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Agarwal P, Arora G, Panwar A, Mathur V, Srinivasan V, Pandita D, Vasanthan KS. Diverse Applications of Three-Dimensional Printing in Biomedical Engineering: A Review. 3D PRINTING AND ADDITIVE MANUFACTURING 2023; 10:1140-1163. [PMID: 37886418 PMCID: PMC10599440 DOI: 10.1089/3dp.2022.0281] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
A three-dimensional (3D) printing is a robotically controlled state-of-the-art technology that is promising for all branches of engineering with a meritorious emphasis to biomedical engineering. The purpose of 3D printing (3DP) is to create exact superstructures without any framework in a brief period with high reproducibility to create intricate and complex patient-tailored structures for organ regeneration, drug delivery, imaging processes, designing personalized dose-specific tablets, developing 3D models of organs to plan surgery and to understand the pathology of disease, manufacturing cost-effective surgical tools, and fabricating implants and organ substitute devices for prolonging the lives of patients, etc. The formulation of bioinks and programmed G codes help to obtain precise 3D structures, which determines the stability and functioning of the 3D-printed structures. Three-dimensional printing for medical applications is ambitious and challenging but made possible with the culmination of research expertise from various fields. Exploring and expanding 3DP for biomedical and clinical applications can be life-saving solutions. The 3D printers are cost-effective and eco-friendly, as they do not release any toxic pollutants or waste materials that pollute the environment. The sampling requirements and processing parameters are amenable, which further eases the production. This review highlights the role of 3D printers in the health care sector, focusing on their roles in tablet development, imaging techniques, disease model development, and tissue regeneration.
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Affiliation(s)
- Prachi Agarwal
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Gargi Arora
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research, Delhi Pharmaceutical Science and Research University, Government of NCT of Delhi, New Delhi, India
| | - Amit Panwar
- Institute of Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong, New Territories, Hong Kong
| | - Vidhi Mathur
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Deepti Pandita
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research, Delhi Pharmaceutical Science and Research University, Government of NCT of Delhi, New Delhi, India
- Centre for Advanced Formulation and Technology (CAFT), Delhi Pharmaceutical Sciences and Research University, PushpVihar, Government of NCT of Delhi, New Delhi, India
| | - Kirthanashri S. Vasanthan
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Alexander LF, McComb BL, Bowman AW, Bonnett SL, Ghazanfari SM, Caserta MP. Ultrasound Simulation Training for Radiology Residents-Curriculum Design and Implementation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:777-790. [PMID: 36106721 DOI: 10.1002/jum.16098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/16/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
Medical simulation training can be used to improve clinician performance, teach communication and professionalism skills, and enhance team training. Radiology residents can benefit from simulation training in diagnostic ultrasound, procedural ultrasound, and communication skills prior to direct patient care experiences. This paper details a weeklong ultrasound simulation training curriculum for radiology residents during the PGY-1 clinical internship. The organization of established teaching methods into a dedicated course early in radiology residency training with the benefit of a multi-disciplinary approach makes this method unique. This framework can be adapted to fit learners at different skill levels or with specific procedural needs.
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Affiliation(s)
- Lauren F Alexander
- Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Barbara L McComb
- Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Andrew W Bowman
- Division Chair of Hospital & Emergency Imaging | Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | | | | | - Melanie P Caserta
- Division Chair of Sonography | Department of Radiology, Mayo Clinic Florida, Jacksonville, Florida, USA
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Shine KM, Schlegel L, Ho M, Boyd K, Pugliese R. From the ground up: understanding the developing infrastructure and resources of 3D printing facilities in hospital-based settings. 3D Print Med 2022; 8:21. [PMID: 35821456 PMCID: PMC9275538 DOI: 10.1186/s41205-022-00147-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 06/09/2022] [Indexed: 12/02/2022] Open
Abstract
Background 3D printing is a popular technology in many industries secondary to its ability to rapidly produce inexpensive, high fidelity models/products, mainly through layer-by-layer fusion of various substrate materials. In healthcare, 3D printing has garnered interest for its applications in surgery, simulation, education, and medical device development, and 3D printing facilities are now being integrated into hospital-based settings. Yet, little is known regarding the leadership, resources, outputs, and role of these new onsite entities. Methods The purpose of this research was to survey features of North American hospital-based 3D printing facilities to understand their design and utility in anticipation of future expansion. Hospital-based 3D printing labs were recruited through online special interest groups to participate via survey response. Anonymous, voluntary data were collected from 21 facilities over 9 weeks and reported/analyzed in aggregate. Results Of the respondents, > 50% were founded in the past 5 years and 80% in the past decade, indicating recent and rapid growth of such facilities. Labs were most commonly found within large, university-affiliated hospitals/health systems with administration frequently, but not exclusively, through radiology departments, which was shown to enhance collaboration. All groups reported collaborating with other medical specialties/departments and image segmentation as part of the workflow, showing widespread interest in high fidelity, personalized medicine applications. Lab leadership was most often multidisciplinary, with physicians present on nearly all leadership teams. Budgets, personnel, and outputs varied among groups, however, all groups reported engagement in multiple 3D printing applications. Conclusion This preliminary study provides a foundation for understanding the unique nature of hospital-based 3D printing labs. While there is much to learn about such in-house facilities, the data obtained reveal important baseline characteristics. Further research is indicated to validate these early findings and create a detailed picture of the developing infrastructure of 3D printing in healthcare settings. Supplementary Information The online version contains supplementary material available at 10.1186/s41205-022-00147-7.
