scholarly journals Hybrid Additive Fabrication of a Transparent Liver with Biosimilar Haptic Response for Preoperative Planning

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1734
Author(s):  
Paolo Aseni ◽  
Tommaso Santaniello ◽  
Francesco Rizzetto ◽  
Lorenzo Gentili ◽  
Federico Pezzotta ◽  
...  

Due to the complexity of liver surgery, the interest in 3D printing is constantly increasing among hepatobiliary surgeons. The aim of this study was to produce a patient-specific transparent life-sized liver model with tissue-like haptic properties by combining additive manufacturing and 3D moulding. A multistep pipeline was adopted to obtain accurate 3D printable models. Semiautomatic segmentation and registration of routine medical imaging using 3D Slicer software allowed to obtain digital objects representing the structures of interest (liver parenchyma, vasculo-biliary branching, and intrahepatic lesion). The virtual models were used as the source data for a hybrid fabrication process based on additive manufacturing using soft resins and casting of tissue-mimicking silicone-based blend into 3D moulds. The model of the haptic liver reproduced with high fidelity the vasculo-biliary branching and the relationship with the intrahepatic lesion embedded into the transparent parenchyma. It offered high-quality haptic perception and a remarkable degree of surgical and anatomical information. Our 3D transparent model with haptic properties can help surgeons understand the spatial changes of intrahepatic structures during surgical manoeuvres, optimising preoperative surgical planning.

Mathematics ◽  
2021 ◽  
Vol 9 (15) ◽  
pp. 1746
Author(s):  
Iñigo Calderon-Uriszar-Aldaca ◽  
Sergio Perez ◽  
Ravi Sinha ◽  
Maria Camara-Torres ◽  
Sara Villanueva ◽  
...  

Additive manufacturing (AM) of scaffolds enables the fabrication of customized patient-specific implants for tissue regeneration. Scaffold customization does not involve only the macroscale shape of the final implant, but also their microscopic pore geometry and material properties, which are dependent on optimizable topology. A good match between the experimental data of AM scaffolds and the models is obtained when there is just a few millimetres at least in one direction. Here, we describe a methodology to perform finite element modelling on AM scaffolds for bone tissue regeneration with clinically relevant dimensions (i.e., volume > 1 cm3). The simulation used an equivalent cubic eight node finite elements mesh, and the materials properties were derived both empirically and numerically, from bulk material direct testing and simulated tests on scaffolds. The experimental validation was performed using poly(ethylene oxide terephthalate)-poly(butylene terephthalate) (PEOT/PBT) copolymers and 45 wt% nano hydroxyapatite fillers composites. By applying this methodology on three separate scaffold architectures with volumes larger than 1 cm3, the simulations overestimated the scaffold performance, resulting in 150–290% stiffer than average values obtained in the validation tests. The results mismatch highlighted the relevance of the lack of printing accuracy that is characteristic of the additive manufacturing process. Accordingly, a sensitivity analysis was performed on nine detected uncertainty sources, studying their influence. After the definition of acceptable execution tolerances and reliability levels, a design factor was defined to calibrate the methodology under expectable and conservative scenarios.


Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 830
Author(s):  
Sina Rößler ◽  
Andreas Brückner ◽  
Iris Kruppke ◽  
Hans-Peter Wiesmann ◽  
Thomas Hanke ◽  
...  

Today, materials designed for bone regeneration are requested to be degradable and resorbable, bioactive, porous, and osteoconductive, as well as to be an active player in the bone-remodeling process. Multiphasic silica/collagen Xerogels were shown, earlier, to meet these requirements. The aim of the present study was to use these excellent material properties of silica/collagen Xerogels and to process them by additive manufacturing, in this case 3D plotting, to generate implants matching patient specific shapes of fractures or lesions. The concept is to have Xerogel granules as active major components embedded, to a large proportion, in a matrix that binds the granules in the scaffold. By using viscoelastic alginate as matrix, pastes of Xerogel granules were processed via 3D plotting. Moreover, alginate concentration was shown to be the key to a high content of irregularly shaped Xerogel granules embedded in a minimum of matrix phase. Both the alginate matrix and Xerogel granules were also shown to influence viscoelastic behavior of the paste, as well as the dimensionally stability of the scaffolds. In conclusion, 3D plotting of Xerogel granules was successfully established by using viscoelastic properties of alginate as matrix phase.


