittance while having a speed of sound and acoustic attenuation close to human tissue. A flow velocity of 0.85 ± 0.01 mm/s, comparable to physiological flow velocity was observed in the smallest diameter phantom (medical gelatin branch) presented here. We successfully constructed more complex geometries, including tortuous and multibranch channels using the medical gelatin as the TMM. We anticipate this will create new avenues for validating quantitative ultrasound microvessel imaging techniques.

Silicone phantoms fabricated with multi-material extrusion 3D printing technology mimicking imaging properties of soft tissues in CT

Recently, 3D printing has been widely used to fabricate medical imaging phantoms. So far, various rigid 3D printable materials have been investigated for their radiological properties and efficiency in imaging phantom fabrication. However, flexible, soft tissue materials are also needed for imaging phantoms for simulating several clinical scenarios where anatomical deformations is important. Recently, various additive manufacturing technologies have been used to produce anatomical models based on extrusion techniques that allow the fabrication of soft tissue materials. To date, there is no systematic study in the literature investigating the radiological properties of silicone rubber materials/fluids for imaging phantoms fabricated directly by extrusion using 3D printing techniques. The aim of this study was to investigate the radiological properties of 3D printed phantoms made of silicone in CT imaging. To achieve this goal, the radiodensity as described as Hounsfield Units (HUs) of several samples composed of three different silicone printing materials were evaluated by changing the infill density to adjust their radiological properties. A comparison of HU values with a Gammex Tissue Characterization Phantom was performed. In addition, a reproducibility analysis was performed by creating several replicas for specific infill densities. A scaled down anatomical model derived from an abdominal CT was also fabricated and the resulting HU values were evaluated. For the three different silicone materials, a spectrum ranging from −639 to +780 HU was obtained on CT at a scan setting of 120 kVp. In addition, using different infill densities, the printed materials were able to achieve a similar radiodensity range as obtained in different tissue-equivalent inserts in the Gammex phantom (238 HU to −673 HU). The reproducibility results showed good agreement between the HU values of the replicas compared to the original samples, confirming the reproducibility of the printed materials. A good agreement was observed between the HU target values in abdominal CT and the HU values of the 3D-printed anatomical phantom in all tissues.

Eye lens dose for medical staff assisting patients during computed tomography: comparison of several types of radioprotective glasses

Medical staff sometimes assists patients in the examination room during computed tomography (CT) scans for several purposes. This study aimed to investigate the dose reduction effects of four radioprotective glasses with different lead equivalents and lens shapes. A medical staff phantom was positioned assuming body movement restraint of the patient during chest CT, and Hp(3) at the eye surfaces of the medical staff phantom and inside the lens of the four types of radioprotective glasses were measured by changing the distance of the staff phantom from the gantry, eye height, and width of the nose pad. The Hp(3) at the right eye surface with glasses of 0.50–0.75 mmPb and 0.07 mmPb was approximately 83.5% and 58.0%, respectively, lower than that without radioprotective glasses. The dose reduction rates at left eye surface increased with over-glass type glasses by 14%–28% by increasing the distance from the CT gantry to the staff phantom from 25 to 65 cm. The dose reduction rates at the left eye surface decreased with over-glass type glasses by 26%–31% by increasing the height of the eye lens for the medical staff phantom from 130 to 170 cm. The Hp(3) on the left eye surface decreased by 46.9% with the widest nose pad width compared to the narrowest nose pad width for the glasses with adjustable nose pad width. The radioprotective glasses for staff assisting patients during CT examinations should have a high lead equivalent and no gap around the nose and under the front lens.

Developing a medical device-grade T2 phantom optimized for myocardial T2 mapping by cardiovascular magnetic resonance

