1
|
Zhao Z, Ma Y, Mushtaq A, Radhakrishnan V, Hu Y, Ren H, Song W, Tse ZTH. Engineering functional and anthropomorphic models for surgical training in interventional radiology: A state-of-the-art review. Proc Inst Mech Eng H 2023; 237:3-17. [PMID: 36377860 PMCID: PMC9841824 DOI: 10.1177/09544119221135086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Training medical students in surgical procedures and evaluating their performance are both necessary steps to ensure the safety and efficacy of surgeries. Traditionally, trainees practiced on live patients, cadavers or animals under the supervision of skilled physicians, but realistic anatomical phantom models have provided a low-cost alternative because of the advance of material technology that mimics multi-layer tissue structures. This setup provides safer and more efficient training. Many research prototypes of phantom models allow rapid in-house prototyping for specific geometries and tissue properties. The gel-based method and 3D printing-based method are two major methods for developing phantom prototypes. This study excluded virtual reality based technologies and focused on physical phantoms, total 189 works published between 2015 and 2020 on anatomical phantom prototypes made for interventional radiology were reviewed in terms of their functions and applications. The phantom prototypes were first categorized based on fabrication methods and then subcategorized based on the organ or body part they simulated; the paper is organized accordingly. Engineering specifications and applications were analyzed and summarized for each study. Finally, current challenges in the development of phantom models and directions for future work were discussed.
Collapse
Affiliation(s)
- Zhuo Zhao
- School of Electrical and Computer Engineering, University of Georgia, Athens, GA, USA
| | - Yangmyung Ma
- Hull York Medical School, University of York, Heslington, York, UK
| | - Adeel Mushtaq
- Hull York Medical School, University of York, Heslington, York, UK
| | - Vignesh Radhakrishnan
- School of Engineering and Materials Science, Queen Mary University of London, London
| | - Yihua Hu
- School of Engineering and Materials Science, Queen Mary University of London, London
| | - Hongliang Ren
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong, China,Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Wenzhan Song
- Department of Computer Science, University of Georgia, Athens, GA, USA
| | - Zion Tsz Ho Tse
- School of Engineering and Materials Science, Queen Mary University of London, London,Zion Tsz Ho Tse, School of Engineering and Materials Science, Queen Mary University of London, Room 229 Mile End Road, London E1 4NS, United Kingdom.
| |
Collapse
|
2
|
Haleem A, Javaid M, Suman R, Singh RP. 3D Printing Applications for Radiology: An Overview. Indian J Radiol Imaging 2021; 31:10-17. [PMID: 34316106 PMCID: PMC8299499 DOI: 10.1055/s-0041-1729129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Three-dimensional (3D) printing technologies are part of additive manufacturing processes and are used to manufacture a 3D physical model from a digital computer-aided design model as per the required shape and size. These technologies are now used for advanced radiology applications by providing all information through 3D physical model. It provides innovation in radiology for clinical applications, treatment planning, procedural simulation, medical and patient education. Radiological advancements have been made in diagnosis and communication through medical digital imaging techniques like computed tomography, magnetic resonance imaging. These images are converted into Digital Imaging and Communications in Medicine in Standard Triangulate Language file format, easily printable in 3D printing technologies. This 3D model provides in-depth information about pathologic and anatomic states. It is useful to create new opportunities related to patient care. This article discusses the potential of 3D printing technology in radiology. The steps involved in 3D printing for radiology are discussed diagrammatically, and finally identified 12 significant applications of 3D printing technology for radiology with a brief description. A radiologist can incorporate this technology to fulfil different challenges such as training, planning, guidelines, and better communications.
Collapse
Affiliation(s)
- Abid Haleem
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Rajiv Suman
- Department of Industrial and Production Engineering, G.B. Pant University of Agriculture and Technology, Pantnagar, Uttarakhand, India
| | - Ravi Pratap Singh
- Department of Industrial and Production Engineering, Dr. B. R. Ambedkar National Institute of Technology, Jalandhar, Punjab, India
| |
Collapse
|
3
|
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.
Collapse
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
| | | |
Collapse
|
4
|
Modelling and manufacturing of 3D-printed, patient-specific, and anthropomorphic gastric phantoms: a pilot study. Sci Rep 2020; 10:18976. [PMID: 33149133 PMCID: PMC7643145 DOI: 10.1038/s41598-020-74110-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 09/23/2020] [Indexed: 11/19/2022] Open
Abstract
Interventional devices including intragastric balloons are widely used to treat obesity. This study aims to develop 3D-printed, patient-specific, and anthropomorphic gastric phantoms with mechanical properties similar to those of human stomach. Using computed tomography gastrography (CTG) images of three patients, gastric phantoms were modelled through shape registration to align the stomach shapes of three different phases. Shape accuracies of the original gastric models versus the 3D-printed phantoms were compared using landmark distances. The mechanical properties (elongation and tensile strength), number of silicone coatings (0, 2, and 8 times), and specimen hardness (50, 60, and 70 Shore A) of three materials (Agilus, Elastic, and Flexa) were evaluated. Registration accuracy was significantly lower between the arterial and portal phases (3.16 ± 0.80 mm) than that between the portal and delayed phases (8.92 ± 0.96 mm). The mean shape accuracy difference was less than 10 mm. The mean elongations and tensile strengths of the Agilus, Elastic, and Flexa were 264%, 145%, and 146% and 1.14, 1.59, and 2.15 MPa, respectively, and their mechanical properties differed significantly (all p < 0.05). Elongation and tensile strength assessments, CTG image registration and 3D printing resulted in highly realistic and patient-specific gastric phantoms with reasonable shape accuracies.
