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Ryan JR, Ghosh R, Sturgeon G, Ali A, Arribas E, Braden E, Chadalavada S, Chepelev L, Decker S, Huang YH, Ionita C, Lee J, Liacouras P, Parthasarathy J, Ravi P, Sandelier M, Sommer K, Wake N, Rybicki F, Ballard D. Clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: pediatric congenital heart disease conditions. 3D Print Med 2024; 10:3. [PMID: 38282094 PMCID: PMC10823658 DOI: 10.1186/s41205-023-00199-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/11/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND The use of medical 3D printing (focusing on anatomical modeling) has continued to grow since the Radiological Society of North America's (RSNA) 3D Printing Special Interest Group (3DPSIG) released its initial guideline and appropriateness rating document in 2018. The 3DPSIG formed a focused writing group to provide updated appropriateness ratings for 3D printing anatomical models across a variety of congenital heart disease. Evidence-based- (where available) and expert-consensus-driven appropriateness ratings are provided for twenty-eight congenital heart lesion categories. METHODS A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with pediatric congenital heart disease indications. Each study was vetted by the authors and strength of evidence was assessed according to published appropriateness ratings. RESULTS Evidence-based recommendations for when 3D printing is appropriate are provided for pediatric congenital heart lesions. Recommendations are provided in accordance with strength of evidence of publications corresponding to each cardiac clinical scenario combined with expert opinion from members of the 3DPSIG. CONCLUSIONS This consensus appropriateness ratings document, created by the members of the RSNA 3DPSIG, provides a reference for clinical standards of 3D printing for pediatric congenital heart disease clinical scenarios.
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Affiliation(s)
- Justin R Ryan
- Webster Foundation 3D Innovations Lab, Rady Children's Hospital-San Diego, San Diego, CA, USA.
- Department of Neurological Surgery, UC San Diego Health, La Jolla, CA, USA.
| | - Reena Ghosh
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Greg Sturgeon
- Duke Children's Pediatric & Congenital Heart Center, Durham, NC, USA
| | - Arafat Ali
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Elsa Arribas
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eric Braden
- Arkansas Children's Hospital, Little Rock, AR, USA
| | - Seetharam Chadalavada
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Leonid Chepelev
- Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Summer Decker
- Department of Radiology, University of South Florida Morsani College of Medicine, Tampa, USA
- Tampa General Hospital, Tampa, FL, USA
| | - Yu-Hui Huang
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Ciprian Ionita
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
| | - Joonhyuk Lee
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Peter Liacouras
- Department of Radiology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | | | - Prashanth Ravi
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Michael Sandelier
- Department of Radiology - Advanced Reality Lab, James A. Haley VA Hospital, Tampa, FL, USA
| | | | - Nicole Wake
- Research and Scientific Affairs, GE HealthCare, New York, NY, USA
- Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene, Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Frank Rybicki
- Department of Radiology, University of Arizona, Phoenix, AZ, USA
| | - David Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
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Aljassam Y, Caputo M, Biglino G. Surgical Patching in Congenital Heart Disease: The Role of Imaging and Modelling. Life (Basel) 2023; 13:2295. [PMID: 38137896 PMCID: PMC10745019 DOI: 10.3390/life13122295] [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: 10/04/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
In congenital heart disease, patches are not tailored to patient-specific anatomies, leading to shape mismatch with likely functional implications. The design of patches through imaging and modelling may be beneficial, as it could improve clinical outcomes and reduce the costs associated with redo procedures. Whilst attention has been paid to the material of the patches used in congenital surgery, this review outlines the current knowledge on this subject and isolated experimental work that uses modelling and imaging-derived information (including 3D printing) to inform the design of the surgical patch.