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Affiliation(s)
- Kristy M Shine
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA. .,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA. .,Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, USA.
| | - Lauren Schlegel
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, USA
| | - Michelle Ho
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA.,Department of Medicine, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, USA
| | - Kaitlyn Boyd
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA.,College of Engineering, Drexel University, Philadelphia, USA
| | - Robert Pugliese
- Health Design Lab, Thomas Jefferson University, Philadelphia, USA.,Innovation Pillar, Thomas Jefferson University, Philadelphia, USA
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Luz FM, Yacoub VRD, Silveira KAA, Reis F, Dertkigi SSJ. A model for training ultrasound-guided fine-needle punctures. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2022; 68:948-952. [PMID: 35946773 PMCID: PMC9574963 DOI: 10.1590/1806-9282.20220150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/15/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the efficacy of a training program in ultrasound-guided fine needle puncture using a cost-effective model. METHODS We evaluated the training of 20 resident radiology physicians, based on a theoretical course and a practical simulation part with models that focused on the puncture technique of thyroid nodules. The total time to perform the procedure, the number of punctures on the model surface, and the application of a questionnaire were used to assess the performance and confidence of the resident physicians in performing the procedure. RESULTS The training model used was easy to reproduce, inexpensive, versatile, and capable of simulating the echotexture of thyroid tissue. There was a significant reduction in the total time needed to perform the procedure with a mean of 173.7 s±91.28 s from R1 and 112.8 s±17.66 s from R2 before the course vs. 19.2 s±112.8 s and 14.3 s±9.36 s, respectively, after the course (p<0.0001); as well as the number of superficial punctures, with a mean of 2.2 punctures±0.92 from R1 and 1.5 punctures±0.32 from R2 before the course vs 1.1 punctures±0.71 and 1.0 puncture±0.0, respectively, after the course (p<0.0001). There was also a subjective improvement in the performance and confidence in performing this procedure. CONCLUSIONS An inexpensive and easy-to-reproduce gelatin-based model enabled adequate training of resident physicians and proved capable of improving their skills and confidence in simulating the procedure, even with a short period of training.
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Affiliation(s)
| | | | | | - Fabiano Reis
- Universidade Estadual de Campinas, Department of Radiology – Campinas (SP), Brazil
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Soft-Tissue-Mimicking Using Hydrogels for the Development of Phantoms. Gels 2022; 8:gels8010040. [PMID: 35049575 PMCID: PMC8774477 DOI: 10.3390/gels8010040] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/20/2021] [Accepted: 01/01/2022] [Indexed: 12/11/2022] Open
Abstract
With the currently available materials and technologies it is difficult to mimic the mechanical properties of soft living tissues. Additionally, another significant problem is the lack of information about the mechanical properties of these tissues. Alternatively, the use of phantoms offers a promising solution to simulate biological bodies. For this reason, to advance in the state-of-the-art a wide range of organs (e.g., liver, heart, kidney as well as brain) and hydrogels (e.g., agarose, polyvinyl alcohol –PVA–, Phytagel –PHY– and methacrylate gelatine –GelMA–) were tested regarding their mechanical properties. For that, viscoelastic behavior, hardness, as well as a non-linear elastic mechanical response were measured. It was seen that there was a significant difference among the results for the different mentioned soft tissues. Some of them appear to be more elastic than viscous as well as being softer or harder. With all this information in mind, a correlation between the mechanical properties of the organs and the different materials was performed. The next conclusions were drawn: (1) to mimic the liver, the best material is 1% wt agarose; (2) to mimic the heart, the best material is 2% wt agarose; (3) to mimic the kidney, the best material is 4% wt GelMA; and (4) to mimic the brain, the best materials are 4% wt GelMA and 1% wt agarose. Neither PVA nor PHY was selected to mimic any of the studied tissues.
