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.

scholarly journals Personalized Three-Dimensional Printed Models in Congenital Heart Disease

2019 ◽  
Vol 8 (4) ◽  
pp. 522 ◽  
Author(s):  
Sun ◽  
Lau ◽  
Wong ◽  
Yeong
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Patient Specific ◽  
Future Research ◽  
Imaging Data ◽  
Doctor Patient Communication ◽  
Medical Education And Training ◽  
3D Printed

Patient-specific three-dimensional (3D) printed models have been increasingly used in cardiology and cardiac surgery, in particular, showing great value in the domain of congenital heart disease (CHD). CHD is characterized by complex cardiac anomalies with disease variations between individuals; thus, it is difficult to obtain comprehensive spatial conceptualization of the cardiac structures based on the current imaging visualizations. 3D printed models derived from patient’s cardiac imaging data overcome this limitation by creating personalized 3D heart models, which not only improve spatial visualization, but also assist preoperative planning and simulation of cardiac procedures, serve as a useful tool in medical education and training, and improve doctor–patient communication. This review article provides an overall view of the clinical applications and usefulness of 3D printed models in CHD. Current limitations and future research directions of 3D printed heart models are highlighted.

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 The first 3D printed multiple sclerosis brain: Towards a 3D era in medicine

F1000Research ◽  
2018 ◽  
Vol 6 ◽  
pp. 1603
Author(s):  
Jagannadha Avasarala ◽  
Todd Pietila
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Diseases ◽  
3D Models ◽  
Patient Specific ◽  
Surface Rendering ◽  
Reconstruction Algorithms ◽  
Imaging Data ◽  
Surgical Options ◽  
3D Printed ◽  
Magnetic Resonance Imaging Mri

Conventional magnetic resonance imaging (MRI) studies depict disease of the human brain in 2D but the reconstruction of a patient’s brain stricken with multiple sclerosis (MS) in 3D using 2D images has not been attempted.  Using 3D reconstruction algorithms, we built a 3D printed patient-specific brain model to scale. It is a first of its kind model that depicts the total white matter lesion (WML) load using T2 FLAIR images in an MS patient. The patient’s images in Digital Imaging and Communications in Medicine (DICOM) format were imported into Mimics inPrint 2.0 (Materialise NV, Leuven, Belgium) a dedicated medical image processing software designed for the purposes of image segmentation and 3D modeling.  The imported axial images were automatically formatted to display coronal and sagittal slices within the software. The imaging data were then segmented into regions and surface rendering was done to achieve 3D virtual printable files of the desired structures of interest. Rendering brain tumor(s) in 3D has been attempted with the specific intent of extending the options available to a surgeon but no study to our knowledge has attempted to quantify brain disease in MS that has, for all practical purposes, no surgical options. The purpose of our study was to demonstrate that 3D depiction of chronic neurological diseases is possible in a printable model while serving a fundamental need for patient education. Medical teaching is moored in 2D graphics and it is time to evolve into 3D models that can be life-like and deliver instant impact.

scholarly journals A workflow to generate patient-specific three-dimensional augmented reality models from medical imaging data and example applications in urologic oncology

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Nicole Wake ◽  
Andrew B. Rosenkrantz ◽  
William C. Huang ◽  
James S. Wysock ◽  
Samir S. Taneja ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Patient Care ◽  
Three Dimensional ◽  
3D Models ◽  
Patient Specific ◽  
Imaging Data ◽  
Urologic Oncology ◽  
Case Examples ◽  
Microsoft Hololens ◽  
Enhance Patient Care

AbstractAugmented reality (AR) and virtual reality (VR) are burgeoning technologies that have the potential to greatly enhance patient care. Visualizing patient-specific three-dimensional (3D) imaging data in these enhanced virtual environments may improve surgeons’ understanding of anatomy and surgical pathology, thereby allowing for improved surgical planning, superior intra-operative guidance, and ultimately improved patient care. It is important that radiologists are familiar with these technologies, especially since the number of institutions utilizing VR and AR is increasing. This article gives an overview of AR and VR and describes the workflow required to create anatomical 3D models for use in AR using the Microsoft HoloLens device. Case examples in urologic oncology (prostate cancer and renal cancer) are provided which depict how AR has been used to guide surgery at our institution.

scholarly journals Three-dimensional printing in adult cardiovascular medicine for surgical and transcatheter procedural planning, teaching and technological innovation

2019 ◽  
Author(s):  
Enrico Ferrari ◽  
Michele Gallo ◽  
Changtian Wang ◽  
Lei Zhang ◽  
Maurizio Taramasso ◽  
...  
Keyword(s):  
3D Printing ◽  
Cardiac Imaging ◽  
Three Dimensional ◽  
3D Models ◽  
Patient Specific ◽  
Digital Information ◽  
Widespread Application ◽  
Mitral Valves ◽  
Materials Used ◽  
Procedural Planning

