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Kim H, Lim S, Park M, Kim K, Kang SH, Lee Y. Optimization of Fast Non-Local Means Noise Reduction Algorithm Parameter in Computed Tomographic Phantom Images Using 3D Printing Technology. Diagnostics (Basel) 2024; 14:1589. [PMID: 39125465 PMCID: PMC11312005 DOI: 10.3390/diagnostics14151589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/09/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
Noise in computed tomography (CT) is inevitably generated, which lowers the accuracy of disease diagnosis. The non-local means approach, a software technique for reducing noise, is widely used in medical imaging. In this study, we propose a noise reduction algorithm based on fast non-local means (FNLMs) and apply it to CT images of a phantom created using 3D printing technology. The self-produced phantom was manufactured using filaments with similar density to human brain tissues. To quantitatively evaluate image quality, the contrast-to-noise ratio (CNR), coefficient of variation (COV), and normalized noise power spectrum (NNPS) were calculated. The results demonstrate that the optimized smoothing factors of FNLMs are 0.08, 0.16, 0.22, 0.25, and 0.32 at 0.001, 0.005, 0.01, 0.05, and 0.1 of noise intensities, respectively. In addition, we compared the optimized FNLMs with noisy, local filters and total variation algorithms. As a result, FNLMs showed superior performance compared to various denoising techniques. Particularly, comparing the optimized FNLMs to the noisy images, the CNR improved by 6.53 to 16.34 times, COV improved by 6.55 to 18.28 times, and the NNPS improved by 10-2 mm2 on average. In conclusion, our approach shows significant potential in enhancing CT image quality with anthropomorphic phantoms, thus addressing the noise issue and improving diagnostic accuracy.
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Affiliation(s)
- Hajin Kim
- Department of Health Science, General Graduate School of Gachon University, 191, Hambakmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea; (H.K.); (S.L.); (M.P.)
| | - Sewon Lim
- Department of Health Science, General Graduate School of Gachon University, 191, Hambakmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea; (H.K.); (S.L.); (M.P.)
| | - Minji Park
- Department of Health Science, General Graduate School of Gachon University, 191, Hambakmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea; (H.K.); (S.L.); (M.P.)
| | - Kyuseok Kim
- Department of Biomedical Engineering, Eulji University, 553, Sanseong-daero, Sujeong-gu, Seongnam-si 13135, Republic of Korea;
| | - Seong-Hyeon Kang
- Department of Biomedical Engineering, Eulji University, 553, Sanseong-daero, Sujeong-gu, Seongnam-si 13135, Republic of Korea;
| | - Youngjin Lee
- Department of Radiological Science, Gachon University, 191, Hambakmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea
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Akça Sümengen A, İsmailoğlu AV, İsmailoğlu P, Gümüş T, Çeliker A, Namlısesli D, Poyraz E, Özçevik Subaşı D, Zeren Erdem C, Çakır GN. The effect of 3D modeling on family quality of life, surgical success, and patient outcomes in congenital heart diseases: objectives and design of a randomized controlled trial. Turk J Pediatr 2024; 66:237-250. [PMID: 38814302 DOI: 10.24953/turkjpediatr.2024.4574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/30/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Understanding the severity of the disease from the parents' perspective can lead to better patient outcomes, improving both the child's health-related quality of life and the family's quality of life. The implementation of 3-dimensional (3D) modeling technology in care is critical from a translational science perspective. AIM The purpose of this study is to determine the effect of 3D modeling on family quality of life, surgical success, and patient outcomes in congenital heart diseases. Additionally, we aim to identify challenges and potential solutions related to this innovative technology. METHODS The study is a two-group pretest-posttest randomized controlled trial protocol. The sample size is 15 in the experimental group and 15 in the control group. The experimental group's heart models will be made from their own computed tomography (CT) images and printed using a 3D printer. The experimental group will receive surgical simulation and preoperative parent education with their 3D heart model. The control group will receive the same parent education using the standard anatomical model. Both groups will complete the Sociodemographic Information Form, the Surgical Simulation Evaluation Form - Part I-II, and the Pediatric Quality of Life Inventory (PedsQL) Family Impacts Module. The primary outcome of the research is the average PedsQL Family Impacts Module score. Secondary outcome measurement includes surgical success and patient outcomes. Separate analyses will be conducted for each outcome and compared between the intervention and control groups. CONCLUSIONS Anomalies that can be clearly understood by parents according to the actual size and dimensions of the child's heart will affect the preoperative preparation of the surgical procedure and the recovery rate in the postoperative period.
