scholarly journals Innovációs lehetőségek a medicinában: 3D tervezési és 3D nyomtatási lehetőségek a felnőtt szív- és mellkassebészeti betegellátásban. Magyarországi tapasztalatok

2019 ◽  
Vol 160 (50) ◽  
pp. 1967-1975 ◽  
Author(s):  
János Imre Barabás ◽  
Áron Kristóf Ghimessy ◽  
Ferenc Rényi-Vámos ◽  
Ákos Kocsis ◽  
László Agócs ◽  
...  
Keyword(s):  
Clinical Case ◽  
Technology Development ◽  
3D Models ◽  
Patient Specific ◽  
Anatomical Models ◽  
Efficient Communication ◽  
The Common ◽  
Case Discussions ◽  
Procedural Planning ◽  
Surgery Department

Abstract: Use of 3D planning and 3D printing is expanding in healthcare. One of the common applications is the creation of anatomical models for the surgical procedure from DICOM files. These patient-specific models are used for multiple purposes, including visualization of complex anatomical situations, simulation of surgical procedures, patient education and facilitating communication between the different disciplines during clinical case discussions. Cardiac and thoracic surgical applications of this technology development include the use of patient-specific 3D models for exploration of ventricle and aorta function and surgical procedural planning in oncology. The 3D virtual and printed models provide a new visualization perspective for the surgeons and more efficient communication between the different clinical disciplines. The 3D project was started at the Semmelweis University with the cooperation of the Thoracic Surgery Department of the National Institute of Oncology in 2018. The authors want to share their experiences in 3D designed medical tools. Orv Hetil. 2019; 160(50): 1967–1975.

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 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.

Development of JIT patient-specific implants

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Leanne SOBEL ◽  
Katrina SKELLERN ◽  
Kat PEREIRA
Keyword(s):  
Design Thinking ◽  
Technology Development ◽  
Complex Problem ◽  
Project Team ◽  
Healthcare Sector ◽  
Strategy Development ◽  
Patient Specific ◽  
Critical System ◽  
Patient Specific Implants ◽  
Human Centred Design

Design thinking and human-centred design is often discussed and utilised by teams and organisations seeking to develop more optimal, effective or innovative solutions for better customer outcomes. In the healthcare sector the opportunity presented by the practice of human-centred design and design thinking in the pursuit of better patient outcomes is a natural alignment. However, healthcare challenges often involve complex problem sets, many stakeholders, large systems and actors that resist change. High-levels of investment and risk aversion results in the status quo of traditional technology-led processes and analytical decision-making dominating product and strategy development. In this case study we present the opportunities, challenges and benefits that including a design-led approach in developing complex healthcare technology can bring. Drawing on interviews with participants and reflections from the project team, we explore and articulate the key learning from using a design-led approach. In particular we discuss how design-led practices that place patients at the heart of technology development facilitated the project team in aligning key stakeholders, unearthing critical system considerations, and identifying product and sector-wide opportunities.

scholarly journals Quality Control in 3D Printing: Accuracy Analysis of 3D-Printed Models of Patient-Specific Anatomy

Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 1021
Author(s):  
Bernhard Dorweiler ◽  
Pia Elisabeth Baqué ◽  
Rayan Chaban ◽  
Ahmed Ghazy ◽  
Oroa Salem
Keyword(s):  
Wall Thickness ◽  
Large Scale ◽  
Fused Deposition Modeling ◽  
Vascular Anatomy ◽  
3D Models ◽  
Patient Specific ◽  
Stl File ◽  
Fused Deposition ◽  
3D Printed ◽  
The Mean

