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

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>

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

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>

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

Biomolecules ◽  
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.

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

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.

Design of a Patient Specific, 3D printed Arm Cast

2017 ◽  
Vol 2 (2) ◽  
pp. 135 ◽  
Author(s):  
Angus P Fitzpatrick
Keyword(s):  
3D Printing ◽  
Critical Parameters ◽  
Patient Specific ◽  
Water Repellent ◽  
Layer By Layer ◽  
Imaging Data ◽  
Manufacturing Technique ◽  
3D Printed ◽  
User Centric ◽  
Product Realization

<p>3D printing is a manufacturing technique by which the material is added layer by layer to create a physical three-dimensional object. This manufacturing technique had primarily found uses in academic and commercial sectors for prototyping and product realization purposes. However, more recently the home consumer market has seen a surge in low cost printers bringing this capability to the masses. More recently 3D printing has seen considerable interest from the clinical sector, where alongside the synergistic use with medical imaging data, a whole generation of patient specific implantable technologies, splints/casts and resection guides can be created. Predominantly, clinical applications have focused on the use of 3D printing for bone replacement, however with the advent of more sophisticated multi-material printers, interest has now begun to move to applications in orthotics and orthopedic casting.</p><p>This study is to review and evaluate the feasibility of designing and realizing a more patient specific orthopedic cast to surpass current limitation with traditional fiberglass/plaster casts, through the use of advanced 3D modelling and printing techniques. To directly compare the efficacy of the traditional and 3D printed casts, we shall investigate critical parameters such as the time for manufacture, the overall weight of the final product, the accuracy off the cast relative to the patient’s unique anatomy and additional user-centric metrics (comfort, aesthetics, etc.). The design examined made use of advanced mesh structures throughout the bulk of the cast, such that the device would require less material (by weight) during fabrication, could allow for tunable weight and mechanical properties and allow for air penetration to the person skin, thereby reducing discomfort due to prolonged moisture exposure (chaffing, bad smells, etc.). As the primary focus of this study is the design and product realization phases and we shall not assess metrics relating to patient recover time or experience.</p><p>Overall it was found that the 3D printed cast was significantly lighter, with improved water repellent and air circulation properties, as compared to a traditional cast. Through the use of high precision design/manufacturing techniques, the final device could be accurately reproduced to match the test patient’s unique anatomy, thereby optimizing the orientation of the patient’s bones during post fracture recovery. It was however found that the manufacturing time for the 3D printed cast was slower than traditional casting methods owing to the additional time during the design phase. In future work we aim to address this limitation and to devise a streamlined methodology such that a generic cast design can be adapted to patient specific anatomical data through parametric design algorithms.</p><p>Ultimately, it was found that through the use of advanced design techniques, patient specific data and 3D printing, a custom orthopedic cast could be realized and with significant potential to augment current use of this technology for surgical intervention and improve patient outcomes. The use of advanced manufacturing in the medical field will likely enable more patient specific/user-centric treatment in the near future.</p>

scholarly journals Accessing 3D Printed Vascular Phantoms for Procedural Simulation

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.

scholarly journals Development of 3D Printed Symbrachydactyly Prosthetic Hand

2019 ◽  
Vol 9 (1) ◽  
pp. 5943-5947
Keyword(s):  
3D Printing ◽  
Minimum Cost ◽  
Acrylonitrile Butadiene Styrene ◽  
Design Stage ◽  
Patient Specific ◽  
Prosthetic Hand ◽  
Simple Task ◽  
3D Printed ◽  
Electrical Component ◽  
Hand Geometry

Symbrachydactyly is a genetical problem occurred to newborn where the newborn experienced underdeveloped or shorten fingers. This condition will limit their normal as even a simple task of holding an item or pushing a button. A device is needed to help them gain a better life. The aim of this project is to fabricate a customized prosthesis hand using 3D printing technology at minimum cost. The proposed prosthetic was not embedded with any electrical component. The patient can only use the wrist to control the prosthetic part which is the prosthetic fingers. The prosthetic hand was also being developed with the patient specific features, which the initial design stage was adapted from a person’s hand geometry using a 3D scanner. Next the model of the prosthesis was analyzed computationally to predict the performance of the product. Different material properties are considered in the analysis to present Polylactic Acid (PLA) and Acrylonitrile Butadiene Styrene (ABS) materials. Then, the prosthesis was fabricated using the 3D printing. The results suggested that PLA material indicated better findings and further be fabricated.

3D Printing of Medical Models: A Literature Review

2017 ◽  
Author(s):  
Xingjian Wei ◽  
Li Zeng ◽  
Zhijian Pei
Keyword(s):  
3D Printing ◽  
Literature Review ◽  
Medical Curriculum ◽  
Industrial Applications ◽  
Physical Models ◽  
Research Directions ◽  
Anatomical Structures ◽  
Medical Models ◽  
3D Printed ◽  
Anatomy Teaching

Medical models are physical models of human or animal anatomical structures such as skull and heart. Such models are used in simulation and planning of complex surgeries. They can also be utilized for anatomy teaching in medical curriculum. Traditionally, medical models are fabricated by paraffin wax or silicone casting. However, this method is time-consuming, of low quality, and not suitable for personalization. Recently, 3D printing technologies are used to fabricate medical models. Various applications of 3D printed medical models in surgeries and anatomy teaching have been reported, and their advantages over traditional medical models have been well-documented. However, 3D printing of medical models bears some special challenges compared to industrial applications of 3D printing. This paper reviews more than 50 publications on 3D printing of medical models between 2006 and 2016, and discusses knowledge gaps and potential research directions in this field.

