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Muñoz-Leija D, Díaz González-Colmenero F, Ramiréz-Mendoza DA, López-Cabrera NG, Llanes-Garza HA, Palacios-Ríos D, Negreros-Osuna AA. Development and Evaluation of An In-House Lumbar Puncture Simulator for First-Year Resident Lumbar Puncture Procedure Learning. Cureus 2024; 16:e56567. [PMID: 38510522 PMCID: PMC10954365 DOI: 10.7759/cureus.56567] [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] [Accepted: 03/20/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Lumbar puncture (LP) is a common invasive technique considered an essential learning milestone for anesthesiologists due to its application in spinal anesthesia. We aimed to develop an in-house LP simulator, test its effectiveness in learning the steps to perform an LP and analyze its impact on the first-year residents' self-confidence at our hospital. METHODS We used 3D printing and silicone casting to create an LP simulator based on a lumbar spine computed tomography (CT). We divided 12 first-year anesthesiology residents into control and experimental groups. The control group received traditional training, while the experimental group practiced with the simulator for three months. We used a procedure checklist and a Likert scale survey to evaluate their procedural knowledge and self-confidence at baseline, three, and six months. Eighteen months later, we evaluated their LP performance skills. RESULTS Both groups showed a significant improvement in their knowledge scores over time. After three months, the experimental group had a higher median knowledge score (10 (10 - 10) median (min-max)) than the control group (9 (8 - 9.5) median (min-max)) (p = 0.03). While there were no apparent differences in median self-confidence scores between the groups at any time point, the experimental group had a significant increase in their self-confidence for performing an unassisted LP, with a median score of 1/5 (1 - 2.3) at baseline and 5/5 (4.8 - 5) after six months (p = 0.006). In contrast, the control group's self-confidence scores decreased from 4/5 (3 - 4) after three months to 3/5 (2 - 5) after six months. The evaluation of performance skills did not yield statistically significant results. CONCLUSION Our study demonstrates that an in-house LP simulator is an effective and practical approach for first-year anesthesiology residents to learn the LP procedure. This approach could be particularly useful in settings with limited resources and a lack of sufficient patients to practice on, as it provides an opportunity for faster learning and increased self-confidence.
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Affiliation(s)
- David Muñoz-Leija
- Radiology Department, Facultad de Medicina y Hospital Universitario "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, MEX
| | - Fernando Díaz González-Colmenero
- Radiology Department, Facultad de Medicina y Hospital Universitario "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, MEX
| | - Diego A Ramiréz-Mendoza
- Radiology Department, Facultad de Medicina y Hospital Universitario "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, MEX
| | - Norma G López-Cabrera
- Anesthesiology Service, Hospital Universitario "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, MEX
| | - Hilda A Llanes-Garza
- Anesthesiology Service, Hospital Universitario "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, MEX
| | - Dionicio Palacios-Ríos
- Anesthesiology Service, Hospital Universitario "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, MEX
| | - Adrián A Negreros-Osuna
- Radiology Department, Hospital Regional Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Monterrey, Universidad Autónoma de Nuevo León, Monterrey, MEX
- Radiology Department, Facultad de Medicina y Hospital Universitario "Dr. José E. González", Universidad Autónoma de Nuevo León, Monterrey, MEX
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Trincado Cobos M, Tapia Salinas B, Gutiérrez Venturini A, Aragón Niño I, Del Castillo Pardo de Vera JL, Cebrián Carretero JL, Uña Orejón R. The application of three-dimensional printing in the management of a difficult airway due to Treacher Collins syndrome. Anaesth Rep 2024; 12:e12290. [PMID: 38645478 PMCID: PMC11026849 DOI: 10.1002/anr3.12290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 04/23/2024] Open
Abstract
We describe the use of three-dimensional printing to create precise airway models for a patient with Treacher Collins syndrome who presented for bimaxillary temporomandibular joint prostheses, and for whom airway management was predicted to be difficult. The model was based on pre-operative cone beam computed tomography images and printed in the 3D Lab of Hospital Universitario La Paz. Transparent models allowed clear visualisation for simulation and iterative refinement of airway management techniques and aided in risk assessment and instrument sizing. This case report emphasises the utility of this approach in complex airway scenarios.