2021 ◽  
Vol 56 (18) ◽  
pp. 10707-10744
Author(s):  
Jonathan Torres ◽  
Ali P. Gordon

AbstractThe small punch test (SPT) was developed for situations where source material is scarce, costly or otherwise difficult to acquire, and has been used for assessing components with variable, location-dependent material properties. Although lacking standardization, the SPT has been employed to assess material properties and verified using traditional testing. Several methods exist for equating SPT results with traditional stress–strain data. There are, however, areas of weakness, such as fracture and fatigue approaches. This document outlines the history and methodologies of SPT, reviewing the body of contemporary literature and presenting relevant findings and formulations for correlating SPT results with conventional tests. Analysis of literature is extended to evaluating the suitability of the SPT for use with additively manufactured (AM) materials. The suitability of this approach is shown through a parametric study using an approximation of the SPT via FEA, varying material properties as would be seen with varying AM process parameters. Equations describing the relationship between SPT results and conventional testing data are presented. Correlation constants dictating these relationships are determined using an accumulation of data from the literature reviewed here, along with novel experimental data. This includes AM materials to assess the fit of these and provide context for a wider view of the methodology and its interest to materials science and additive manufacturing. A case is made for the continued development of the small punch test, identifying strengths and knowledge gaps, showing need for standardization of this simple yet highly versatile method for expediting studies of material properties and optimization.


2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Dafydd O. Visscher ◽  
Maureen van Eijnatten ◽  
Niels P. T. J. Liberton ◽  
Jan Wolff ◽  
Mark B. M. Hofman ◽  
...  

Author(s):  
Bradley Hanks ◽  
Shantanab Dinda ◽  
Sanjay Joshi

Total hip arthroplasty (THA) is an increasingly common procedure that replaces all or part of the hip joint. The average age of patients is decreasing, which in turn increases the need for more durable implants. Revisions in hip implants are frequently caused by three primary issues: femoral loading, poor fixation, and stress shielding. First, as the age of hip implant patients decreases, the hip implants are seeing increased loading, beyond what they were traditionally designed for. Second, traditional implants may have roughened surfaces but are not fully porous which would allow bone to grow in and through the implant. Third, traditional implants are too stiff, causing more load to be carried by the implant and shielding the bone from stress. Ultimately this stress shielding leads to bone resorption and implant loosening. Additive manufacturing (AM) presents a unique opportunity for enhanced performance by allowing for personalized medicine and increased functionality through geometrically complex parts. Much research has been devoted to how AM can be used to improve surgical implants through lattice structures. To date, the authors have found no studies that have performed a complete 3D lattice structure optimization in patient specific anatomy. This paper discusses the general design of an AM hip implant that is personalized for patient specific anatomy and proposes a workflow for optimizing a lattice structure within the implant. Using this design workflow, several lattice structured AM hip implants of various unit cell types are optimized. A solid hip implant is compared against the optimized hip implants. It appears the AM hip implant with a tetra lattice outperforms the other implant by reducing stiffness and allowing for greater bone ingrowth. Ultimately it was found that AM software still has many limitations associated with attempting complex optimizations with multiple materials in patient specific anatomy. Though software limitations prevented a full 3D optimization in patient specific anatomy, the challenges associated such an approach and limitations of the current software are discussed.


2021 ◽  
Vol 11 (11) ◽  
pp. 1162
Author(s):  
Jungsoo Lee ◽  
Won Hyuk Chang ◽  
Yun-Hee Kim

The corticospinal tract (CST) and corticocerebellar tract (CCT) are both involved in the upper extremity (UE) function after stroke. Understanding the relationship between the tracts and their functions can contribute to developing patient-specific rehabilitative strategies. Seventy ischemic stroke patients who underwent diffusion tensor imaging (DTI) two weeks after the stroke onset and motor function assessments two weeks and three months after the stroke onset were included in this study. To obtain the CST and CCT integrity, the functional anisotropy (FA) values of both tracts were extracted from the DTI data. Linear regression was used to identify the relationship and predictive accuracy. The CST FA data had predictive values, but CCT FA did not. There were interaction effects between the CST and CCT FA values (p = 0.011). The CCT was significantly associated with high CST FA but not low CST FA. When the CST or CCT FA were applied to patients depending on the CST status, the stratified model showed higher predictive accuracy (R2 = 0.380) than that of the CST-only model (R2 = 0.320). In this study, the conditional role of CCT depending on CST status was identified in terms of UE recovery in stroke patients. This result could provide useful information about individualized rehabilitative strategies in stroke patients.


Author(s):  
Lakshya P. Rathore ◽  
Naina Verma

Additive manufacturing (AM) is a novel technique that despite having been around for more than 35 years, has been underutilized. Its great advantage lies in the basic fact that it is incredibly customizable. Since its use was recognized in various fields of medicine like orthopaedics, otorhinolaryngology, ophthalmology etc, it has proved to be one of the most promising developments in most of them. Customizable orthotics, prosthetics and patient specific implants and tracheal splints are few of its advantages. And in the future too, the combination of tissue engineering with AM is believed to produce an immense change in biological tissue replacement.


