Understanding Spatially Complex Segmental and Branch Anatomy Using 3D Printing

Rationale and Objectives

Three-dimensional (3D) manufacturing is shaping personalized medicine, in which radiologists can play a significant role, be it as consultants to surgeons for surgical planning or by creating powerful visual aids for communicating with patients, physicians, and trainees. This report illustrates the steps in development of custom 3D models that enhance the understanding of complex anatomy.

Materials and Methods

We graphically designed 3D meshes or modified imported data from cross-sectional imaging to develop physical models targeted specifically for teaching complex segmental and branch anatomy. The 3D printing itself is easily accessible through online commercial services, and the models are made of polyamide or gypsum.

Results

Anatomic models of the liver, lungs, prostate, coronary arteries, and the Circle of Willis were created. These models have advantages that include customizable detail, relative low cost, full control of design focusing on subsegments, color-coding potential, and the utilization of cross-sectional imaging combined with graphic design.

Conclusions

Radiologists have an opportunity to serve as leaders in medical education and clinical care with 3D printed models that provide beneficial interaction with patients, clinicians, and trainees across all specialties by proactively taking on the educator’s role. Complex models can be developed to show normal anatomy or common pathology for medical educational purposes. There is a need for randomized trials, which radiologists can design, to demonstrate the utility and effectiveness of 3D printed models for teaching simple and complex anatomy, simulating interventions, measuring patient satisfaction, and improving clinical care.

Introduction

Three-dimensional (3D) printing is contributing to the revolution of personalized and precision medicine . The use of 3D products in medicine is burgeoning : planning surgical procedures for hepatic and renal cancer removal; innovative cardiac and vascular device testing for pediatric and adult populations; visualization of complex head and neck anatomy for neurosurgeons and neurologists; practicing spine and lung procedures ex vivo for residents and medical students; personalized drug tablets and delivery with potential for nanotechnology; training models for image guided spinal pain management; and educating medical providers and the patients.

Patient-customized 3D products are available because of advanced 3D printing in conjunction with the evolution of cross-sectional imaging , which includes high-resolution multidetector computed tomography, computed tomography angiography, steady-state free precession and fast spoiled gradient-echo, magnetic resonance imaging (MRI), and magnetic resonance angiogram (MRA). Similar to an inkjet printer that reproduces a digital image with ink and paper, a 3D printer takes virtual data that are derived from cross-sectional imaging. The anatomic data are then processed by 3D reconstruction software into a virtual 3D mesh. Various materials are then loaded onto 3D printers to fabricate solid forms in a layer-by-layer fashion. The exquisite and customizable detail can be produced in a reasonable time frame and at a relatively low cost. Innovations in 3D printing have the potential to afford the medical team direct production capabilities and advance the practice of medicine through unique and customizable educational tools.

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Materials and Methods

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Table 1

Combination of Methods for Creating Final Digital 3D File with Relative Time and Cost Involved, Where the Simplest Model, the Lung, Is Used as a Reference

Anatomy Initial 3D Mesh Method of Obtaining Modification Time Cost Lung Graphically designed Free online library Radiologist − − Liver Graphically designed Commercially customized Graphic artist +++ +++ Coronary Graphically designed Commercially available Radiologist + ++ COW 3D Reconstructed (MRA) Performed with free software Radiologist ++ + Prostate 3D Reconstructed (MRI) Freely available online Radiologist +++ ++

COW, Circle of Willis, MRA, magnetic resonance angiography; MRI, magnetic resonance imaging.

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Results

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Scaletarget=PricetargetPricecurrent−−−−−−−√3 Scal

target

Pric

target

Pric

current

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Discussion

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Financial Disclosure

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Understanding Spatially Complex Segmental and Branch Anatomy Using 3D Printing

Rationale and Objectives

Materials and Methods

Results

Conclusions

Introduction

Materials and Methods

Results

Discussion

Financial Disclosure

References

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