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Arribas EM, Kelil T, Santiago L, Ali A, Chadalavada SC, Chepelev L, Ghodadra A, Ionita CN, Lee J, Ravi P, Ryan JR, Sheikh AM, Rybicki FJ, Ballard DH. Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: breast conditions. 3D Print Med 2023; 9:8. [PMID: 36952139 PMCID: PMC10037829 DOI: 10.1186/s41205-023-00171-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/07/2023] [Indexed: 03/24/2023] Open
Abstract
The use of medical 3D printing has expanded dramatically for breast diseases. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides updated appropriateness criteria for breast 3D printing in various clinical scenarios. Evidence-based appropriateness criteria are provided for the following clinical scenarios: benign breast lesions and high-risk breast lesions, breast cancer, breast reconstruction, and breast radiation (treatment planning and radiation delivery).
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Affiliation(s)
- Elsa M Arribas
- Division of Diagnostic Imaging, Department of Breast Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Tatiana Kelil
- Department of Radiology, University of California, 1600 Divisadero St, C250, Box 1667, San Francisco, CA, 94115, USA
| | - Lumarie Santiago
- Division of Diagnostic Imaging, Department of Breast Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Arafat Ali
- Diagnostic Radiology, Henry Ford Medical Group, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI, 48202, USA
| | | | - Leonid Chepelev
- Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Anish Ghodadra
- UPMC Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Ciprian N Ionita
- Department of Biomedical Engineering, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, University at Buffalo School of Engineering and Applied Sciences, 8052 Clinical Translational Research Center, 875 Ellicott Street, Buffalo, NY, 14203, USA
| | - Joonhyuk Lee
- University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
| | - Prashanth Ravi
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Justin R Ryan
- 3D Innovations Lab, Rady Children's Hospital, San Diego, CA, USA
| | - Adnan M Sheikh
- Department of Medical Imaging, Ottawa Hospital Research Institute (OHRI), The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University, St Louis, MO, USA
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Tongxin L, Jing X, Runyuan W, Wei W, Yu Z, Dong W, Wang H, Yi W, Ping H, Yong F. Application Research of Three-Dimensional Printing Technology and Three-Dimensional Computed Tomography in Segmentectomy. Front Surg 2022; 9:881076. [PMID: 35574524 PMCID: PMC9100398 DOI: 10.3389/fsurg.2022.881076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo compare the application of the emerging 3D printing technology and 3D-CT in segmentectomy. And to explore the advantages of 3D printing technology in thoracoscopic segmentectomy.MethodsWe collected the clinical data of 118 patients undergoing thoracoscopic segmentectomy from January 2019 to April 2021 at the Thoracic Surgery Department, the Dianjiang People's Hospital of Chongqing and Southwest Hospital. Among them, 61 patients were in the 3D printing group and 57 patients were in the 3D-CT group respectively. The perioperative data of these two groups of patients were analyzed respectively.ResultsThere were no significant differences between the two groups in age, gender, tumor diameter, pathology, the preoperative complications of diabetes and heart disease. However, the patients with the complications of hypertension in the 3D printing group are significantly more than the 3D-CT group (P = 0.003). Compared with the 3D-CT group, patients in the 3D printing group had significantly shorter operation time (162.7 ± 47.0 vs. 190.3 ± 56.9 min, P = 0.006), less intraoperative fluid input (1,158.5 ± 290.2 vs. 1,433.2 ± 653.3, P = 0.013), and less total intraoperative fluid output, including intraoperative blood loss, urine excretion, and other fluid loss. In addition, there were no statistically significant differences in intraoperative blood loss, 24 h pleural fluid volume, 48 h pleural fluid volume, postoperative chest tube duration, postoperative hospital stay and complications between the two groups of patients (P > 0.05).ConclusionsIn thoracoscopic segmentectomy, the application of 3D printing technology shortens the operation time, reduces intraoperative fluid input and output, guides the operation more safely and effectively, and has better clinical application value.