Collapse
|
5
|
Kwon CI, Shin Y, Hong J, Im M, Kim GB, Koh DH, Song TJ, Park WS, Hyun JJ, Jeong S. Production of ERCP training model using a 3D printing technique (with video). BMC Gastroenterol 2020; 20:145. [PMID: 32393185 PMCID: PMC7216470 DOI: 10.1186/s12876-020-01295-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND ERCP training models are very different in terms of anatomical differences, ethical issues, storage problems, realistic tactile sensation, durability and portability. There is no easy way to select an optimized model for ERCP training. If the ERCP training model could be made as a soft silicone model using 3D printing technique, it would have numerous advantages over the models presented so far. The purpose of this study was to develop an optimized ERCP training model using a 3D printing technique and to try to find ways for implementing various practical techniques. METHODS All organ parts of this model were fabricated using silicone molding techniques with 3D printing. Especially, various anatomy of the ampulla of Vater and common bile duct (CBD) were creatively designed for different diagnostic and therapeutic procedures. In order to manufacture each of the designed organ parts with silicone, a negative part had to be newly designed to produce the molder. The negative molders were 3D printed and then injection molding was applied to obtain organ parts in silicone material. The eight different types of ampulla and CBD were repeatedly utilized and replaced to the main system as a module-type. RESULTS ERCP training silicone model using 3D technique was semi-permanently used to repeat various ERCP procedures. All ERCP procedures using this model could be observed by real-time fluoroscopic examination as well as endoscopic examination simultaneously. Using different ampulla and CBD modules, basic biliary cannulation, difficult cannulation, stone extraction, mechanical lithotripsy, metal stent insertion, plastic stent insertion, and balloon dilation were successfully and repeatedly achieved. Endoscopic sphincterotomy was also performed on a specialized ampulla using a Vienna sausage. After repeat procedures and trainings, all parts of organs including the ampulla and CBD modules were not markedly damaged or deformed. CONCLUSIONS We made a specialized ERCP training silicon model with 3D printing technique. This model is durable, relatively cheap and easy to make, and thus allows the users to perform various specialized ERCP techniques, which increases its chances of being a good ERCP training model.
Collapse
Affiliation(s)
- Chang-Il Kwon
- Digestive Disease Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.,Research Group for Endoscopic Instruments and Stents, Korean Society of Gastrointestinal Endoscopy, Seoul, Korea
| | | | | | - Minje Im
- Anymedi Inc., Seoul, South Korea
| | | | - Dong Hee Koh
- Research Group for Endoscopic Instruments and Stents, Korean Society of Gastrointestinal Endoscopy, Seoul, Korea.,Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, South Korea
| | - Tae Jun Song
- Research Group for Endoscopic Instruments and Stents, Korean Society of Gastrointestinal Endoscopy, Seoul, Korea.,Division of Gastroenterology, Department of Internal Medicine, Asan medical center, Ulsan University College of medicine, Seoul, South Korea
| | - Won Suk Park
- Research Group for Endoscopic Instruments and Stents, Korean Society of Gastrointestinal Endoscopy, Seoul, Korea.,Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, South Korea
| | - Jong Jin Hyun
- Division of Gastroenterology and Hepatology, Korea University College of Medicine, Seoul, South Korea
| | - Seok Jeong
- Research Group for Endoscopic Instruments and Stents, Korean Society of Gastrointestinal Endoscopy, Seoul, Korea. .,Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea.
| |
Collapse
|
6
|
An overview on 3D printing for abdominal surgery. Surg Endosc 2019; 34:1-13. [PMID: 31605218 DOI: 10.1007/s00464-019-07155-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 09/24/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Three-dimensional (3D) printing is a disruptive technology that is quickly spreading to many fields, including healthcare. In this context, it allows the creation of graspable, patient-specific, anatomical models generated from medical images. The ability to hold and show a physical object speeds up and facilitates the understanding of anatomical details, eases patient counseling and contributes to the education and training of students and residents. Several medical specialties are currently exploring the potential of this technology, including general surgery. METHODS In this review, we provide an overview on the available 3D printing technologies, together with a systematic analysis of the medical literature dedicated to its application for abdominal surgery. Our experience with the first clinical laboratory for 3D printing in Italy is also reported. RESULTS There was a tenfold increase in the number of publications per year over the last decade. About 70% of these papers focused on kidney and liver models, produced primarily for pre-interventional planning, as well as for educational and training purposes. The most used printing technologies are material jetting and material extrusion. Seventy-three percent of publications reported on fewer than ten clinical cases. CONCLUSION The increasing application of 3D printing in abdominal surgery reflects the dawn of a new technology, although it is still in its infancy. The potential benefit of this technology is clear, however, and it may soon lead to the development of new hospital facilities to improve surgical training, research, and patient care.
Collapse
|