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Affiliation(s)
| | | | | | - I. Aragón Niño
- Department of Maxillo‐facial SurgeryHospital La PazMadridSpain
| | | | | | - R. Uña Orejón
- Department of AnaesthesiologyHospital La PazMadridSpain
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Paulsen SJ, Mitcham TM, Pan CS, Long J, Grigoryan B, Sazer DW, Harlan CJ, Janson KD, Pagel MD, Miller JS, Bouchard RR. Projection-based stereolithography for direct 3D printing of heterogeneous ultrasound phantoms. PLoS One 2021; 16:e0260737. [PMID: 34882719 PMCID: PMC8659365 DOI: 10.1371/journal.pone.0260737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/16/2021] [Indexed: 01/17/2023] Open
Abstract
Modern ultrasound (US) imaging is increasing its clinical impact, particularly with the introduction of US-based quantitative imaging biomarkers. Continued development and validation of such novel imaging approaches requires imaging phantoms that recapitulate the underlying anatomy and pathology of interest. However, current US phantom designs are generally too simplistic to emulate the structure and variability of the human body. Therefore, there is a need to create a platform that is capable of generating well-characterized phantoms that can mimic the basic anatomical, functional, and mechanical properties of native tissues and pathologies. Using a 3D-printing technique based on stereolithography, we fabricated US phantoms using soft materials in a single fabrication session, without the need for material casting or back-filling. With this technique, we induced variable levels of stable US backscatter in our printed materials in anatomically relevant 3D patterns. Additionally, we controlled phantom stiffness from 7 to >120 kPa at the voxel level to generate isotropic and anisotropic phantoms for elasticity imaging. Lastly, we demonstrated the fabrication of channels with diameters as small as 60 micrometers and with complex geometry (e.g., tortuosity) capable of supporting blood-mimicking fluid flow. Collectively, these results show that projection-based stereolithography allows for customizable fabrication of complex US phantoms.
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Affiliation(s)
- Samantha J. Paulsen
- Department of Bioengineering, Rice University, Houston, TX, United States of America
| | - Trevor M. Mitcham
- Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
- The University of Texas MD Anderson Cancer Center Graduate School of Biomedical Sciences, Houston, TX, United States of America
| | - Charlene S. Pan
- Department of Bioengineering, Rice University, Houston, TX, United States of America
| | - James Long
- Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Bagrat Grigoryan
- Department of Bioengineering, Rice University, Houston, TX, United States of America
| | - Daniel W. Sazer
- Department of Bioengineering, Rice University, Houston, TX, United States of America
| | - Collin J. Harlan
- Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
- The University of Texas MD Anderson Cancer Center Graduate School of Biomedical Sciences, Houston, TX, United States of America
| | - Kevin D. Janson
- Department of Bioengineering, Rice University, Houston, TX, United States of America
| | - Mark D. Pagel
- The University of Texas MD Anderson Cancer Center Graduate School of Biomedical Sciences, Houston, TX, United States of America
- Department of Cancer Systems Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Jordan S. Miller
- Department of Bioengineering, Rice University, Houston, TX, United States of America
- * E-mail: (RRB); (JSM)
| | - Richard R. Bouchard
- Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
- The University of Texas MD Anderson Cancer Center Graduate School of Biomedical Sciences, Houston, TX, United States of America
- * E-mail: (RRB); (JSM)
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Hacker L, Joseph J, Ivory AM, Saed MO, Zeqiri B, Rajagopal S, Bohndiek SE. A Copolymer-in-Oil Tissue-Mimicking Material With Tuneable Acoustic and Optical Characteristics for Photoacoustic Imaging Phantoms. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:3593-3603. [PMID: 34152979 DOI: 10.1109/tmi.2021.3090857] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Photoacoustic imaging (PAI) standardisation demands a stable, highly reproducible physical phantom to enable routine quality control and robust performance evaluation. To address this need, we have optimised a low-cost copolymer-in-oil tissue-mimickingmaterial formulation. The base material consists of mineral oil, copolymer and stabiliser with defined Chemical Abstract Service numbers. Speed of sound c(f) and acoustic attenuation coefficient α (f) were characterised over 2-10 MHz; optical absorption μa ( λ ) and reduced scattering μs '( λ ) coefficients over 450-900 nm. Acoustic properties were optimised by modifying base component ratios and optical properties were adjusted using additives. The temporal, thermomechanical and photo-stabilitywere studied, alongwith intra-laboratory fabrication and field-testing. c(f) could be tuned up to (1516±0.6) [Formula: see text] and α (f) to (17.4±0.3)dB · cm -1 at 5 MHz. The base material exhibited negligible μa ( λ ) and μs '( λ ), which could be independently tuned by addition of Nigrosin or TiO2 respectively. These properties were stable over almost a year and were minimally affected by recasting. The material showed high intra-laboratory reproducibility (coefficient of variation <4% for c ( f ), α ( f ), optical transmittance and reflectance), and good photo- and mechanical-stability in the relevant working range (20-40°C). The optimised copolymer-in-oil material represents an excellent candidate for widespread application in PAI phantoms, with properties suitable for broader use in biophotonics and ultrasound imaging standardisation efforts.