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Affiliation(s)
- Aylin Akça Sümengen
- Department of Nursing, Faculty of Health Sciences, Yeditepe University, İstanbul, Türkiye
- Capstone College of Nursing, The University of Alabama, Alabama, United States of America
| | - Abdul Veli İsmailoğlu
- Department of Anatomy, School of Medicine, Acıbadem University, İstanbul, Türkiye
- Department of Anatomy, School of Medicine, Marmara University, İstanbul, Türkiye
| | - Pelin İsmailoğlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Fenerbahce University, İstanbul, Türkiye
- Department of Anatomy, School of Medicine, Recep Tayyip Erdoğan University, Rize, Türkiye
| | - Terman Gümüş
- Department of Radiology, School of Medicine, Koç University Research and Training Hospital, İstanbul, Türkiye
| | - Alpay Çeliker
- Pediatric Cardiology Department, American Hospital, İstanbul, Türkiye
| | - Deniz Namlısesli
- Department of Electrical and Electronics Engineering, Faculty of Engineering, Yeditepe University, İstanbul, Türkiye
| | - Ezgi Poyraz
- Pediatric Cardiology Department, American Hospital, İstanbul, Türkiye
| | | | - Ceren Zeren Erdem
- Department of Nursing, Faculty of Health Sciences, Yeditepe University, İstanbul, Türkiye
| | - Gökçe Naz Çakır
- Department of Nursing, Faculty of Health Sciences, Yeditepe University, İstanbul, Türkiye
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Ke Re Mu ALM, Liang ZL, Chen L, Tu Xun AKBE, A Bu Li Ke Mu MMTAL, Wu YQ. 3D printed PLGA scaffold with nano-hydroxyapatite carrying linezolid for treatment of infected bone defects. Biomed Pharmacother 2024; 172:116228. [PMID: 38320333 DOI: 10.1016/j.biopha.2024.116228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Linezolid has been reported to protect against chronic bone and joint infection. In this study, linezolid was loaded into the 3D printed poly (lactic-co-glycolic acid) (PLGA) scaffold with nano-hydroxyapatite (HA) to explore the effect of this composite scaffold on infected bone defect (IBD). METHODS PLGA scaffolds were produced using the 3D printing method. Drug release of linezolid was analyzed by elution and high-performance liquid chromatography assay. PLGA, PLGA-HA, and linezolid-loaded PLGA-HA scaffolds, were implanted into the defect site of a rabbit radius defect model. Micro-CT, H&E, and Masson staining, and immunohistochemistry were performed to analyze bone infection and bone healing. Evaluation of viable bacteria was performed. The cytocompatibility of 3D-printed composite scaffolds in vitro was detected using human bone marrow mesenchymal stem cells (BMSCs). Long-term safety of the scaffolds in rabbits was evaluated. RESULTS The linezolid-loaded PLGA-HA scaffolds exhibited a sustained release of linezolid and showed significant antibacterial effects. In the IBD rabbit models implanted with the scaffolds, the linezolid-loaded PLGA-HA scaffolds promoted bone healing and attenuated bone infection. The PLGA-HA scaffolds carrying linezolid upregulated the expression of osteogenic genes including collagen I, runt-related transcription factor 2, and osteocalcin. The linezolid-loaded PLGA-HA scaffolds promoted the proliferation and osteogenesis of BMSCs in vitro via the PI3K/AKT pathway. Moreover, the rabbits implanted with the linezolid-loaded scaffolds showed normal biochemical profiles and normal histology, which suggested the safety of the linezolid-loaded scaffolds. CONCLUSION Overall, the linezolid-loaded PLGA-HA scaffolds fabricated by 3D printing exerts significant bone repair and anti-infection effects.
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Affiliation(s)
- A Li Mu Ke Re Mu
- Orthopedics Center, First People's Hospital of Kashgar, Kashgar 844000, Xinjiang, China
| | - Zhi Lin Liang
- Orthopedics Center, First People's Hospital of Kashgar, Kashgar 844000, Xinjiang, China
| | - Linlin Chen
- Nanjing Genebios Biotechnology Co., Ltd., Nanjing 21100, China
| | - Ai Ke Bai Er Tu Xun
- Orthopedics Center, First People's Hospital of Kashgar, Kashgar 844000, Xinjiang, China
| | | | - Yuan Quan Wu
- Orthopedics Center, First People's Hospital of Kashgar, Kashgar 844000, Xinjiang, China.
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Wang T, Wu M, Cao L, Liu B. Organic functional substance engineered living materials for biomedical applications. Biomaterials 2023; 301:122248. [PMID: 37487360 DOI: 10.1016/j.biomaterials.2023.122248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/09/2023] [Accepted: 07/16/2023] [Indexed: 07/26/2023]
Abstract
Modifying living materials with organic functional substances (OFS) is a convenient and effective strategy to control and monitor the transport, engraftment, and secretion processes in living organisms. OFSs, including small organic molecules and organic polymers, own the merit of design flexibility, satisfying performance, and excellent biocompatibility, which allow for living materials functionalization to realize real-time sensing, controlled drug release, enhanced biocompatibility, accurate diagnosis, and precise treatment. In this review, we discuss the different principles of OFS modification on living materials and demonstrate the applications of engineered living materials in health monitoring, drug delivery, wound healing, and tissue regeneration.
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Affiliation(s)
- Tongtong Wang
- Joint School of National University of Singapore and Tianjin University, International Campus of Tianjin University, Binhai New City, Fuzhou, 350207, China; Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, 117585, Singapore
| | - Min Wu
- Joint School of National University of Singapore and Tianjin University, International Campus of Tianjin University, Binhai New City, Fuzhou, 350207, China.
| | - Lei Cao
- Joint School of National University of Singapore and Tianjin University, International Campus of Tianjin University, Binhai New City, Fuzhou, 350207, China; Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, 117585, Singapore
| | - Bin Liu
- Joint School of National University of Singapore and Tianjin University, International Campus of Tianjin University, Binhai New City, Fuzhou, 350207, China; Department of Chemical and Biomolecular Engineering, National University of Singapore, 4 Engineering Drive 4, 117585, Singapore.