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Affiliation(s)
- Yousef Aljassam
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK;
| | - Massimo Caputo
- Bristol Heart Institute, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK;
- Cardiac Surgery, University Hospitals Bristol & Weston, NHS Foundation Trust, Bristol BS2 8HW, UK
| | - Giovanni Biglino
- Bristol Heart Institute, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK;
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Valverde I, Gomez G, Byrne N, Anwar S, Silva Cerpa MA, Martin Talavera M, Pushparajah K, Velasco Forte MN. Criss-cross heart three-dimensional printed models in medical education: A multicenter study on their value as a supporting tool to conventional imaging. ANATOMICAL SCIENCES EDUCATION 2022; 15:719-730. [PMID: 34008341 DOI: 10.1002/ase.2105] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
The utility of three-dimensional (3D) printed models for medical education in complex congenital heart disease (CHD) is sparse and limited. The purpose of this study was to evaluate the utility of 3D printed models for medical education in criss-cross hearts covering a wide range of participants with different levels of knowledge and experience, from medical students, clinical fellows up to senior medical personnel. Study participants were enrolled from four dedicated imaging workshops developed between 2016 and 2019. The study design was a non-randomized cross-over study to evaluate 127 participants' level of understanding of the criss-cross heart anatomy. This was evaluated using the scores obtained following teaching with conventional images (echocardiography and magnetic resonance imaging) versus a 3D printed model learning approach. A significant improvement in anatomical knowledge of criss-cross heart anatomy was observed when comparing conventional imaging test scores to 3D printed model tests [76.9% (61.5%-87.8%) vs. 84.6% (76.9%-96.2%), P < 0.001]. The increase in the questionnaire marks was statistically significant across all academic groups (consultants in pediatric cardiology, fellows in pediatric cardiology, and medical students). Ninety-four percent (120) and 95.2% (121) of the participants agreed or strongly agreed, respectively, that 3D models helped them to better understand the medical images. Participants scored their overall satisfaction with the 3D printed models as 9.1 out of 10 points. In complex CHD such as criss-cross hearts, 3D printed replicas improve the understanding of cardiovascular anatomy. They enhanced the teaching experience especially when approaching medical students.
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Affiliation(s)
- Israel Valverde
- Pediatric Cardiology Unit, Hospital Virgen del Rocio, Seville, Spain
- Cardiovascular Pathology Unit and Fabrication Laboratory, Institute of Biomedicine of Seville, Seville, Spain
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
| | - Gorka Gomez
- Cardiovascular Pathology Unit and Fabrication Laboratory, Institute of Biomedicine of Seville, Seville, Spain
| | - Nick Byrne
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Shafkat Anwar
- Division of Cardiology, Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California, USA
| | | | | | - Kuberan Pushparajah
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London, UK
| | - Maria Nieves Velasco Forte
- Cardiovascular Pathology Unit and Fabrication Laboratory, Institute of Biomedicine of Seville, Seville, Spain
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
- Department of Pediatric Cardiology, University of Bristol, Bristol Royal Hospital for Children, Bristol, UK
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Krasemann T, Branstetter J. Virtual Reality Treatment Planning for Congenital Heart Disease. JACC Case Rep 2021; 3:1584-1585. [PMID: 34729505 PMCID: PMC8543154 DOI: 10.1016/j.jaccas.2021.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Thomas Krasemann
- Department of Pediatric Cardiology, Sophia Children’s Hospital, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Joshua Branstetter
- Department of Pharmacy, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
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Wang H, Song H, Yang Y, Cao Q, Hu Y, Chen J, Guo J, Wang Y, Jia D, Cao S, Zhou Q. Three-dimensional printing for cardiovascular diseases: from anatomical modeling to dynamic functionality. Biomed Eng Online 2020; 19:76. [PMID: 33028306 PMCID: PMC7542711 DOI: 10.1186/s12938-020-00822-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/28/2020] [Indexed: 12/16/2022] Open
Abstract
Three-dimensional (3D) printing is widely used in medicine. Most research remains focused on forming rigid anatomical models, but moving from static models to dynamic functionality could greatly aid preoperative surgical planning. This work reviews literature on dynamic 3D heart models made of flexible materials for use with a mock circulatory system. Such models allow simulation of surgical procedures under mock physiological conditions, and are; therefore, potentially very useful to clinical practice. For example, anatomical models of mitral regurgitation could provide a better display of lesion area, while dynamic 3D models could further simulate in vitro hemodynamics. Dynamic 3D models could also be used in setting standards for certain parameters for function evaluation, such as flow reserve fraction in coronary heart disease. As a bridge between medical image and clinical aid, 3D printing is now gradually changing the traditional pattern of diagnosis and treatment.