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Silvestro E, Betts KN, Francavilla ML, Andronikou S, Sze RW. Imaging Properties of Additive Manufactured (3D Printed) Materials for Potential Use for Phantom Models. J Digit Imaging 2021; 33:456-464. [PMID: 31520278 DOI: 10.1007/s10278-019-00257-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Over the last few decades, there has been growing interest in the application of additive manufacturing (AM) or 3D printing for medical research and clinical application. Imaging phantoms offer clear benefits in the way of training, planning, and quality assurance, but the model's availability per catalog tend to be suited for general testing purposes only. AM, on the contrary, offers flexibility to clinicians by enabling custom-built phantoms based on specific interests or even individual patient needs. This study aims to quantify the radiographic properties (ultrasound, magnetic resonance imaging, and computed tomography) of common additive manufacturing technologies and to discuss potential opportunities to fabricate imaging phantoms. Test phantoms were composed of samples from the three most common AM styles, namely PolyJet, fused deposition modeling (FDM), and stereolithography (SLA). Test imaging of the phantoms was performed on ultrasound, MRI, and CT and reviewed and evaluated with radiology software. The ultrasound images showed clearly defined upper and lower edges of the material but did not demonstrate distinct differences in internal echogenicity between materials. The MR scans revealed a distinct signal intensity difference between the model (17 grayscale value) and the printer support (778 grayscale value). Finally, the CT images showed a slight variation between the plastic (82 HU) and rubber (145 HU) materials. The radiographic properties of AM offer a clear opportunity to create basic two- or three-material phantoms. These would be high-accuracy and cost-effective models. Although the materials currently available are not suitable for complex multi-material applications as realistic as true human anatomy, one can easily foresee the development of new materials with broader density in the near future.
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Affiliation(s)
- Elizabeth Silvestro
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Khalil N Betts
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael L Francavilla
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Savvas Andronikou
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Raymond W Sze
- Children's Hospital Additive Manufacturing for Pediatrics (CHAMP Lab), Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Lopez CD, Boddapati V, Lee NJ, Dyrszka MD, Sardar ZM, Lehman RA, Lenke LG. Three-Dimensional Printing for Preoperative Planning and Pedicle Screw Placement in Adult Spinal Deformity: A Systematic Review. Global Spine J 2021; 11:936-949. [PMID: 32762378 PMCID: PMC8258819 DOI: 10.1177/2192568220944170] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
STUDY DESIGN Systematic review. OBJECTIVES This current systematic review seeks to identify current applications and surgical outcomes for 3-dimensional printing (3DP) in the treatment of adult spinal deformity. METHODS A comprehensive search of publications was conducted through literature databases using relevant keywords. Inclusion criteria consisted of original studies, studies with patients with adult spinal deformities, and studies focusing on the feasibility and/or utility of 3DP technologies in the planning or treatment of scoliosis and other spinal deformities. Exclusion criteria included studies with patients without adult spinal deformity, animal subjects, pediatric patients, reviews, and editorials. RESULTS Studies evaluating the effect of 3DP drill guide templates found higher screw placement accuracy in the 3DP cohort (96.9%), compared with non-3DP cohorts (81.5%, P < .001). Operative duration was significant decreased in 3DP cases (378 patients, 258 minutes) relative to non-3DP cases (301 patients,272 minutes, P < .05). The average deformity correction rate was 72.5% in 3DP cases (245 patients). There was no significant difference in perioperative blood loss between 3DP (924.6 mL, 252 patients) and non-3DP cases (935.6 mL, 177 patients, P = .058). CONCLUSIONS Three-dimensional printing is currently used for presurgical planning, patient and trainee communication and education, pre- and intraoperative guides, and screw drill guides in the treatment of scoliosis and other adult spinal deformities. In adult spinal deformity, the usage of 3DP guides is associated with increased screw accuracy and favorable deformity correction outcomes; however, average costs and production lead time are highly variable between studies.