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Zhang C, Lewin W, Cullen A, Thommen D, Hill R. Evaluation of 3D-printed bolus for radiotherapy using megavoltage X-ray beams. Radiol Phys Technol 2023; 16:414-421. [PMID: 37294521 PMCID: PMC10435601 DOI: 10.1007/s12194-023-00727-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/10/2023]
Abstract
A radiotherapy bolus is a tissue-equivalent material placed on the skin to adjust the surface dose of megavoltage X-ray beams used for treatment. In this study, the dosimetric properties of two 3D-printed filament materials, polylactic acid (PLA) and thermoplastic polyether urethane (TPU), used as radiotherapy boluses, were investigated. The dosimetric properties of PLA and TPU were compared with those of several conventional bolus materials and RMI457 Solid Water. Percentage depth-dose (PDD) measurements in the build-up region were performed for all materials using 6 and 10 MV photon treatment beams on Varian linear accelerators. The results showed that the differences in the PDDs of the 3D-printed materials from the RMI457 Solid Water were within 3%, whereas those of the dental wax and SuperFlab gel materials were within 5%. This indicates that PLA and TPU 3D-printed materials are suitable radiotherapy bolus materials.
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Affiliation(s)
- Chunsu Zhang
- Institute of Medical Physics, School of Physics, The University of Sydney, Sydney, NSW, 2006, Australia
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW, 2050, Australia
| | - Will Lewin
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW, 2050, Australia
| | - Ashley Cullen
- Institute of Medical Physics, School of Physics, The University of Sydney, Sydney, NSW, 2006, Australia
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW, 2050, Australia
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Missenden Rd, Camperdown,Sydney, NSW, 2050, Australia
| | - Daniel Thommen
- Institute of Medical Physics, School of Physics, The University of Sydney, Sydney, NSW, 2006, Australia
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW, 2050, Australia
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Missenden Rd, Camperdown,Sydney, NSW, 2050, Australia
| | - Robin Hill
- Institute of Medical Physics, School of Physics, The University of Sydney, Sydney, NSW, 2006, Australia.
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW, 2050, Australia.
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Missenden Rd, Camperdown,Sydney, NSW, 2050, Australia.
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McMillan A, McMillan N, Gupta N, Kanotra SP, Salem AK. 3D Bioprinting in Otolaryngology: A Review. Adv Healthc Mater 2023; 12:e2203268. [PMID: 36921327 PMCID: PMC10502192 DOI: 10.1002/adhm.202203268] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/05/2023] [Indexed: 03/17/2023]
Abstract
The evolution of tissue engineering and 3D bioprinting has allowed for increased opportunities to generate musculoskeletal tissue grafts that can enhance functional and aesthetic outcomes in otolaryngology-head and neck surgery. Despite literature reporting successes in the fabrication of cartilage and bone scaffolds for applications in the head and neck, the full potential of this technology has yet to be realized. Otolaryngology as a field has always been at the forefront of new advancements and technology and is well poised to spearhead clinical application of these engineered tissues. In this review, current 3D bioprinting methods are described and an overview of potential cell types, bioinks, and bioactive factors available for musculoskeletal engineering using this technology is presented. The otologic, nasal, tracheal, and craniofacial bone applications of 3D bioprinting with a focus on engineered graft implantation in animal models to highlight the status of functional outcomes in vivo; a necessary step to future clinical translation are reviewed. Continued multidisciplinary efforts between material chemistry, biological sciences, and otolaryngologists will play a key role in the translation of engineered, 3D bioprinted constructs for head and neck surgery.
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Affiliation(s)
- Alexandra McMillan
- Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, IA
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA
| | - Nadia McMillan
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Nikesh Gupta
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA
| | - Sohit P. Kanotra
- Department of Otolaryngology, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Aliasger K. Salem
- Department of Pharmaceutical Sciences and Experimental Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA
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马 驰, 朴 成. [Application status of open-wedge high tibial osteotomy assisted by three-dimensional printing patient-specific cutting guides]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2023; 37:360-364. [PMID: 36940997 PMCID: PMC10027522 DOI: 10.7507/1002-1892.202212031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/31/2023] [Indexed: 03/23/2023]
Abstract
Objective To review the application of three-dimensional (3D) printing patient-specific cutting guides (PSCG) in open-wedge high tibial osteotomy (OWHTO). Methods The domestic and foreign literature about the use of 3D printing PSCG to assist the OWHTO in recent years was reviewed, and the effectiveness of different types of 3D printing PSCG to assist OWHTO was summarized. Results Many scholars design and use different 3D printing PSCGs to confirm the precise positioning of the osteotomy site (the bone surface around the cutting line, the "H" point of the proximal tibia, the internal and external malleolus fixators, etc.) and the correction angle (the pre-drilled holes, the wedge-shaped filling blocks, the angle-guided connecting rod, etc.) during operation, and all of them achieve good effectiveness. Conclusion Compared with conventional OWHTO, 3D printing PSCG assisted OWHTO has many obvious advantages, such as shortening the operation time, and the frequency of fluoroscopy, and being closer to the expected preoperative correction, etc. However, the effectiveness between different 3D printing PSCGs still need to be discussed in the follow-up studies.