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Affiliation(s)
- Li Tongxin
- Clinical Medicine Department, North Sichuan Medical College, Nanchong, Sichuan, China
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
| | - Xu Jing
- Health Economy Department, Southwest Hospital, Chongqing, China
| | - Wang Runyuan
- Digital Medicine Department, Biomedical Engineering College, Army Military Medical University, Chongqing, China
| | - Wu Wei
- Thoracic Surgery Department, Southwest Hospital, Chongqing, China
| | - Zhou Yu
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
| | - Wang Dong
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
| | - He Wang
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
| | - Wu Yi
- Digital Medicine Department, Biomedical Engineering College, Army Military Medical University, Chongqing, China
| | - He Ping
- Cardic Surgery Department, Southwest Hospital, Chongqing, China
- Correspondence: He Ping Fu Yong
| | - Fu Yong
- Clinical Medicine Department, North Sichuan Medical College, Nanchong, Sichuan, China
- Cardiothoracic Surgery Department, Dianjiang People’s Hospital of Chongqing, Chongqing, China
- Correspondence: He Ping Fu Yong
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Liu J, Wang X, Shan P, Hu S, Liu D, Ma J, Nie X. A randomized controlled trial: evaluation of efficiency and safety of a novel surgical guide in the extraction of deeply impacted supernumerary teeth in the anterior maxilla. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:292. [PMID: 35433976 PMCID: PMC9011240 DOI: 10.21037/atm-22-585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/07/2022] [Indexed: 11/06/2022]
Abstract
Background Preoperative X-ray and cone-beam computed tomography (CBCT) are helpful for locating supernumerary teeth, but the images cannot be transferred to the operation. To design a novel surgical guide plate for intraoperative navigation, we transfer the patient's oral CBCT and gypsum model scan data to a computer for analysis. In our study, we evaluate the efficiency and safety of a novel surgical guide plate for the extraction of deeply impacted supernumerary teeth (DIMSNT) in the anterior maxilla. Methods Forty patients treated at the Department of School & Hospital of Stomatology, Wenzhou Medical University from March 2019 to December 2020 with DIMSNT (type II/III according to Liu et al.) in the anterior maxilla were randomly divided into 2 groups (20 patients for each group) for the extraction. For group I, a novel surgical guide was selected using CBCT and gypsum model scan. In contrast, for group II who underwent freehand surgery, only the CBCT data was used. The evaluation of operation time, complications, satisfaction score, and the number of cases that underwent extraction immediately after removing the bone were performed to assess the efficiency and safety of this novel surgical plate. Results All patients completed the surgery successfully. The guides for group I had a good application effect. Group I's operation time (23.35±5.39 min) was shorter than group II (29.60±9.76 min) (P=0.0194). The average pain degree of group I (1.8±1.08) was significantly less than group II (2.82±1.68) (P<0.05). The average swelling score of group I (34) was significantly less than group II (44.7). Patient satisfaction was significantly higher in group I (8.95±1.05) than in group II (7.90±1.51) (P=0.0152). Conclusions The novel surgical guide assisted with DIMSNT extraction have been effective in improving the quality of the surgery, patient satisfaction, and reduce its difficulty and duration. We can construct a surgical guide plate to guide the incision and osteotomy in DIMSNT surgery through the data analysis of DIMSNT on computer, which has a broad application prospect for clinical use. Trial registration Chinese Clinical Trial Registry ChiCTR2100054523.
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Affiliation(s)
- Jiefan Liu
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xiaole Wang
- Department of Orthodontics, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Peifen Shan
- Department of Prosthodontics, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Sunqiang Hu
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Dengfeng Liu
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Jianfeng Ma
- Department of Prosthodontics, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xin Nie
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
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Accuracy evaluation of a 3D printing surgical guide for breast-conserving surgery using a realistic breast phantom. Comput Biol Med 2021; 137:104784. [PMID: 34438204 DOI: 10.1016/j.compbiomed.2021.104784] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/04/2021] [Accepted: 08/17/2021] [Indexed: 11/22/2022]
Abstract
To prevent recurrence after breast-conserving surgery (BCS), it is imperative to secure a clear resection margin, and magnetic resonance imaging (MRI) is useful for predicting this. Although MRI is highly accurate in predicting the extent of a tumor, it is difficult to quantitatively mark the tumor area directly on the patient's breast skin using MRI. Therefore, we developed a 3D-printed breast surgical guide (3DP-BSG). The 3DP-BGS is positioned on the breast using the guideline pointing to the opposite nipple and clavicle notch, centering on the nipple of the breast with the tumor. Then, the tumor was visualized by injecting blue-dye into the breast along the guide's columns using a syringe. For the quantitative evaluation of 3DP-BSG, the experiment must be done in the simulated environment. However, since it is difficult to construct the environment in the clinical field, we have fabricated a realistic breast phantom using an MRI. For modeling the 3DP-BSG, the phantom was scanned using computed tomography (CT), and. Based on these images, the 3DP-BSG was modeled to mark a 5-mm safety margin on a patient's breast skin by inserting a 16-gauge intravenous catheter. Then, the breast phantom was scanned by CT for quantitative evaluation. The insertion point measurement error (mean ± standard deviation) was 2.513 ± 0.914 mm, and the cosine similarity of the trajectories was 0.997 ± 0.005. This 3DP-BSG exhibits high accuracy in tumor targeting and is expected to facilitate precise BCS by providing a quantitative measure of the tumor area to surgeons.