As comparative data on the precision of 3D-printed anatomical models are sparse, the aim of this study was to evaluate the accuracy of 3D-printed models of vascular anatomy generated by two commonly used printing technologies. Thirty-five 3D models of large (aortic, wall thickness of 2 mm, n = 30) and small (coronary, wall thickness of 1.25 mm, n = 5) vessels printed with fused deposition modeling (FDM) (rigid, n = 20) and PolyJet (flexible, n = 15) technology were subjected to high-resolution CT scans. From the resulting DICOM (Digital Imaging and Communications in Medicine) dataset, an STL file was generated and wall thickness as well as surface congruency were compared with the original STL file using dedicated 3D engineering software. The mean wall thickness for the large-scale aortic models was 2.11 µm (+5%), and 1.26 µm (+0.8%) for the coronary models, resulting in an overall mean wall thickness of +5% for all 35 3D models when compared to the original STL file. The mean surface deviation was found to be +120 µm for all models, with +100 µm for the aortic and +180 µm for the coronary 3D models, respectively. Both printing technologies were found to conform with the currently set standards of accuracy (<1 mm), demonstrating that accurate 3D models of large and small vessel anatomy can be generated by both FDM and PolyJet printing technology using rigid and flexible polymers.

scholarly journals Complex wall modeling for hemodynamic simulations of intracranial aneurysms based on histologic images

2021 ◽  
Vol 16 (4) ◽  
pp. 597-607
Author(s):  
Annika Niemann ◽  
Samuel Voß ◽  
Riikka Tulamo ◽  
Simon Weigand ◽  
Bernhard Preim ◽  
...  
Keyword(s):  
Wall Thickness ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Geometric Model ◽  
Image Data ◽  
Outer Wall ◽  
3D Models ◽  
Patient Specific ◽  
Intracranial Vessel ◽  
Hemodynamic Simulations

Abstract Purpose For the evaluation and rupture risk assessment of intracranial aneurysms, clinical, morphological and hemodynamic parameters are analyzed. The reliability of intracranial hemodynamic simulations strongly depends on the underlying models. Due to the missing information about the intracranial vessel wall, the patient-specific wall thickness is often neglected as well as the specific physiological and pathological properties of the vessel wall. Methods In this work, we present a model for structural simulations with patient-specific wall thickness including different tissue types based on postmortem histologic image data. Images of histologic 2D slices from intracranial aneurysms were manually segmented in nine tissue classes. After virtual inflation, they were combined into 3D models. This approach yields multiple 3D models of the inner and outer wall and different tissue parts as a prerequisite for subsequent simulations. Result We presented a pipeline to generate 3D models of aneurysms with respect to the different tissue textures occurring in the wall. First experiments show that including the variance of the tissue in the structural simulation affect the simulation result. Especially at the interfaces between neighboring tissue classes, the larger influence of stiffer components on the stability equilibrium became obvious. Conclusion The presented approach enables the creation of a geometric model with differentiated wall tissue. This information can be used for different applications, like hemodynamic simulations, to increase the modeling accuracy.

The applicability of patient-Specific 3D models in the planning of nerve-sparing robot-assisted radical prostatectomy

2021 ◽  
Vol 79 ◽  
pp. S1556-S1557
Author(s):  
H. Veerman ◽  
T.N. Boellaard ◽  
C. Hoeks ◽  
J.A. Van Eick ◽  
J. Sluijter ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
3D Models ◽  
Patient Specific ◽  
Nerve Sparing ◽  
Robot Assisted

scholarly journals Multiclass CBCT Image Segmentation for Orthodontics with Deep Learning

2021 ◽  
pp. 002203452110053
Author(s):  
H. Wang ◽  
J. Minnema ◽  
K.J. Batenburg ◽  
T. Forouzanfar ◽  
F.J. Hu ◽  
...  
Keyword(s):  
Gold Standard ◽  
Orthodontic Treatment ◽  
3D Models ◽  
Similarity Coefficient ◽  
Patient Specific ◽  
Dice Similarity Coefficient ◽  
Surface Deviations ◽  
Surface Deviation ◽  
Binary Segmentation ◽  
Time Required