Abstract Three-dimensional (3D)-printing technologies in cardiovascular surgery have provided a new way to tailor surgical and percutaneous treatments. Digital information from standard cardiac imaging is integrated into physical 3D models for an accurate spatial visualization of anatomical details. We reviewed the available literature and analysed the different printing technologies, the required procedural steps for 3D prototyping, the used cardiac imaging, the available materials and the clinical implications. We have highlighted different materials used to replicate aortic and mitral valves, vessels and myocardial properties. 3D printing allows a heuristic approach to investigate complex cardiovascular diseases, and it is a unique patient-specific technology providing enhanced understanding and tactile representation of cardiovascular anatomies for the procedural planning and decision-making process. 3D printing may also be used for medical education and surgical/transcatheter training. Communication between doctors and patients can also benefit from 3D models by improving the patient understanding of pathologies. Furthermore, medical device development and testing can be performed with rapid 3D prototyping. Additionally, widespread application of 3D printing in the cardiovascular field combined with tissue engineering will pave the way to 3D-bioprinted tissues for regenerative medicinal applications and 3D-printed organs.

scholarly journals A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Teresa E. Flaxman ◽  
Carly M. Cooke ◽  
Olivier X. Miguel ◽  
Adnan M. Sheikh ◽  
Sukhbir S. Singh
Keyword(s):  
3D Printing ◽  
Clinical Benefit ◽  
Three Dimensional ◽  
Uterine Fibroids ◽  
3D Models ◽  
Gynecologic Surgery ◽  
Patient Specific ◽  
Mr Images ◽  
Adjacent Structures ◽  
3D Printed

Abstract Background Patient specific three-dimensional (3D) models can be derived from two-dimensional medical images, such as magnetic resonance (MR) images. 3D models have been shown to improve anatomical comprehension by providing more accurate assessments of anatomical volumes and better perspectives of structural orientations relative to adjacent structures. The clinical benefit of using patient specific 3D printed models have been highlighted in the fields of orthopaedics, cardiothoracics, and neurosurgery for the purpose of pre-surgical planning. However, reports on the clinical use of 3D printed models in the field of gynecology are limited. Main text This article aims to provide a brief overview of the principles of 3D printing and the steps required to derive patient-specific, anatomically accurate 3D printed models of gynecologic anatomy from MR images. Examples of 3D printed models for uterine fibroids and endometriosis are presented as well as a discussion on the barriers to clinical uptake and the future directions for 3D printing in the field of gynecological surgery. Conclusion Successful gynecologic surgery requires a thorough understanding of the patient’s anatomy and burden of disease. Future use of patient specific 3D printed models is encouraged so the clinical benefit can be better understood and evidence to support their use in standard of care can be provided.

scholarly journals The use of three-dimensional anatomical patient-specific printed models in surgical clipping of intracranial aneurysm: A pilot study

2020 ◽  
Vol 11 ◽  
pp. 381
Author(s):  
Moneer K. Faraj ◽  
Samer S. Hoz ◽  
Amjad J. Mohammad
Keyword(s):  
3D Printing ◽  
Teaching Hospital ◽  
Three Dimensional ◽  
3D Models ◽  
Patient Specific ◽  
Anterior Communicating Artery ◽  
Parent Vessel ◽  
Microsurgical Clipping ◽  
Valuable Adjunct ◽  
3D Printed

Background: In the present study, we aim to develop simulation models based on computed tomography angiography images of intracranial aneurysms (IAs) and their parent vessels using three-dimensional (3D) printing technology. The study focuses on the value of these 3D models in presurgical planning and intraoperative navigation and ultimately their impact on patient outcomes. To the best of our knowledge, this is the first report of its kind from a war-torn country, like Iraq. Methods: This is a prospective study of a series of 11, consecutively enrolled, patients suffering from IAs for the period between February and September 2019. The study represents a collaboration between the two major neurosurgical centers in Baghdad/Iraq; Neurosciences Teaching Hospital and Neurosurgery Teaching Hospital. We analyzed the data of eleven patients with IAs treated by microsurgical clipping. These data include patient demographics, clinical, surgical, and outcomes along with the data of the 3D-printed replica used in these surgeries. All cases were operated on by one surgeon. Results: Our study included 11 patients, with a total of 11 aneurysms clipped. The mean age was 44 ± 8, with a median of 42.5 and a range of 35–61 years. About 60% of our patients were female with a female-to-male ratio of 1:5. About 60% of the aneurysms were located at the anterior communicating artery (Acom) while the remaining 40% were equally distributed between the posterior communicating and internal carotid arteries bifurcation. The standard pterional approach was followed in 50% of cases, whereas the other 50% of patients were treated through the lateral supraorbital approach. About 90% (n = 9) of the patients had a Glasgow Outcome Scale (GOS) of 5 and 10% had a GOS of 4. The 3D-printed models successfully replicated the aneurysm size, location, and relation to the parent vessel with 100% accuracy and were used for intraoperative guidance. The average production time was 24–48 h and the production cost was 10–20 US dollars. Conclusion: 3D printing is a promising technology that is rapidly penetrating the field of neurosurgery. In particular, the use of 3D-printed patient-matched, anatomically accurate replicas of the cerebral vascular tree is valuable adjunct to the microsurgical clipping of IAs, and our study conclusions support this concept. However, both the feasibility and clinical utility of 3D printing remain the subject of much, ongoing investigations.