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Affiliation(s)
- 驰 马
- 沈阳医学院研究生院(沈阳 110034)Graduate School, Shenyang Medical College, Shenyang Liaoning, 110034, P. R. China
| | - 成哲 朴
- 沈阳医学院研究生院(沈阳 110034)Graduate School, Shenyang Medical College, Shenyang Liaoning, 110034, P. R. China
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Application of 3D Printing in Bone Grafts. Cells 2023; 12:cells12060859. [PMID: 36980200 PMCID: PMC10047278 DOI: 10.3390/cells12060859] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
The application of 3D printing in bone grafts is gaining in importance and is becoming more and more popular. The choice of the method has a direct impact on the preparation of the patient for surgery, the probability of rejection of the transplant, and many other complications. The aim of the article is to discuss methods of bone grafting and to compare these methods. This review of literature is based on a selective literature search of the PubMed and Web of Science databases from 2001 to 2022 using the search terms “bone graft”, “bone transplant”, and “3D printing”. In addition, we also reviewed non-medical literature related to materials used for 3D printing. There are several methods of bone grafting, such as a demineralized bone matrix, cancellous allograft, nonvascular cortical allograft, osteoarticular allograft, osteochondral allograft, vascularized allograft, and an autogenic transplant using a bone substitute. Currently, autogenous grafting, which involves removing the patient’s bone from an area of low aesthetic importance, is referred to as the gold standard. 3D printing enables using a variety of materials. 3D technology is being applied to bone tissue engineering much more often. It allows for the treatment of bone defects thanks to the creation of a porous scaffold with adequate mechanical strength and favorable macro- and microstructures. Bone tissue engineering is an innovative approach that can be used to repair multiple bone defects in the process of transplantation. In this process, biomaterials are a very important factor in supporting regenerative cells and the regeneration of tissue. We have years of research ahead of us; however, it is certain that 3D printing is the future of transplant medicine.
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Ngomi N, Khayeka-Wandabwa C, Egondi T, Marinda PA, Haregu TN. Determinants of inequality in health care seeking for childhood illnesses: insights from Nairobi informal settlements. GLOBAL HEALTH JOURNAL 2022. [DOI: 10.1016/j.glohj.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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10
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Javaid M, Haleem A, Singh RP, Suman R. 3D printing applications for healthcare research and development. GLOBAL HEALTH JOURNAL 2022. [DOI: 10.1016/j.glohj.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Gao W, Wang C, Li Q, Zhang X, Yuan J, Li D, Sun Y, Chen Z, Gu Z. Application of medical imaging methods and artificial intelligence in tissue engineering and organ-on-a-chip. Front Bioeng Biotechnol 2022; 10:985692. [PMID: 36172022 PMCID: PMC9511994 DOI: 10.3389/fbioe.2022.985692] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/08/2022] [Indexed: 12/02/2022] Open
Abstract
Organ-on-a-chip (OOC) is a new type of biochip technology. Various types of OOC systems have been developed rapidly in the past decade and found important applications in drug screening and precision medicine. However, due to the complexity in the structure of both the chip-body itself and the engineered-tissue inside, the imaging and analysis of OOC have still been a big challenge for biomedical researchers. Considering that medical imaging is moving towards higher spatial and temporal resolution and has more applications in tissue engineering, this paper aims to review medical imaging methods, including CT, micro-CT, MRI, small animal MRI, and OCT, and introduces the application of 3D printing in tissue engineering and OOC in which medical imaging plays an important role. The achievements of medical imaging assisted tissue engineering are reviewed, and the potential applications of medical imaging in organoids and OOC are discussed. Moreover, artificial intelligence - especially deep learning - has demonstrated its excellence in the analysis of medical imaging; we will also present the application of artificial intelligence in the image analysis of 3D tissues, especially for organoids developed in novel OOC systems.
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Affiliation(s)
- Wanying Gao
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Chunyan Wang
- State Key Laboratory of Space Medicine Fundamentals and Application, Chinese Astronaut Science Researching and Training Center, Beijing, China
| | - Qiwei Li
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Xijing Zhang
- Central Research Institute, United Imaging Group, Shanghai, China
| | - Jianmin Yuan
- Central Research Institute, United Imaging Group, Shanghai, China
| | - Dianfu Li
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Sun
- International Children’s Medical Imaging Research Laboratory, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Zaozao Chen
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Zhongze Gu
- State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
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Fakhoury Y, Ellabban A, Attia U, Sallam A, Elsherbiny S. Three-dimensional printing in ophthalmology and eye care: current applications and future developments. Ther Adv Ophthalmol 2022; 14:25158414221106682. [PMID: 35782482 PMCID: PMC9247992 DOI: 10.1177/25158414221106682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Three-dimensional (3D) printing uses a process of adding material in a layer-by-layer fashion to form the end product. This technology is advancing rapidly and is being increasingly utilized in the medical field as it becomes more accessible and cost-effective. It has an increasingly important role in ophthalmology and eyecare as its current and potential applications are extensive and slowly evolving. Three-dimensional printing represents an important method of manufacturing customized products such as orbital implants, ocular prostheses, ophthalmic models, surgical instruments, spectacles and other gadgets. Surgical planning, simulation, training and teaching have all benefitted from this technology. Advances in bioprinting seem to be the future direction of 3D printing with possibilities of printing out viable ocular tissues such as corneas and retinas in the future. It is expected that more ophthalmologists and other clinicians will use this technology in the near future.