Accurate segmentation of the jaw (i.e., mandible and maxilla) and the teeth in cone beam computed tomography (CBCT) scans is essential for orthodontic diagnosis and treatment planning. Although various (semi)automated methods have been proposed to segment the jaw or the teeth, there is still a lack of fully automated segmentation methods that can simultaneously segment both anatomic structures in CBCT scans (i.e., multiclass segmentation). In this study, we aimed to train and validate a mixed-scale dense (MS-D) convolutional neural network for multiclass segmentation of the jaw, the teeth, and the background in CBCT scans. Thirty CBCT scans were obtained from patients who had undergone orthodontic treatment. Gold standard segmentation labels were manually created by 4 dentists. As a benchmark, we also evaluated MS-D networks that segmented the jaw or the teeth (i.e., binary segmentation). All segmented CBCT scans were converted to virtual 3-dimensional (3D) models. The segmentation performance of all trained MS-D networks was assessed by the Dice similarity coefficient and surface deviation. The CBCT scans segmented by the MS-D network demonstrated a large overlap with the gold standard segmentations (Dice similarity coefficient: 0.934 ± 0.019, jaw; 0.945 ± 0.021, teeth). The MS-D network–based 3D models of the jaw and the teeth showed minor surface deviations when compared with the corresponding gold standard 3D models (0.390 ± 0.093 mm, jaw; 0.204 ± 0.061 mm, teeth). The MS-D network took approximately 25 s to segment 1 CBCT scan, whereas manual segmentation took about 5 h. This study showed that multiclass segmentation of jaw and teeth was accurate and its performance was comparable to binary segmentation. The MS-D network trained for multiclass segmentation would therefore make patient-specific orthodontic treatment more feasible by strongly reducing the time required to segment multiple anatomic structures in CBCT scans.

Development of patient-specific 3D models from histopathological samples for applications in radiation therapy

2021 ◽  
Vol 81 ◽  
pp. 162-169
Author(s):  
Joseph M. DeCunha ◽  
Christopher M. Poole ◽  
Martin Vallières ◽  
Jose Torres ◽  
Sophie Camilleri-Broët ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
3D Models ◽  
Patient Specific

Combining patient-specific, digital 3D models with tele-education for adolescents with CHD

2021 ◽  
pp. 1-6
Author(s):  
David Liddle ◽  
Sheri Balsara ◽  
Karin Hamann ◽  
Adam Christopher ◽  
Laura Olivieri ◽  
...  
Keyword(s):  
Medical Condition ◽  
Three Dimensional ◽  
Medical Knowledge ◽  
3D Models ◽  
Patient Specific ◽  
Coarctation Of Aorta ◽  
Education Session ◽  
Post Intervention ◽  
Cardiac Defects ◽  
Transposition Of Great Arteries

Abstract Introduction: Adolescents with CHD require transition to specialised adult-centred care. Previous studies have shown that adolescents’ knowledge of their medical condition is correlated with transition readiness. Three-dimensional printed models of CHD have been used to educate medical trainees and patients, although no studies have focused on adolescents with CHD. This study investigates the feasibility of combining patient-specific, digital 3D heart models with tele-education interventions to improve the medical knowledge of adolescents with CHD. Methods: Adolescent patients with CHD, aged between 13 and 18 years old, were enrolled and scheduled for a tele-education session. Patient-specific digital 3D heart models were created using images from clinically indicated cardiac magnetic resonance studies. The tele-education session was performed using commercially available, web-conferencing software (Zoom, Zoom Video Communications Inc.) and a customised software (Cardiac Review 3D, Indicated Inc.) incorporating an interactive display of the digital 3D heart model. Medical knowledge was assessed using pre- and post-session questionnaires that were scored by independent reviewers. Results: Twenty-two adolescents completed the study. The average age of patients was 16 years old (standard deviation 1.5 years) and 56% of patients identified as female. Patients had a variety of cardiac defects, including tetralogy of Fallot, transposition of great arteries, and coarctation of aorta. Post-intervention, adolescents’ medical knowledge of their cardiac defects and cardiac surgeries improved compared to pre-intervention (p < 0.01). Conclusions: Combining patient-specific, digital 3D heart models with tele-education sessions can improve adolescents’ medical knowledge and may assist with transition to adult-centred care.

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