scholarly journals The impact of using three-dimensional printed liver models for patient education

2018 ◽  
Vol 46 (4) ◽  
pp. 1570-1578 ◽  
Author(s):  
Tianyou Yang ◽  
Tianbao Tan ◽  
Jiliang Yang ◽  
Jing Pan ◽  
Chao Hu ◽  
...  
Keyword(s):  
Patient Education ◽  
Surgical Procedure ◽  
Three Dimensional ◽  
Ct Images ◽  
Patient Specific ◽  
Liver Anatomy ◽  
Anatomy And Physiology ◽  
3D Printed ◽  
Tumour Characteristics ◽  
The Impact

Objective To investigate the impact of using a three-dimensional (3D) printed liver model for patient education. Methods Children with hepatic tumours who were scheduled for hepatectomy were enrolled, and patient-specific 3D liver models were printed with photosensitive resin, based on computed tomography (CT) images. Before surgery, their parents received information regarding liver anatomy, physiology, tumour characteristics, planned surgery, and surgical risks using these CT images. Then, parents completed questionnaires regarding this information. Thereafter, 3D printed models of each patient were presented along with an explanation of the general printing process, and the same questionnaire was completed. The median number of correct responses in each category before and after the 3D printed model presentation was compared. Results Seven children and their 14 parents were enrolled in the study. After the presentation of 3D printed models, parental understanding of basic liver anatomy and physiology, tumour characteristics, the planned surgical procedure, and surgical risks significantly improved. Parents demonstrated improvements in their understanding of basic liver anatomy by 26.4%, basic liver physiology by 23.6%, tumour characteristics by 21.4%, the planned surgical procedure by 31.4%, and surgical risks by 27.9%. Conclusions Using 3D printed liver models improved parental education regarding the understanding of liver anatomy and physiology, tumour characteristics, surgical procedure, and associated surgical risks.

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 The first 3D printed multiple sclerosis brain: Towards a 3D era in medicine

F1000Research ◽  
2018 ◽  
Vol 6 ◽  
pp. 1603
Author(s):  
Jagannadha Avasarala ◽  
Todd Pietila
Keyword(s):  
Multiple Sclerosis ◽  
Neurological Diseases ◽  
3D Models ◽  
Patient Specific ◽  
Surface Rendering ◽  
Reconstruction Algorithms ◽  
Imaging Data ◽  
Surgical Options ◽  
3D Printed ◽  
Magnetic Resonance Imaging Mri

Conventional magnetic resonance imaging (MRI) studies depict disease of the human brain in 2D but the reconstruction of a patient’s brain stricken with multiple sclerosis (MS) in 3D using 2D images has not been attempted.  Using 3D reconstruction algorithms, we built a 3D printed patient-specific brain model to scale. It is a first of its kind model that depicts the total white matter lesion (WML) load using T2 FLAIR images in an MS patient. The patient’s images in Digital Imaging and Communications in Medicine (DICOM) format were imported into Mimics inPrint 2.0 (Materialise NV, Leuven, Belgium) a dedicated medical image processing software designed for the purposes of image segmentation and 3D modeling.  The imported axial images were automatically formatted to display coronal and sagittal slices within the software. The imaging data were then segmented into regions and surface rendering was done to achieve 3D virtual printable files of the desired structures of interest. Rendering brain tumor(s) in 3D has been attempted with the specific intent of extending the options available to a surgeon but no study to our knowledge has attempted to quantify brain disease in MS that has, for all practical purposes, no surgical options. The purpose of our study was to demonstrate that 3D depiction of chronic neurological diseases is possible in a printable model while serving a fundamental need for patient education. Medical teaching is moored in 2D graphics and it is time to evolve into 3D models that can be life-like and deliver instant impact.

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