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Affiliation(s)
| | - Abdallah Ellabban
- Hull University Teaching Hospitals NHS Trust,
Kingston upon Hull, UK,Suez Canal University, Ismailia, Egypt
| | - Usama Attia
- Manufacturing Technology Centre (MTC),
Coventry, UK
| | - Ahmed Sallam
- Jones Eye Institute, University of Arkansas for
Medical Sciences, Little Rock, AR, USA
| | - Samer Elsherbiny
- Machen Eye Unit, Warwick Hospital, South
Warwickshire NHS Foundation Trust, Warwick, UK,Warwick Medical School, University of Warwick,
Coventry, UK
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Usefulness of an Additional Filter Created Using 3D Printing for Whole-Body X-ray Imaging with a Long-Length Detector. SENSORS 2022; 22:s22114299. [PMID: 35684921 PMCID: PMC9185553 DOI: 10.3390/s22114299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/31/2022] [Accepted: 06/04/2022] [Indexed: 02/05/2023]
Abstract
We recently developed a long-length detector that combines three detectors and successfully acquires whole-body X-ray images. Although the developed detector system can efficiently acquire whole-body images in a short time, it may show problems with diagnostic performance in some areas owing to the use of high-energy X-rays during whole-spine and long-length examinations. In particular, during examinations of relatively thin bones, such as ankles, with a long-length detector, the image quality deteriorates because of an increase in X-ray transmission. An additional filter is primarily used to address this limitation, but this approach imposes a higher load on the X-ray tube to compensate for reductions in the radiation dose and the problem of high manufacturing costs. Thus, in this study, a newly designed additional filter was fabricated using 3D printing technology to improve the applicability of the long-length detector. Whole-spine anterior–posterior (AP), lateral, and long-leg AP X-ray examinations were performed using 3D-printed additional filters composed of 14 mm thick aluminum (Al) or 14 mm thick Al + 1 mm thick copper (Cu) composite material. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and radiation dose for the acquired X-ray images were evaluated to demonstrate the usefulness of the filters. Under all X-ray inspection conditions, the most effective data were obtained when the composite additional filter based on a 14 mm thick Al + 1 mm thick Cu material was used. We confirmed that an SNR improvement of up to 46%, CNR improvement of 37%, and radiation dose reduction of 90% could be achieved in the X-ray images obtained using the composite additional filter in comparison to the images obtained with no filter. The results proved that the additional filter made with a 3D printer was effective in improving image quality and reducing the radiation dose for X-ray images obtained using a long-length detector.
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Cornejo J, Cornejo-Aguilar JA, Vargas M, Helguero CG, Milanezi de Andrade R, Torres-Montoya S, Asensio-Salazar J, Rivero Calle A, Martínez Santos J, Damon A, Quiñones-Hinojosa A, Quintero-Consuegra MD, Umaña JP, Gallo-Bernal S, Briceño M, Tripodi P, Sebastian R, Perales-Villarroel P, De la Cruz-Ku G, Mckenzie T, Arruarana VS, Ji J, Zuluaga L, Haehn DA, Paoli A, Villa JC, Martinez R, Gonzalez C, Grossmann RJ, Escalona G, Cinelli I, Russomano T. Anatomical Engineering and 3D Printing for Surgery and Medical Devices: International Review and Future Exponential Innovations. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6797745. [PMID: 35372574 PMCID: PMC8970887 DOI: 10.1155/2022/6797745] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 12/26/2022]
Abstract
Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients' needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions.
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Affiliation(s)
- José Cornejo
- Facultad de Ingeniería, Universidad San Ignacio de Loyola, La Molina, Lima 15024, Peru
- Department of Medicine and Biology & Department of Physics and Engineering, Bioastronautics and Space Mechatronics Research Group, Lima 15024, Peru
| | | | | | | | - Rafhael Milanezi de Andrade
- Robotics and Biomechanics Laboratory, Department of Mechanical Engineering, Universidade Federal do Espírito Santo, Brazil
| | | | | | - Alvaro Rivero Calle
- Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
| | - Jaime Martínez Santos
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Aaron Damon
- Department of Neurosurgery, Mayo Clinic, FL, USA
| | | | | | - Juan Pablo Umaña
- Cardiovascular Surgery, Instituto de Cardiología-Fundación Cardioinfantil, Universidad del Rosario, Bogotá DC, Colombia
| | | | - Manolo Briceño
- Villamedic Group, Lima, Peru
- Clínica Internacional, Lima, Peru
| | | | - Raul Sebastian
- Department of Surgery, Northwest Hospital, Randallstown, MD, USA
| | | | - Gabriel De la Cruz-Ku
- Universidad Científica del Sur, Lima, Peru
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jiakai Ji
- Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY, USA
| | - Laura Zuluaga
- Department of Urology, Fundación Santa Fe de Bogotá, Colombia
| | | | - Albit Paoli
- Howard University Hospital, Washington, DC, USA
| | | | | | - Cristians Gonzalez
- Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut of Image-Guided Surgery (IHU-Strasbourg), Strasbourg, France
| | | | - Gabriel Escalona
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Santiago, Chile
| | - Ilaria Cinelli
- Aerospace Human Factors Association, Aerospace Medical Association, VA, USA