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Geduk G, Geduk SE, Seker C. Simulating submandibular area with everyday-use materials in dental education: A didactic US study. Niger J Clin Pract 2022; 25:849-854. [DOI: 10.4103/njcp.njcp_1831_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tenewitz C, Le RT, Hernandez M, Baig S, Meyer TE. Systematic review of three-dimensional printing for simulation training of interventional radiology trainees. 3D Print Med 2021; 7:10. [PMID: 33881672 PMCID: PMC8059217 DOI: 10.1186/s41205-021-00102-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/08/2021] [Indexed: 12/13/2022] Open
Abstract
RATIONALE AND OBJECTIVES Three-dimensional (3D) printing has been utilized as a means of producing high-quality simulation models for trainees in procedure-intensive or surgical subspecialties. However, less is known about its role for trainee education within interventional radiology (IR). Thus, the purpose of this review was to assess the state of current literature regarding the use of 3D printed simulation models in IR procedural simulation experiences. MATERIALS AND METHODS A literature query was conducted through April 2020 for articles discussing three-dimensional printing for simulations in PubMed, Embase, CINAHL, Web of Science, and the Cochrane library databases using key terms relating to 3D printing, radiology, simulation, training, and interventional radiology. RESULTS We identified a scarcity of published sources, 4 total articles, that appraised the use of three-dimensional printing for simulation training in IR. While trainee feedback is generally supportive of the use of three-dimensional printing within the field, current applications utilizing 3D printed models are heterogeneous, reflecting a lack of best practices standards in the realm of medical education. CONCLUSIONS Presently available literature endorses the use of three-dimensional printing within interventional radiology as a teaching tool. Literature documenting the benefits of 3D printed models for IR simulation has the potential to expand within the field, as it offers a straightforward, sustainable, and reproducible means for hands-on training that ought to be standardized.
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Affiliation(s)
- Chase Tenewitz
- Mercer University School of Medicine, Savannah, GA, USA.
| | - Rebecca T Le
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | | | - Saif Baig
- UF Health Jacksonville, Jacksonville, FL, USA
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3D printed soft surgical planning prototype for a biliary tract rhabdomyosarcoma. J Mech Behav Biomed Mater 2020; 109:103844. [PMID: 32543408 DOI: 10.1016/j.jmbbm.2020.103844] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 04/08/2020] [Accepted: 04/28/2020] [Indexed: 12/18/2022]
Abstract
Biliary tract rhabdomyosarcoma is a soft tissue malignant musculoskeletal tumor which is located in the biliary tract. Although this tumor represents less than 1% of the total amount of childhood cancers, when localized, a >70% overall 5-year survival rate, the resection is clinically challenging and complications might exist during the biliary obstruction. Although surgery remains a mainstay, complete tumor resection is generally difficult to achieve without mutilation and severe long-term sequelae. Therefore, manufacturing multi-material 3D surgical planning prototypes of the case provides a great opportunity for surgeons to learn beforehand what they can expect. Additionally, practicing before the operation enhances the probability of success. That is why different compositions of materials have been characterized to match the mechanical properties of the liver. To do this, Dynamic Mechanical Analysis (DMA) tests and Shore hardness tests have been carried out. Amongst the material samples produced, 6%wt PVA (poly vinyl alcohol)/1%wt PHY (Phytagel)-1FT (Freeze-Thaw cycles) and 1%wt agarose appear as the best options for mimicking the liver tissue in terms of viscoelasticity. Regarding the Shore hardness, the best solution is 1%wt agarose. Additionally, a surgical planning prototype using this last material mentioned was manufactured and validated using a CT (Computed Tomography) scanner. In most of the structures the difference between the 3D model and the organ in terms of dimensions is less than 3.35 mm, which represents a low dimensional error, around 1%. On the other hand, the total manufacturing cost of the 3D physical model was €513 which is relatively low in comparison with other technologies.