Investigation of three-dimensional printing materials for printing aorta model replicating Type B aortic dissection

2021 ◽  
Vol 17 ◽  
Author(s):  
Chia-An Wu ◽  
Andrew Squelch ◽  
Zhonghua Sun
Keyword(s):  
3D Printing ◽  
Aortic Dissection ◽  
Three Dimensional ◽  
Ct Images ◽  
Patient Specific ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Ct Attenuation ◽  
Significant Difference ◽  
3D Printed

Aim: To determine a printing material that has both elastic property and radiology equivalence close to real aorta for simulation of endovascular stent graft repair of aortic dissection. Background: With the rapid development of three-dimensional (3D) printing technology, a patient-specific 3D printed model is able to help surgeons to make better treatment plan for Type B aortic dissection patients. However, the radiological properties of most 3D printing materials have not been well characterized. This study aims to investigate the appropriate materials for printing human aorta with mechanical and radiological properties similar to the real aortic computed tomography (CT) attenuation. Objective: Quantitative assessment of CT attenuation of different materials used in 3D printed models of aortic dissection for developing patient-specific 3D printed aorta models to simulate type B aortic dissection. Method: A 25-mm length of aorta model was segmented from a patient’s image dataset with diagnosis of type B aortic dissection. Four different elastic commercial 3D printing materials, namely Agilus A40 and A50, Visijet CE-NT A30 and A70 were selected and printed with different hardness. Totally four models were printed out and conducted CT scanned twice on a 192-slice CT scanner using the standard aortic CT angiography protocol, with and without contrast inside the lumen.Five reference points with region of interest (ROI) of 1.77 mm2 were selected at the aortic wall and intimal flap and their Hounsfield units (HU) were measured and compared with the CT attenuation of original CT images. The comparison between the patient’s aorta and models was performed through a paired-sample t-test to determine if there is any significant difference. Result: The mean CT attenuation of aortic wall of the original CT images was 80.7 HU. Analysis of images without using contrast medium showed that the material of Agilus A50 produced the mean CT attenuation of 82.6 HU, which is similar to that of original CT images. The CT attenuation measured at images acquired with other three materials was significantly lower than that of original images (p<0.05). After adding contrast medium, Visijet CE-NT A30 had an average CT attenuation of 90.6 HU, which is close to that of the original images with statistically significant difference (p>0.05). In contrast, the CT attenuation measured at images acquired with other three materials (Agilus A40, A50 and Visiject CE-NT A70) was 129 HU, 135 HU and 129.6 HU, respectively, which is significantly higher than that of original CT images (p<0.05). Conclusion: Both Visijet CE-NT and Agilus have tensile strength and elongation close to real patient’s tissue properties producing similar CT attenuation. Visijet CE-NT A30 is considered the appropriate material for printing aorta to simulate contrast-enhanced CT imaging of type B aortic dissection. Due to lack of body phantom in the experiments, further research with simulation of realistic anatomical body environment should be conducted.

scholarly journals Current Practice in Preoperative Virtual and Physical Simulation in Neurosurgery

2020 ◽  
Vol 7 (1) ◽  
pp. 7 ◽  
Author(s):  
Elisa Mussi ◽  
Federico Mussa ◽  
Chiara Santarelli ◽  
Mirko Scagnet ◽  
Francesca Uccheddu ◽  
...  
Keyword(s):  
Clinical Practice ◽  
3D Printing ◽  
Surgical Planning ◽  
Physical Simulation ◽  
Planning Process ◽  
Preoperative Planning ◽  
Cost Effective ◽  
Patient Specific ◽  
Anatomical Models ◽  
Standard Clinical Practice

In brain tumor surgery, an appropriate and careful surgical planning process is crucial for surgeons and can determine the success or failure of the surgery. A deep comprehension of spatial relationships between tumor borders and surrounding healthy tissues enables accurate surgical planning that leads to the identification of the optimal and patient-specific surgical strategy. A physical replica of the region of interest is a valuable aid for preoperative planning and simulation, allowing the physician to directly handle the patient’s anatomy and easily study the volumes involved in the surgery. In the literature, different anatomical models, produced with 3D technologies, are reported and several methodologies were proposed. Many of them share the idea that the employment of 3D printing technologies to produce anatomical models can be introduced into standard clinical practice since 3D printing is now considered to be a mature technology. Therefore, the main aim of the paper is to take into account the literature best practices and to describe the current workflow and methodology used to standardize the pre-operative virtual and physical simulation in neurosurgery. The main aim is also to introduce these practices and standards to neurosurgeons and clinical engineers interested in learning and implementing cost-effective in-house preoperative surgical planning processes. To assess the validity of the proposed scheme, four clinical cases of preoperative planning of brain cancer surgery are reported and discussed. Our preliminary results showed that the proposed methodology can be applied effectively in the neurosurgical clinical practice both in terms of affordability and in terms of simulation realism and efficacy.

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