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Fuentes JM, Arrieta MP, Boronat T, Ferrándiz S. Effects of Steam Heat and Dry Heat Sterilization Processes on 3D Printed Commercial Polymers Printed by Fused Deposition Modeling. Polymers (Basel) 2022; 14:polym14050855. [PMID: 35267683 PMCID: PMC8912381 DOI: 10.3390/polym14050855] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 02/01/2023] Open
Abstract
Fused deposition modeling (FDM), the most widely used additive manufacturing (AM) technology, is gaining considerable interest in the surgical sector for the production of single-use surgical devices that can be tailor-made according to specific requirements (e.g., type of patient surgery, specific shapes, etc.) due to its low cost, ease of access to materials (3D-printing filament), and the relatively low complexity. However, surgical 3D-printing parts should resist sterilization treatments without losing structural, mechanical, and dimensional accuracy. Thus, in this work, 3D-filaments based on poly(lactic acid) (PLA), poly(ethylene glycol-co-1,4-cyclohexanedimethanol terephthalate) (PETG), and a modified PETG material (CPE) were used to produce 3D-printed parts and further subjected to moist heat (MH) and dry heat (DH) sterilization processes as affordable and widely used sterilization processes in the medical field. The effect of MH and DH was evaluated by performing a complete mechanical, structural, thermal, and morphological characterization before and after both treatments. In general, the moist heat treatment produced a higher degradation of the polymeric matrix of PETG and CPE due to hydrolytic and thermal degradation, particularly affecting the tensile test and flexural properties. For instance, the linear coefficient of thermal expansion (LCTE) before glass transition temperature (Tg) increased 47% and 31% in PETG samples due to the MH and DH, respectively, while it increased 31% in CPE due to MH and was mainly maintained after the DH process. Nevertheless, in PLA, the MH produced an increase of 20% in LCTE value and the DH showed an increase of 33%. Dry heat treatment resulted in being more suitable for medical applications in which dimensional accuracy is not a key factor and there are no great mechanical demands (e.g., surgical guides).
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Affiliation(s)
- Jorge Mauricio Fuentes
- Departamento de Ingeniería Mecánica y de Materiales, Instituto de Tecnología de Materiales, Universitat Politécnica de València, Plaza Ferrándiz y Carbonell s/n, 03801 Alcoi, Spain;
- Ingeniería en Diseño Industrial, Facultad de Ingeniería y Ciencias Aplicadas, Universidad Central del Ecuador, Quito 170521, Ecuador
- Correspondence: (J.M.F.); (M.P.A.); (S.F.)
| | - Marina Patricia Arrieta
- Departamento Ingeniería Química Industrial y Medio Ambiente, Universidad Politécnica de Madrid, E.T.S.I. Industriales, 28006 Madrid, Spain
- Grupo de Investigación: Polímeros, Caracterización y Aplicaciones (POLCA), 28006 Madrid, Spain
- Correspondence: (J.M.F.); (M.P.A.); (S.F.)
| | - Teodomiro Boronat
- Departamento de Ingeniería Mecánica y de Materiales, Instituto de Tecnología de Materiales, Universitat Politécnica de València, Plaza Ferrándiz y Carbonell s/n, 03801 Alcoi, Spain;
| | - Santiago Ferrándiz
- Departamento de Ingeniería Mecánica y de Materiales, Instituto de Tecnología de Materiales, Universitat Politécnica de València, Plaza Ferrándiz y Carbonell s/n, 03801 Alcoi, Spain;
- Correspondence: (J.M.F.); (M.P.A.); (S.F.)
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Properties and Characteristics of Three-Dimensional Printed Head Models Used in Simulation of Neurosurgical Procedures: A Scoping Review. World Neurosurg 2021; 156:133-146.e6. [PMID: 34571242 DOI: 10.1016/j.wneu.2021.09.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Intracranial surgery can be complex and high risk. Safety, ethical and financial factors make training in the area challenging. Head model 3-dimensional (3D) printing is a realistic training alternative to patient and traditional means of cadaver and animal model simulation. OBJECTIVE To describe important factors relating to the 3D printing of human head models and how such models perform as simulators. METHODS Searches were performed in PubMed, the Cochrane Library, Scopus, and Web of Science. Articles were screened independently by 3 reviewers using Covidence software. Data items were collected under 5 categories: study information; printers and processes; head model specifics; simulation and evaluations; and costs and production times. RESULTS Forty articles published over the last 10 years were included in the review. A range of printers, printing methods, and substrates were used to create head models and tissue types. Complexity of the models ranged from sections of single tissue type (e.g., bone) to high-fidelity integration of multiple tissue types. Some models incorporated disease (e.g., tumors and aneurysms) and artificial physiology (e.g., pulsatile circulation). Aneurysm clipping, bone drilling, craniotomy, endonasal surgery, and tumor resection were the most commonly practiced procedures. Evaluations completed by those using the models were generally favorable. CONCLUSIONS The findings of this review indicate that those who practice surgery and surgical techniques on 3D-printed head models deem them to be valuable assets in cranial surgery training. Understanding how surgical simulation on such models affects surgical performance and patient outcomes, and considering cost-effectiveness, are important future research endeavors.