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Tejo-Otero A, Buj-Corral I, Fenollosa-Artés F. 3D Printing in Medicine for Preoperative Surgical Planning: A Review. Ann Biomed Eng 2019; 48:536-555. [DOI: 10.1007/s10439-019-02411-0] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022]
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A Prototype Educational Model for Hepatobiliary Interventions: Unveiling the Role of Graphic Designers in Medical 3D Printing. J Digit Imaging 2019; 31:133-143. [PMID: 28808803 DOI: 10.1007/s10278-017-0012-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In the context of medical three-dimensional (3D) printing, in addition to 3D reconstruction from cross-sectional imaging, graphic design plays a role in developing and/or enhancing 3D-printed models. A custom prototype modular 3D model of the liver was graphically designed depicting segmental anatomy of the parenchyma containing color-coded hepatic vasculature and biliary tree. Subsequently, 3D printing was performed using transparent resin for the surface of the liver and polyamide material to develop hollow internal structures that allow for passage of catheters and wires. A number of concepts were incorporated into the model. A representative mass with surrounding feeding arterial supply was embedded to demonstrate tumor embolization. A straight narrow hollow tract connecting the mass to the surface of the liver, displaying the path of a biopsy device's needle, and the concept of needle "throw" length was designed. A connection between the middle hepatic and right portal veins was created to demonstrate transjugular intrahepatic portosystemic shunt (TIPS) placement. A hollow amorphous structure representing an abscess was created to allow the demonstration of drainage catheter placement with the formation of pigtail tip. Percutaneous biliary drain and cholecystostomy tube placement were also represented. The skills of graphic designers may be utilized in creating highly customized 3D-printed models. A model was developed for the demonstration and simulation of multiple hepatobiliary interventions, for training purposes, patient counseling and consenting, and as a prototype for future development of a functioning interventional phantom.
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Matalon SA, Chikarmane SA, Yeh ED, Smith SE, Mayo-Smith WW, Giess CS. Variability in the Use of Simulation for Procedural Training in Radiology Residency: Opportunities for Improvement. Curr Probl Diagn Radiol 2019; 48:241-246. [DOI: 10.1067/j.cpradiol.2018.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/25/2018] [Accepted: 02/26/2018] [Indexed: 11/22/2022]
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Li P, Yang Z, Jiang S. Tissue mimicking materials in image-guided needle-based interventions: A review. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 93:1116-1131. [PMID: 30274042 DOI: 10.1016/j.msec.2018.09.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 08/25/2018] [Accepted: 09/07/2018] [Indexed: 12/17/2022]
Abstract
Image-guided interventions are widely employed in clinical medicine, which brings significant revolution in healthcare in recent years. However, it is impossible for medical trainees to experience the image-guided interventions physically in patients due to the lack of certificated skills. Therefore, training phantoms, which are normally tissue mimicking materials, are widely used in medical research, training, and quality assurance. This review focuses on the tissue mimicking materials used in image-guided needle-based interventions. In this case, we need to investigate the microstructure characteristics and mechanical properties (for needle intervention), optical properties and acoustical properties (for imaging) of these training phantoms to compare with the related properties of human real tissues. The widely used base materials, additives and the corresponding concentrations of the training phantoms are summarized from the literatures in recent ten years. The microstructure characteristics, mechanical behavior, optical properties and acoustical properties of the tissue mimicking materials are investigated, accompanied with the common experimental methods, apparatus and theoretical algorithm. The influence of the concentrations of the base materials and additives on these characteristics are compared and classified. In this review, we assess a comprehensive overview of the existing techniques with the main accomplishments, and limitations as well as recommendations for tissue mimicking materials used in image-guided needle-based interventions.
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Affiliation(s)
- Pan Li
- Centre for Advanced Mechanisms and Robotics, School of Mechanical Engineering, Tianjin University, No. 135, Yaguan Road, Jinnan District, Tianjin City 300354, China
| | - Zhiyong Yang
- Centre for Advanced Mechanisms and Robotics, School of Mechanical Engineering, Tianjin University, No. 135, Yaguan Road, Jinnan District, Tianjin City 300354, China
| | - Shan Jiang
- Centre for Advanced Mechanisms and Robotics, School of Mechanical Engineering, Tianjin University, No. 135, Yaguan Road, Jinnan District, Tianjin City 300354, China.