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Wu ZY, Kim HJ, Lee J, Chung IY, Kim J, Lee S, Son BH, Ahn SH, Kim HH, Seo JB, Jeong JH, Gong G, Kim N, Ko B. Breast-conserving surgery with 3D-printed surgical guide: a single-center, prospective clinical study. Sci Rep 2021; 11:2252. [PMID: 33500555 PMCID: PMC7838396 DOI: 10.1038/s41598-021-81936-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/11/2021] [Indexed: 11/17/2022] Open
Abstract
To facilitate precise tumor resection at the time of breast-conserving surgery (BCS), we developed and implemented a magnetic resonance imaging (MRI)-based three-dimensional-printed (3DP) breast surgical guide (BSG). This prospective cohort study was conducted at a single institution from July 2017 to February 2019 on women with breast cancer who underwent partial breast resection using patient-specific 3DP BSGs. Eighty-eight patients with invasive cancer were enrolled, of whom 1 patient had bilateral breast cancer. The mean size of the tumor long-axis on MRI before surgery was 2.8 ± 0.9 cm, and multiple tumors were observed in 34 patients. In 16 cases (18.0%), the resection margin was tumor-positive according to intraoperative frozen biopsy; all of these tumors were ductal carcinoma in situ and were re-excised intraoperatively. In 93.3% of the cases, the resection margin was tumor-free in the permanent pathology. The mean pathological tumor size was 1.7 ± 1.0 cm, and the mean distance from the tumor to the border was 1.5 ± 1.0 cm. This exploratory study showed that the tumor area on the MRI could be directly displayed on the breast when using a 3DP BSG for BCS, thereby allowing precise surgery and safe tumor removal. Trial Registration Clinical Research Information Service (CRIS) Identifier (No. KCT0002375, KCT0003043).
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Affiliation(s)
- Zhen-Yu Wu
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.,Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.,Department of Breast Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hee Jeong Kim
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Jongwon Lee
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Il Yong Chung
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Jisun Kim
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Saebyeol Lee
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Byung Ho Son
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Sei-Hyun Ahn
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Hak Hee Kim
- Department of Radiology, Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Joon Beom Seo
- Department of Radiology, Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Jae Ho Jeong
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Gyungyub Gong
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Namkug Kim
- Department of Radiology, Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. .,Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | - BeomSeok Ko
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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Additive Manufacturing of Resected Oral and Oropharyngeal Tissue: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030911. [PMID: 33494422 PMCID: PMC7908081 DOI: 10.3390/ijerph18030911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/16/2021] [Accepted: 01/18/2021] [Indexed: 11/21/2022]
Abstract
Better visualization of tumor structure and orientation are needed in the postoperative setting. We aimed to assess the feasibility of a system in which oral and oropharyngeal tumors are resected, photographed, 3D modeled, and printed using additive manufacturing techniques. Three patients diagnosed with oral/oropharyngeal cancer were included. All patients underwent preoperative magnetic resonance imaging followed by resection. In the operating room (OR), the resected tissue block was photographed using a smartphone. Digital photos were imported into Agisoft Photoscan to produce a digital 3D model of the resected tissue. Physical models were then printed using binder jetting techniques. The aforementioned process was applied in pilot cases including carcinomas of the tongue and larynx. The number of photographs taken for each case ranged from 63 to 195. The printing time for the physical models ranged from 2 to 9 h, costs ranging from 25 to 141 EUR (28 to 161 USD). Digital photography may be used to additively manufacture models of resected oral/oropharyngeal tumors in an easy, accessible and efficient fashion. The model may be used in interdisciplinary discussion regarding postoperative care to improve understanding and collaboration, but further investigation in prospective studies is required.
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