IntroductionA long T2 relaxation time can reflect oedema, and myocardial inflammation when combined with increased plasma troponin levels. Cardiovascular magnetic resonance (CMR) T2 mapping therefore has potential to provide a key diagnostic and prognostic biomarkers. However, T2 varies by scanner, software, and sequence, highlighting the need for standardization and for a quality assurance system for T2 mapping in CMR. AimTo fabricate and assess a phantom dedicated to the quality assurance of T2 mapping in CMR. MethodA T2 mapping phantom was manufactured to contain 9 T1 and T2 (T1|T2) tubes to mimic clinically relevant native and post-contrast T2 in myocardium across the health to inflammation spectrum (i.e., 43–74 ms) and across both field strengths (1.5 and 3 T). We evaluated the phantom's structural integrity, B0 and B1 uniformity using field maps, and temperature dependence. Baseline reference T1|T2 were measured using inversion recovery gradient echo and single-echo spin echo (SE) sequences respectively, both with long repetition times (10 s). Long-term reproducibility of T1|T2 was determined by repeated T1|T2 mapping of the phantom at baseline and at 12 months. ResultsThe phantom embodies 9 internal agarose-containing T1|T2 tubes doped with nickel di-chloride (NiCl2) as the paramagnetic relaxation modifier to cover the clinically relevant spectrum of myocardial T2. The tubes are surrounded by an agarose-gel matrix which is doped with NiCl2 and packed with high-density polyethylene (HDPE) beads. All tubes at both field strengths, showed measurement errors up to ≤ 7.2 ms [< 14.7%] for estimated T2 by balanced steady-state free precession T2 mapping compared to reference SE T2 with the exception of the post-contrast tube of ultra-low T1 where the deviance was up to 16 ms [40.0%]. At 12 months, the phantom remained free of air bubbles, susceptibility, and off-resonance artifacts. The inclusion of HDPE beads effectively flattened the B0 and B1 magnetic fields in the imaged slice. Independent temperature dependency experiments over the 13–38 °C range confirmed the greater stability of shorter vs longer T1|T2 tubes. Excellent long-term (12-month) reproducibility of measured T1|T2 was demonstrated across both field strengths (all coefficients of variation < 1.38%). ConclusionThe T2 mapping phantom demonstrates excellent structural integrity, B0 and B1 uniformity, and reproducibility of its internal tube T1|T2 out to 1 year. This device may now be mass-produced to support the quality assurance of T2 mapping in CMR.

Realistic 3D printed CT imaging tumor phantoms for validation of image processing algorithms

Medical imaging phantoms are widely used for validation and verification of imaging systems and algorithms in surgical guidance and radiation oncology procedures. Especially, for the performance evaluation of new algorithms in the field of medical imaging, manufactured phantoms need to replicate specific properties of the human body, e.g., tissue morphology and radiological properties. Additive manufacturing (AM) technology provides an inexpensive opportunity for accurate anatomical replication with customization capabilities. In this study, we proposed a simple and cheap protocol using Fused Deposition Modeling (FDM) technology to manufacture realistic tumor phantoms based on the filament 3D printing technology. Tumor phantoms with both homogenous and heterogeneous radiodensity were fabricated. The radiodensity similarity between the printed tumor models and real tumor data from CT images of lung cancer patients was evaluated. Additionally, it was investigated whether a heterogeneity in the 3D printed tumor phantoms as observed in the tumor patient data had an influence on the validation of image registration algorithms.A radiodensity range between −217 to 226 HUs was achieved for 3D printed phantoms using different filament materials; this range of radiation attenuation is also observed in the human lung tumor tissue. The resulted HU range could serve as a lookup-table for researchers and phantom manufactures to create realistic CT tumor phantoms with the desired range of radiodensities. The 3D printed tumor phantoms also precisely replicated real lung tumor patient data regarding morphology and could also include life-like heterogeneity of the radiodensity inside the tumor models. An influence of the heterogeneity on accuracy and robustness of the image registration algorithms was not found.

Medical imaging data analysis using 3D deep learning models towards improving the individual treatment plans

This work is a part of a research project aiming at delivering the next generation active medical phantom, Dose-3D, with high spatial granulation for quasi-real time measurement of the volumetric radiotherapeutic dose deposited during photon therapy. The preliminary results, discussed here, pertain to the intelligent medical data augmentation using Generative Adversarial Networks (GANs) technique implemented inside MONAI framework. However, in the scope of the project, we perform a broad search for the most efficient and advanced Deep Learning (DL) models to create tools for 3D Computed Tomography (CT) images segmentation and cancer diagnosis improvement that will be an integral part of the custom designed software platform for processing data collected with Dose-3D phantom. Apart from the innovative detection system the software itself may prove to be disruptive in the context of the currently available tools by offering open-source high quality toolkit for wide use in everyday clinical applications.

Regularising disparity estimation via multi task learning with structured light reconstruction

ABSTRACT 3D reconstruction is a useful tool for surgical planning and guidance. Supervised methods for disparity/depth estimation are the state of the art, with demonstrated performances far superior to all alternatives, such as self supervised and traditional geometric methods. However, supervised training requires large datasets, and in this field, data is lacking. In this paper, we investigate the learning of structured light projections to enhance the development of disparity estimation networks. Improving supervised learning on small datasets without needing to collect extra data. We first show that it is possible to learn the projection of structured light on a scene. Secondly, we show that the joint training of structured light and disparity, using a multi-task learning (MTL) framework, improves the learning of disparity. Our MTL setup outperformed the single task learning (STL) network in every validation test. Notably, in the generalisation test, the STL error was 1.4 times worse than that of the best MTL performance. A dataset containing stereoscopic images, disparity maps and structured light projections on medical phantoms and ex vivo tissue was created for evaluation together with virtual scenes. This dataset will be made publicly available in the future.