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Affiliation(s)
- Cesar D. Lopez
- The Spine Hospital, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA
| | - Venkat Boddapati
- The Spine Hospital, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA,Venkat Boddapati, The Spine Hospital, New York-Presbyterian/Columbia University Medical Center, 622 West 168th Street, PH-11, New York, NY 10032, USA.
| | - Nathan J. Lee
- The Spine Hospital, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA
| | - Marc D. Dyrszka
- The Spine Hospital, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA
| | - Zeeshan M. Sardar
- The Spine Hospital, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA
| | - Ronald A. Lehman
- The Spine Hospital, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA
| | - Lawrence G. Lenke
- The Spine Hospital, New York-Presbyterian/Columbia University Medical Center, New York, NY, USA
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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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Gallagher P, Smith R, Sheppard G. Use of three-dimensional printing for simulation in ultrasound education: a scoping review. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 7:410-413. [DOI: 10.1136/bmjstel-2020-000663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/24/2020] [Accepted: 08/25/2020] [Indexed: 11/04/2022]
Abstract
BackgroundThere is a significant learning curve when teaching ultrasonography to medical trainees; task trainers can help learners to bridge this gap and develop their skills. Three-dimensional printing technology has the potential to be a great tool in the development of such simulators.
ObjectiveThis scoping review aimed to identify what 3D-printed models have been used in ultrasound education to date, how they were created and the pros and limitations involved.DesignResearchers searched three online databases to identify 3D-printed ultrasound models used in medical education.ResultsTwelve suitable publications were identified for inclusion in this review. The models from included articles simulated largely low frequency and/or high stakes events, with many models simulating needle guidance procedures. Most models were created by using patient imaging data and a computer-aided design software to print structures directly or print casting molds. The benefits of 3D-printed educational trainers are their low cost, reproducibility, patient specificity and accuracy. The current limitations of this technology are upfront investments and a lack of optimisation of materials.ConclusionsThe use of 3D-printed ultrasound task trainers is in its infancy, and more research is needed to determine whether or not this technology will benefit medical learners in the future.
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The Development of a Novel Device Based on Loss of Guidewire Resistance to Identify Epidural Space in a Porcine Model. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:8899628. [PMID: 32908659 PMCID: PMC7463384 DOI: 10.1155/2020/8899628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/31/2020] [Indexed: 12/24/2022]
Abstract
Background The application of additive manufacturing (3D printing) has been recently expanded to various medical fields. The new technique named loss of guide wire resistance (LOGR) was developed via 3D printing for the detection of epidural space using a guide wire instead of air or saline used in the loss of resistance (LOR) technique. Methods The prototype model of epidural space finder consists of a polyactic acid (PLA) or a resin. It was manufactured with 3D printing. Biocompatibility test (eluate and sterility tests) was performed in both products. The advantage of the newly developed device was compared with conventional loss of resistance (LOR) technique in a porcine model. Results Eluate and sterility tests revealed that the PLA was more biocompatible than the resin. The LOGR technique facilitated rapid access to epidural space compared with the LOR technique (41.64 ± 32.18 vs. 92.28 ± 61.46 seconds, N = 14, p=0.0102, paired sample t-test), without any differences in success rate (87.5%). Conclusion We conclude that LOGR technique is comparable to LOR technique to access the epidural space, although the advantage of either technique in terms of complications such as dural puncture or epidural hematoma is unknown. We demonstrated the potential benefit of 3D printer for the development of a new medical device for anesthesia.