2021 ◽  
Author(s):  
Raphael Bertani ◽  
Caio Moreno Perret Novo ◽  
Pedro Henrique Freitas ◽  
Amanda Amorin Nunes ◽  
Thiago Nunes Palhares ◽  
...  

Abstract We present a detailed step-by-step approach for the low-cost production and surgical implantation of cranial prostheses, aimed at restoring aesthetics, cerebral protection, and facilitating neurological rehabilitation. This protocol uses combined scan computed tomography (CT) cross-sectional images, in DICOM format, along with a 3D printing (additive manufacturing) setup. The in-house developed software InVesalius®️ is an open-source tool for medical imaging manipulation. The protocol describes image acquisition (CT scanning) procedures, and image post-processing procedures such as image segmentation, surface/volume rendering, mesh generation of a 3D digital model of the cranial defect and the desired prostheses, and their preparation for use in 3D printers. Furthermore, the protocol describes a detailed powder bed fusion additive manufacturing process, known as Selective Laser Sintering (SLS), using Polyamide (PA12) as feedstock to produce a 3-piece customized printed set per patient. Each set consists of a “cranial defect printout” and a “testing prosthesis” to assemble parts for precision testing, and a cranial “prostheses mold” in 2 parts to allow for the intraoperative modeling of the final implant cast using the medical grade Poly(methyl methacrylate) (PMMA) in a time span of a few min. The entire 3D processing time, including modelling, design, production, post-processing and qualification, takes approximately 42 h. Modeling the PMMA flap with a critical thickness of 4 mm by means of Finite Element Method (FEM) assures mechanical and impact properties to be slightly weaker than the bone tissue around it, a safety design to prevent fracturing the skull after a possible subsequent episode of head injury. On a parallel track, the Protocol seeks to provide guidance in the context of equipment, manufacturing cost and troubleshooting. Customized 3D PMMA prostheses offers a reduced operating time, good biocompatibility, and great functional and aesthetic outcomes. Additionally, it offers greater than 15-fold cost advantage over the usage of other materials, including metallic parts produced by additive manufacturing.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Gowtham Venkatraman ◽  
Adam Hehr ◽  
Leon M. Headings ◽  
Marcelo J. Dapino

Purpose Ultrasonic additive manufacturing (UAM) is a solid-state joining technology used for three-dimensional printing of metal foilstock. The electrical power input to the ultrasonic welder is a key driver of part quality in UAM, but under the same process parameters, it can vary widely for different build geometries and material combinations because of mechanical compliance in the system. This study aims to model the relationship between UAM weld power and system compliance considering the workpiece (geometry and materials) and the fixture on which the build is fabricated. Design/methodology/approach Linear elastic finite element modeling and experimental modal analysis are used to characterize the system’s mechanical compliance, and linear system dynamics theory is used to understand the relationship between weld power and compliance. In-situ measurements of the weld power are presented for various build stiffnesses to compare model predictions with experiments. Findings Weld power in UAM is found to be largely determined by the mechanical compliance of the build and insensitive to foil material strength. Originality/value This is the first research paper to develop a predictive model relating UAM weld power and the mechanical compliance of the build over a range of foil combinations. This model is used to develop a tool to determine the process settings required to achieve a consistent weld power in builds with different stiffnesses.


2011 ◽  
Vol 11 ◽  
pp. 930-958 ◽  
Author(s):  
Irena Dimov ◽  
Deasanka Tasic-Dimov ◽  
Irena Conic ◽  
Vladisav Stefanovic

Glioblastoma multiforme (GBM) is an aggressive, malignant, and lethal brain tumor, resistant to all current forms of treatment. The rapidly emerging focus on cancer stem cells embodies a paradigm shift in our understanding of tumor pathogenesis, while the development of powerful genome-wide screening techniques has provided cause for optimism related to the development of more reliable therapies primarily targeting GBM stem cells (GBMSCs). There are promising mounting data on providing new molecular targets and predictive markers of response, leading to more effective therapies of GBM, guided by patient-specific genetic and epigenetic profiling. However, the achievement of efficient GBMSC targeting also requires an adequate understanding of the unique microenvironment, and the relationship with the immune system in the central nervous system (CNS) and CNS tumors. The endogenous immune regulation is likely to limit or abrogate the efficacy of the host's immune response, as well as the developed immunotherapeutic strategies at present. Therefore, a comprehensive understanding of the mechanisms underlying the GBM-induced immunosuppression is indispensable. This review presents a summary of the present knowledge both on GBMSCs and the GBM, and/or GBMSC-related mechanisms of developing both local and systemic immunosuppression, of which an understanding may lead to the development of the novel and effective therapeutic strategies.


Sign in / Sign up

Export Citation Format

Share Document