Novel 3-D printed radiation shielding materials embedded with bulk and nanoparticles of bismuth

In the present study, a new type of radiation shielding material was developed by using a 3-D printing technique which enables to create a light radiation shielding materials of a great variety of shapes and dimensions. Micro and nano bismuth particles were incorporated as a filler between the inner layers of polylactic acid thermoplastic polymer (PLA Plastic) designed of the investigated 3-D printed prototypes to achieve the desired radiation attenuation. The effect of particle size on the attenuation parameters were studied over the energy range from 0.0595 to 1.41 MeV. The mass and thickness needed to reduce the intensity of the incoming radiation to half of its original value were determined experimentally for pure polymer (ABS Plastic), polymer with bulk Bi, and polymer with nano Bi. The results reveal that bismuth NPs with average particle size of about 17 ± 3 nm have a greater mass attenuation capability than normal bulk bismuth particles, meaning they are more efficient and a lighter shield can be produced. The enhanced shielding ability of nano bismuth particles was contributed to the excellent particle distribution, leading to an increase in the probability of photons interacting with the bismuth atoms. The bismuth NPs 3-D printed objects can be considered as a promising radiation shielding candidates and also could be utilized in manufacturing of radiation medical phantom.

Robotic Sensorized Gastroendoscopy with Wireless Single-Hand Control

Abstract The manipulation of flexible endoscopes is a procedure that requires great dexterity since it requires the synchronization and use of both hands in parallel. Imprecise handling during gastroendoscopy could harm the digestive tract. Our solution allows the physician to use only one hand to wirelessly control the forward, backward, and tip bending motion. The proposed system provides endoscopic vision and tactile impact force sensing at the tip to detect the force applied to tissue and thus avoid damage. We experimentally evaluate the handling of the robotic system in open space and inside a medical phantom. The results revealed a training effect with less time demand for task completion and reduction of average impact force after only 5 runs. The proposed system was successfully controlled using one hand and, together with the force information, could enhance the physician’s experience during endoscopy. Future work will address axial control and an intensive user study with clinical experts.

3D printed mechanically representative aortic model made of gelatin fiber reinforced silicone composite

Additive manufacturing (AM) is a useful technology to produce artificial aortic models for the training of transcatheter aortic valve replacement (TAVR) surgery. With AM, the models can be tailored towards the individualized aortic anatomy of patients. Most of these reported models so far are manufactured using single rubber-like materials. However, such materials do not replicate the mechanical properties of natural aortic tissue, especially the stress–strain response in higher strain (>0.1) regions. This could be problematic for surgeons training for surgeries using a model which does not exhibit properties of the real aorta. To overcome this limitation, we developed a 3D-printed, mechanically representative aortic model comprising gelatin fibers and silicone. The model is promising as a realistic analog of aortic sinus for mock TAVR surgery. Computerized tomography data was analyzed beforehand using medical imaging to identify the anatomy of a specific patient’s aortic sinus and the surrounding blood vessels. A novel silicone matrix composite reinforced with gelatin fibers designed in this work was tested and compared with the stress–strain response of aortic tissue. Such a model comprising both patient-specific geometries as well as realistic material properties of aortic tissue can be helpful for the development of next-generation medical phantoms.

Design and validation of a phantom for transcranial ultrasonography.

Commercial medical ultrasound phantoms are highly specific as they simulate particular clinical scenarios. This makes them expensive to use in multi-target research and training. General approaches to human tissue and organ modeling are described in the manufacturing methodology, access to which is restricted by the manufacturer's trade secret. Our aim is to propose a reproducible methodology to design a head phantom for transcranial ultrasound training and research from widely available materials and to validate its applicability. To create an anthropomorphic phantom, we used data from real patients obtained by CT and MRI scans. We combined FDM and LCD 3D printing to achieve the desired acoustic performance and ergonomics of the phantom. We fabricated the phantom using polyvinyl chloride plastisol, photopolymer, and PLA to simulate brain tissue, temporal acoustic windows, and acoustically opaque parts of the skull, respectively. Notably, the phantom fabrication method uses only readily available materials and is easy to reproduce. We developed a basic one and anatomical one versions of the head phantom. The basic version contains a simplified brain: tissue-mimicking material is poured into the skull with needles inserted, which specific pattern is easy to recognize in B-mode images. The anatomical version has an anatomically correct brain dummy extracted from MRI data and contains multiple randomly distributed small metal, plastic, and bony objects ranging in size from 1 to 3mm each. The proposed methodology allows producing head phantoms for transcranial ultrasound training and research. The anatomical accuracy of the model is proved by ultrasonography and CT studies. Both versions of the phantom comprise the skull and the brain and are intended for ultrasound imaging through the temporal bone acoustic window. Needles and small objects serve as navigation targets during the training procedure. The basic version helps learning basic navigation skills, while the anatomical one provides a realistic setting to perform the diagnostic procedure.