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Ustbas B, Kilic D, Bozkurt A, Aribal ME, Akbulut O. Silicone-based composite materials simulate breast tissue to be used as ultrasonography training phantoms. ULTRASONICS 2018. [PMID: 29525227 DOI: 10.1016/j.ultras.2018.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
A silicone-based composite breast phantom is fabricated to be used as an education model in ultrasonography training. A matrix of silicone formulations is tracked to mimic the ultrasonography and tactile response of human breast tissue. The performance of two different additives: (i) silicone oil and (ii) vinyl-terminated poly (dimethylsiloxane) (PDMS) are monitored by a home-made acoustic setup. Through the use of 75 wt% vinyl-terminated PDMS in two-component silicone elastomer mixture, a sound velocity of 1.29 ± 0.09 × 103 m/s and an attenuation coefficient of 12.99 ± 0.08 dB/cm-values those match closely to the human breast tissue-are measured with 5 MHz probe. This model can also be used for needle biopsy as well as for self-exam trainings. Herein, we highlight the fabrication of a realistic, durable, accessible, and cost-effective training platform that contains skin layer, inner breast tissue, and tumor masses.
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Affiliation(s)
- Burcin Ustbas
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Deniz Kilic
- Surgitate Medikal Arge Sanayi ve Ticaret A.Ş., Kocaeli, Turkey
| | - Ayhan Bozkurt
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Mustafa Erkin Aribal
- Marmara University Pendik Research and Application Hospital, Radiology Department, Istanbul, Turkey
| | - Ozge Akbulut
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey.
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Tsai A, Barnewolt CE, Prahbu SP, Yonekura R, Hosmer A, Schulz NE, Weinstock PH. Creation and Validation of a Simulator for Neonatal Brain Ultrasonography: A Pilot Study. Acad Radiol 2017; 24:76-83. [PMID: 27773459 DOI: 10.1016/j.acra.2016.09.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 09/07/2016] [Accepted: 09/08/2016] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES Historically, skills training in performing brain ultrasonography has been limited to hours of scanning infants for lack of adequate synthetic models or alternatives. The aim of this study was to create a simulator and determine its utility as an educational tool in teaching the skills that can be used in performing brain ultrasonography on infants. MATERIALS AND METHODS A brain ultrasonography simulator was created using a combination of multi-modality imaging, three-dimensional printing, material and acoustic engineering, and sculpting and molding. Radiology residents participated prior to their pediatric rotation. The study included (1) an initial questionnaire and resident creation of three coronal images using the simulator; (2) brain ultrasonography lecture; (3) hands-on simulator practice; and (4) a follow-up questionnaire and re-creation of the same three coronal images on the simulator. A blinded radiologist scored the quality of the pre- and post-training images using metrics including symmetry of the images and inclusion of predetermined landmarks. Wilcoxon rank-sum test was used to compare pre- and post-training questionnaire rankings and image quality scores. RESULTS Ten residents participated in the study. Analysis of pre- and post-training rankings showed improvements in technical knowledge and confidence, and reduction in anxiety in performing brain ultrasonography. Objective measures of image quality likewise improved. Mean reported value score for simulator training was high across participants who reported perceived improvements in scanning skills and enjoyment from simulator use, with interest in additional practice on the simulator and recommendations for its use. CONCLUSIONS This pilot study supports the use of a simulator in teaching radiology residents the skills that can be used to perform brain ultrasonography.
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Dietrich CF, Horn R, Morf S, Chiorean L, Dong Y, Cui XW, Atkinson NSS, Jenssen C. Ultrasound-guided central vascular interventions, comments on the European Federation of Societies for Ultrasound in Medicine and Biology guidelines on interventional ultrasound. J Thorac Dis 2016; 8:E851-E868. [PMID: 27747022 DOI: 10.21037/jtd.2016.08.49] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Central venous access has traditionally been performed on the basis of designated anatomical landmarks. However, due to patients' individual anatomy and vessel pathology and depending on individual operators' skill, this landmark approach is associated with a significant failure rate and complication risk. There is substantial evidence demonstrating significant improvement in effectiveness and safety of vascular access by realtime ultrasound (US)-guidance, as compared to the anatomical landmark-guided approach. This review comments on the evidence-based recommendations on US-guided vascular access which have been published recently within the framework of Guidelines on Interventional Ultrasound (InVUS) of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) from a clinical practice point of view.