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Gharleghi R, Dessalles CA, Lal R, McCraith S, Sarathy K, Jepson N, Otton J, Barakat AI, Beier S. 3D Printing for Cardiovascular Applications: From End-to-End Processes to Emerging Developments. Ann Biomed Eng 2021; 49:1598-1618. [PMID: 34002286 PMCID: PMC8648709 DOI: 10.1007/s10439-021-02784-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 04/24/2021] [Indexed: 12/16/2022]
Abstract
3D printing as a means of fabrication has seen increasing applications in medicine in the last decade, becoming invaluable for cardiovascular applications. This rapidly developing technology has had a significant impact on cardiovascular research, its clinical translation and education. It has expanded our understanding of the cardiovascular system resulting in better devices, tools and consequently improved patient outcomes. This review discusses the latest developments and future directions of generating medical replicas ('phantoms') for use in the cardiovascular field, detailing the end-to-end process from medical imaging to capture structures of interest, to production and use of 3D printed models. We provide comparisons of available imaging modalities and overview of segmentation and post-processing techniques to process images for printing, detailed exploration of latest 3D printing methods and materials, and a comprehensive, up-to-date review of milestone applications and their impact within the cardiovascular domain across research, clinical use and education. We then provide an in-depth exploration of future technologies and innovations around these methods, capturing opportunities and emerging directions across increasingly realistic representations, bioprinting and tissue engineering, and complementary virtual and mixed reality solutions. The next generation of 3D printing techniques allow patient-specific models that are increasingly realistic, replicating properties, anatomy and function.
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Affiliation(s)
- Ramtin Gharleghi
- Faculty of Engineering, School of Mechanical and Manufacturing, UNSW, Sydney, Australia
| | | | - Ronil Lal
- Faculty of Engineering, School of Mechanical and Manufacturing, UNSW, Sydney, Australia
| | - Sinead McCraith
- Faculty of Engineering, School of Mechanical and Manufacturing, UNSW, Sydney, Australia
| | | | - Nigel Jepson
- Prince of Wales Hospital, Sydney, Australia
- Prince of Wales Clinical School of Medicine, UNSW, Sydney, Australia
| | - James Otton
- Department of Cardiology, Liverpool Hospital, Sydney, Australia
| | | | - Susann Beier
- Faculty of Engineering, School of Mechanical and Manufacturing, UNSW, Sydney, Australia.
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Shannon A, O'Connell A, O'Sullivan A, Byrne M, Clifford S, O'Sullivan KJ, O'Sullivan L. A Radiopaque Nanoparticle-Based Ink Using PolyJet 3D Printing for Medical Applications. 3D PRINTING AND ADDITIVE MANUFACTURING 2020; 7:259-268. [PMID: 36654671 PMCID: PMC9586492 DOI: 10.1089/3dp.2019.0160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The aim of this study was to develop a 3D printable radiopaque ink and successfully print a finished artifact. Radiopaque 3D printing would be hugely beneficial to improve the visibility of medical devices and implants, as well as allowing more realistic phantoms and calibration aids to be produced. Most 3D printing technologies are polymer based. Polymers are naturally radiolucent, allowing X-rays to pass through, showing up as faint dark gray regions on X-ray detectors, as for soft tissues. During this study, a 3D printable ultraviolet (UV) curable resin containing zirconium oxide (ZrO2) nanoparticles was developed. 5 wt.% ZrO2 was dispersed in a base resin using a high-shear mixer. Particles remained in suspension for 6-8 h at room temperature, allowing time for 3D printing. A model of a hand including radiopaque bones and a test block demonstrating a range of internal radiopaque features were successfully 3D printed. Radiopacity was demonstrated in the 3D-printed models, and there was good dispersion of ZrO2 within the resin matrix. The impregnated resin remained UV curable and viscosity was not compromised. In this study, 3D-printed radiopaque features demonstrated clear radiopacity under X-ray and microcomputed tomography imaging.
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Affiliation(s)
- Alice Shannon
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
| | - Aine O'Connell
- Radiology Department, University Hospital Limerick, Limerick, Ireland
| | - Aidan O'Sullivan
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
- Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Michael Byrne
- School of Engineering, University of Limerick, Limerick, Ireland
| | - Seamus Clifford
- School of Engineering, University of Limerick, Limerick, Ireland
| | - Kevin J. O'Sullivan
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
- Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Leonard O'Sullivan
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
- Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
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Abdullah KA, McEntee MF, Reed WM, Kench PL. Increasing iterative reconstruction strength at low tube voltage in coronary CT angiography protocols using 3D-printed and Catphan ® 500 phantoms. J Appl Clin Med Phys 2020; 21:209-214. [PMID: 32657493 PMCID: PMC7497920 DOI: 10.1002/acm2.12977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/21/2020] [Accepted: 06/12/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose The purpose of this study was to investigate the effect of increasing iterative reconstruction (IR) algorithm strength at different tube voltages in coronary computed tomography angiography (CCTA) protocols using a three‐dimensional (3D)‐printed and Catphan® 500 phantoms. Methods A 3D‐printed cardiac insert and Catphan 500 phantoms were scanned using CCTA protocols at 120 and 100 kVp tube voltages. All CT acquisitions were reconstructed using filtered back projection (FBP) and Adaptive Statistical Iterative Reconstruction (ASIR) algorithm at 40% and 60% strengths. Image quality characteristics such as image noise, signal–noise ratio (SNR), contrast–noise ratio (CNR), high spatial resolution, and low contrast resolution were analyzed. Results There was no significant difference (P > 0.05) between 120 and 100 kVp measures for image noise for FBP vs ASIR 60% (16.6 ± 3.8 vs 16.7 ± 4.8), SNR of ASIR 40% vs ASIR 60% (27.3 ± 5.4 vs 26.4 ± 4.8), and CNR of FBP vs ASIR 40% (31.3 ± 3.9 vs 30.1 ± 4.3), respectively. Based on the Modulation Transfer Function (MTF) analysis, there was a minimal change of image quality for each tube voltage but increases when higher strengths of ASIR were used. The best measure of low contrast detectability was observed at ASIR 60% at 120 kVp. Conclusions Changing the IR strength has yielded different image quality noise characteristics. In this study, the use of 100 kVp and ASIR 60% yielded comparable image quality noise characteristics to the standard CCTA protocols using 120 kVp of ASIR 40%. A combination of 3D‐printed and Catphan® 500 phantoms could be used to perform CT dose optimization protocols.
