Three-dimensional (3D) printing refers to a number of manufacturing technologies that create physical models from digital information. Radiology is poised to advance the application of 3D printing in health care because our specialty has an established history of acquiring and managing the digital information needed to create such models. The 3D Printing Task Force of the Radiology Research Alliance presents a review of the clinical applications of this burgeoning technology, with a focus on the opportunities for radiology. Topics include uses for treatment planning, medical education, and procedural simulation, as well as patient education. Challenges for creating custom implantable devices including financial and regulatory processes for clinical application are reviewed. Precedent procedures that may translate to this new technology are discussed. The task force identifies research opportunities needed to document the value of 3D printing as it relates to patient care.
Introduction
What began as a largely industrial tool to facilitate concept-to-prototype development, three-dimensional (3D) printing has evolved into a widely used technology, affecting many aspects of modern society. The term “3D printing” grew out of the research and development laboratories of the automotive and aerospace industries . The technology was developed throughout the 1980s and 1990s , and medical applications were initially reported in the early 2000s . Initially, these reports focused on custom prostheses , but as the technology improved, reports of using anatomic models for preoperative planning began appearing . Today, 3D printing continues to find new applications: customized eyeglasses can be printed to exact specifications , an increasing number of foods can be printed on demand , and there are plans to manufacture cars entirely using 3D printing .
Recent rapid growth of 3D printing in medicine has been staggering. A search of Pubmed.gov using the term “3D printing” yielded only six publications in the year 2000, 61 publications in 2010, and more than 1100 publications in 2016. To encourage continued growth of this technology, the National Additive Manufacturing Innovation Institute was launched in 2012 . Many professional societies have also advocated the use of this technology in medicine. For example, the Society for Manufacturing Engineers has a dedicated medical 3D printing workgroup . In 2016, the Radiological Society of North America formed the 3D Printing Special Interest Group. The 3D Printing Special Interest Group has already sponsored many educational sessions at the annual meeting and is committed to building evidence for clinical utility of 3D printing .
Undoubtedly, this topic has gained popularity because of the tremendous potential it offers to radiologists, our colleagues, and patients. If implemented correctly, 3D printing promises to improve patient care and enhance the relative contribution to that care by radiologists. Specifically, 3D printing can deliver personalized medicine based on the anatomic data radiologists acquire and interpret every day. Providing such a service offers a new way to interact with referring clinicians and a potential way radiology can demonstrate value in patient care.
Radiologists have witnessed the evolution of medical imaging that allows for 3D printing. Multiplanar imaging with computed tomography (CT) and magnetic resonance imaging gave rise to 3D reconstructions that improved the evaluation of complex anatomy . At its most basic level, 3D printing takes imaging data from the two dimensions of a computer screen to the three dimensions of the real world .
3D printing has been used in a wide range of healthcare settings including Cardiology , Cardiothoracic Surgery , Critical Care , Gastroenterology , General Surgery , Interventional Radiology , Neurosurgery , Ophthalmology , Oral and Maxillofacial Surgery , Orthopedic Surgery , Otolaryngology , Plastic Surgery , Podiatry , Pulmonology , Radiation Oncology , Transplant Surgery , Urology , and Vascular Surgery .
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Transforming Clinical Care
Treatment Planning
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Fracture fixation
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Resection of renal tumors
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Cardiovascular applications
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Customized Surgical Tools and Prostheses
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Surgical Tools
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Prostheses
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Maxillofacial prostheses
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Joint prostheses
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Patient Education
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Transforming Medical Education
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Anatomy Teaching
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Operative Rehearsal
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Applications in Radiology
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Research Directions
Bioprinting Revolution
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Research Opportunities for Radiology
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Challenges to Clinical Application of 3D Printing
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Financial Challenges
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Regulatory Challenges
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Medicolegal Challenges
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Conclusion
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Acknowledgment
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