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Affiliation(s)
- Christoph F Dietrich
- Medical Department, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Würzburg, Germany;; Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
| | - Rudolf Horn
- Notfallstation, Kantonsspital Glarus, Glarus, Switzerland
| | - Susanne Morf
- Intensivmedizin Kantonsspital Graubünden, Chur, Switzerland
| | - Liliana Chiorean
- Department of Medical Imaging, des Cévennes Clinic, Annonay, France
| | - Yi Dong
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Xin-Wu Cui
- Medical Department, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Würzburg, Germany;; Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Nathan S S Atkinson
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland Strausberg, Wriezen, Germany
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Chetlen AL, Mendiratta-Lala M, Probyn L, Auffermann WF, DeBenedectis CM, Marko J, Pua BB, Sato TS, Little BP, Dell CM, Sarkany D, Gettle LM. Conventional Medical Education and the History of Simulation in Radiology. Acad Radiol 2015; 22:1252-67. [PMID: 26276167 DOI: 10.1016/j.acra.2015.07.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 05/29/2015] [Accepted: 07/08/2015] [Indexed: 01/22/2023]
Abstract
Simulation is a promising method for improving clinician performance, enhancing team training, increasing patient safety, and preventing errors. Training scenarios to enrich medical student and resident education, and apply toward competency assessment, recertification, and credentialing are important applications of simulation in radiology. This review will describe simulation training for procedural skills, interpretive and noninterpretive skills, team-based training and crisis management, professionalism and communication skills, as well as hybrid and in situ applications of simulation training. A brief overview of current simulation equipment and software and the barriers and strategies for implementation are described. Finally, methods of measuring competency and assessment are described, so that the interested reader can successfully implement simulation training into their practice.
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Aydogan F, Mallory MA, Tukenmez M, Sagara Y, Ozturk E, Ince Y, Celik V, Akca T, Golshan M. A low cost training phantom model for radio-guided localization techniques in occult breast lesions. J Surg Oncol 2015; 112:449-51. [PMID: 26250621 DOI: 10.1002/jso.23984] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 07/15/2015] [Indexed: 12/29/2022]
Abstract
Radio-guided localization (RGL) for identifying occult breast lesions has been widely accepted as an alternative technique to other localization methods, including those using wire guidance. An appropriate phantom model would be an invaluable tool for practitioners interested in learning the technique of RGL prior to clinical application. The aim of this study was to devise an inexpensive and reproducible training phantom model for RGL. We developed a simple RGL phantom model imitating an occult breast lesion from inexpensive supplies including a pimento olive, a green pea and a turkey breast. The phantom was constructed for a total cost of less than $20 and prepared in approximately 10 min. After the first model's construction, we constructed approximately 25 additional models and demonstrated that the model design was easily reproducible. The RGL phantom is a time- and cost-effective model that accurately simulates the RGL technique for non-palpable breast lesions. Future studies are warranted to further validate this model as an effective teaching tool.
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Affiliation(s)
- Fatih Aydogan
- Women's Cancer Center, Dana-Farber/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Breast Division, Department of Surgery, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - Melissa Anne Mallory
- Women's Cancer Center, Dana-Farber/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mustafa Tukenmez
- Women's Cancer Center, Dana-Farber/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Yasuaki Sagara
- Women's Cancer Center, Dana-Farber/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Erkan Ozturk
- Department of Surgery Gulhane Military Medical Academy and Medical School, Ankara, Turkey
| | | | - Varol Celik
- Breast Division, Department of Surgery, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - Tamer Akca
- Department of General Surgery, Mersin University Medical Faculty, Mersin, Turkey
| | - Mehra Golshan
- Women's Cancer Center, Dana-Farber/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Radiology education: keeping pace with changing times, new technology, and increased challenges. Acad Radiol 2014; 21:827-8. [PMID: 24928156 DOI: 10.1016/j.acra.2014.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 04/21/2014] [Accepted: 04/28/2014] [Indexed: 11/23/2022]
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