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Affiliation(s)
- Hao Wang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hongning Song
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yuanting Yang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Quan Cao
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yugang Hu
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jinling Chen
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Juan Guo
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yijia Wang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Dan Jia
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Sheng Cao
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qing Zhou
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Zhou X, Zhang D, Xie Z, Chen M, Yang Y, Liang Z, Zhang G. 3D printing and thoracoscopy assisted MIPO in treatment of long-range comminuted rib fractures, a case report. J Cardiothorac Surg 2019; 14:83. [PMID: 31036030 PMCID: PMC6489358 DOI: 10.1186/s13019-019-0892-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/01/2019] [Indexed: 11/10/2022] Open
Abstract
Background To investigate the application of 3D printing technology combined with percutaneous Minimally Invasive Plate Oseoynthesis (MIPO) and thoracoscopic techniques in the treatment of long comminuted rib fractures. Case presentation One case of multiple rib fractures with abnormal respiratory disease (including rib 3 and 4 of long comminuted fractures) due to a fall injury was selected. The 3D model of comminuted rib fracture was reconstructed and printed according to the thin-layer CT scan results. After the fracture model was restored to the normal rib anatomy, the metal plate was accurately shaped according to the 3D rib shape. Conclusions 3D printing technology combined with MIPO technology under thoracoscopy in the minimally invasive treatment of long-range comminuted rib fractures, greatly reduced the time and improved the accuracy of intraoperative fixation, reduced the difficulty of surgery, patient injury, and perfectly reconstructed the chest wall. Application of the 3D printing technique to make the rib model and pre-mold the metal plate combined the thoracoscopic MIPO technology provides less invasive and accurate individualized treatment for complex rib fractures.
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Affiliation(s)
- Xuetao Zhou
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Dongsheng Zhang
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China.
| | - Zexin Xie
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Menghui Chen
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Yang Yang
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Zheng Liang
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
| | - Guoliang Zhang
- Department of Cardiothoracic Surgery, The Third Hospital of Shijiazhuang City, Shijiazhuang, 050000, China
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Garner KH, Singla DK. 3D modeling: a future of cardiovascular medicine. Can J Physiol Pharmacol 2019; 97:277-286. [DOI: 10.1139/cjpp-2018-0472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cardiovascular disease resulting from atypical cardiac structures continues to be a leading health concern despite advancements in diagnostic imaging and surgical techniques. However, the ability to visualize spatial relationships using current technologies remains a challenge. Therefore, 3D modeling has gained significant interest to understand complex and atypical cardiovascular disorders. Moreover, 3D modeling can be personalized and patient-specific. 3D models have been demonstrated to aid surgical planning and simulation, enhance communication among surgeons and patients, optimize medical device design, and can be used as a potential teaching tool in medical schools. In this review, we discuss the key components needed to generate cardiac 3D models. We highlight prevalent structural conditions that have utilized 3D modeling in pre-operative planning. Furthermore, we discuss the current limitations of routine use of 3D models in the clinic as well as future directions for utilization of this technology in the cardiovascular field.
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Affiliation(s)
- Kaley H. Garner
- Division of Metabolic and Cardiovascular Sciences, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816, USA
- Division of Metabolic and Cardiovascular Sciences, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816, USA
| | - Dinender K. Singla
- Division of Metabolic and Cardiovascular Sciences, Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL 32816, USA
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