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Affiliation(s)
- Kamarul A Abdullah
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Malaysia
| | - Mark F McEntee
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Imaging Science, Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - Warren M Reed
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Imaging Science, Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - Peter L Kench
- Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Imaging Science, Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia
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Albantow C, Hargrave C, Brown A, Halsall C. Comparison of 3D printed nose bolus to traditional wax bolus for cost-effectiveness, volumetric accuracy and dosimetric effect. J Med Radiat Sci 2020; 67:54-63. [PMID: 32011102 PMCID: PMC7063257 DOI: 10.1002/jmrs.378] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 12/12/2019] [Accepted: 12/12/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction Three‐dimensional printing technology has the potential to streamline custom bolus production in radiotherapy. This study evaluates the volumetric, dosimetric and cost differences between traditional wax and 3D printed versions of nose bolus. Method Nose plaster impressions from 24 volunteers were CT scanned and planned. Planned virtual bolus was manufactured in wax and created in 3D print (100% and 18% shell infill density) for comparison. To compare volume variations and dosimetry, each constructed bolus was CT scanned and a plan replicating the reference plan fields generated. Bolus manufacture time and material costs were analysed. Results Mean volume differences between the virtual bolus (VB) and wax, and the VB and 18% and 100% 3D shells were −3.05 ± 11.06 cm3, −1.03 ± 8.09 cm3 and 1.31 ± 2.63 cm3, respectively. While there was no significant difference for the point and mean doses between the 100% 3D shell filled with water and the VB plans (P> 0.05), the intraclass coefficients for these dose metrics for the 100% 3D shell filled with wax compared to VB doses (0.69–0.96) were higher than those for the 18% and 100% 3D shell filled with water and the wax (0.48–0.88). Average costs for staff time and materials were higher for the wax ($138.54 and $20.49, respectively) compared with the 3D shell prints ($10.58 and $13.87, respectively). Conclusion Three‐dimensional printed bolus replicated the VB geometry with less cost for manufacture than wax bolus. When shells are printed with 100% infill density, 3D bolus dosimetrically replicates the reference plan.
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Affiliation(s)
- Christine Albantow
- Radiation Therapy, Townsville Cancer Centre, Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Catriona Hargrave
- Radiation Oncology, Princess Alexandra Hospital - Raymond Tce Campus, South Brisbane, Queensland, Australia.,Faculty of Health, School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Amy Brown
- Radiation Therapy, Townsville Cancer Centre, Townsville Hospital and Health Service, Townsville, Queensland, Australia
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Chen JV, Dang ABC, Lee CS, Dang ABC. 3D printed PLA Army-Navy retractors when used as linear retractors yield clinically acceptable tolerances. 3D Print Med 2019; 5:16. [PMID: 31754879 PMCID: PMC6873412 DOI: 10.1186/s41205-019-0053-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/24/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Modern low-cost 3D printing technologies offer the promise of access to surgical tools in resource scarce areas, however optimal designs for manufacturing have not yet been established. We explore how the optimization of 3D printing parameters when manufacturing polylactic acid filament based Army-Navy retractors vastly increases the strength of retractors, and investigate sources of variability in retractor strength, material cost, printing time, and parameter limitations. METHODS Standard retractors were printed from various polylactic acid filament spools intra-manufacturer and inter-manufacturer to measure variability in retractor strength. Printing parameters were systematically varied to determine optimum printing parameters. These parameters include retractor width, thickness, infill percentage, infill geometry, perimeter number, and a reinforced joint design. Estimated retractor mass from computer models allows us to estimate material cost. RESULTS We found statistically significant differences in retractor strength between spools of the same manufacturer and between manufacturers. We determined the true strength optimized retractor to have 30% infill, 3 perimeters, 0.25 in. thickness, 0.75 in. width, and has "Triangle" infill geometry and reinforced joints, failing at more than 15X the threshold for clinically excessive retraction and costs $1.25 USD. CONCLUSIONS The optimization of 3D printed Army-Navy retractors greatly improve the efficacy of this instrument and expedite the adoption of 3D printing technology in many diverse fields in medicine not necessarily limited to resource poor settings.
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Affiliation(s)
- Joshua V. Chen
- Department of Orthopaedic Surgery, University of California, San Francisco, CA USA
| | - Alexis B. C. Dang
- Department of Orthopaedic Surgery, University of California, San Francisco, CA USA
- Department of Surgery, Orthopaedic Section, San Francisco VA Health Center, San Francisco, CA USA
| | - Carlin S. Lee
- Department of Orthopaedic Surgery, University of California, San Francisco, CA USA
| | - Alan B. C. Dang
- Department of Orthopaedic Surgery, University of California, San Francisco, CA USA
- Department of Surgery, Orthopaedic Section, San Francisco VA Health Center, San Francisco, CA USA
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