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Meineri M, Qua-Hiansen J, Garijo JM, Ansari B, Ruggeri GM, Ender J, Mashari A. Evaluation of a Patient-Specific, Low-Cost, 3-Dimensional-Printed Transesophageal Echocardiography Human Heart Phantom. J Cardiothorac Vasc Anesth 2020; 35:208-215. [PMID: 32732098 DOI: 10.1053/j.jvca.2020.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Currently available 3-dimensional (3D) modeling and printing techniques allow for the creation of patient-specific models based on 3D medical imaging data. The authors hypothesized that a low-cost, patient-specific, cardiac computed tomography-based phantom, created using desktop 3D printing and casting, would have comparable image quality, accuracy, and usability to an existing commercially available echocardiographic phantom. DESIGN Blinded comparative study. SETTING Simulation laboratory at a single academic institution. PARTICIPANTS Voluntary cardiac anesthesiologists at a single academic institution. INTERVENTIONS Stage 1 of the study consisted of an online questionnaire in which a set of basic transesophageal echocardiography (TEE) views obtained from the 3D printed phantom and commercial phantom were presented to participants, who had to identify the views and evaluate their fidelity to clinical images on a Likert scale. In stage 2, participants performed an unblinded basic TEE examination on both phantoms. MEASUREMENTS AND MAIN RESULTS The time needed to acquire each basic view was recorded. Overall usability of the phantoms was assessed through a questionnaire. The participants could recognize most of the views. Fidelity ratings for both phantoms were similar (p < 0.05), with the exception of a midesophageal 2-chamber view that was observed better on the 3D printed phantom. The time required to obtain the views was shorter for the 3D printed phantom, although not statistically significant for most views. The overall user experience was better for the 3D phantom for all categories examined (p < 0.05). CONCLUSIONS The study suggested that a 3D-printed TEE phantom is comparable with the commercially available one with good usability.
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Affiliation(s)
- Massimiliano Meineri
- Department of Anesthesiology and Intensive Care, Herzzentrum Leipzig, Leipzig, Germany.
| | - Joshua Qua-Hiansen
- Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Jacobo Moreno Garijo
- Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bilal Ansari
- Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Giulia Maria Ruggeri
- Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Joerg Ender
- Department of Anesthesiology and Intensive Care, Herzzentrum Leipzig, Leipzig, Germany
| | - Azad Mashari
- Department of Anesthesiology and Pain Management, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada
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Liu DCY, Koo TH, Wong JKK, Wong YH, Fung KSC, Chan Y, Lim HS. Adapting re-usable elastomeric respirators to utilise anaesthesia circuit filters using a 3D-printed adaptor - a potential alternative to address N95 shortages during the COVID-19 pandemic. Anaesthesia 2020; 75:1022-1027. [PMID: 32348561 PMCID: PMC7267584 DOI: 10.1111/anae.15108] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2020] [Indexed: 02/07/2023]
Abstract
The COVID‐19 pandemic has increased the demand for disposable N95 respirators. Re‐usable elastomeric respirators may provide a suitable alternative. Proprietary elastomeric respirator filters may become depleted as demand increases. An alternative may be the virus/bacterial filters used in anaesthesia circuits, if they can be adequately fitted onto the elastomeric respirators. In addition, many re‐usable elastomeric respirators do not filter exhaled breaths. If used for sterile procedures, this would also require modification. We designed a 3D‐printed adaptor that permits elastomeric respirators to interface with anaesthesia circuit filters and created a simple modification to divert exhaled breaths through the filter. We conducted a feasibility study evaluating the performance of our modified elastomeric respirators. A convenience sample of eight volunteers was recruited. Quantitative fit testing, respiratory rate and end‐tidal carbon dioxide were recorded during fit testing exercises and after 1 h of wear. All eight volunteers obtained excellent quantitative fit testing throughout the trial. The mean (SD) end‐tidal carbon dioxide was 4.5 (0.5) kPa and 4.6 (0.4) kPa at baseline and after 1 h of wear (p = 0.148). The mean (SD) respiratory rate was 17 (4) breaths.min−1 and 17 (3) breaths.min−1 at baseline and after 1 h of wear (p = 0.435). Four out of eight subjects self‐reported discomfort; two reported facial pressure, one reported exhalation resistance and one reported transient dizziness on exertion. Re‐usable elastomeric respirators to utilise anaesthesia circuit filters through a 3D‐printed adaptor may be a potential alternative to disposable N95 respirators during the COVID‐19 pandemic.
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Affiliation(s)
- D C Y Liu
- Department of Anaesthesiology and Pain Medicine, United Christian Hospital, Hong Kong
| | - T H Koo
- Department of Occupational Therapy, United Christian Hospital, Hong Kong
| | - J K K Wong
- Department of Occupational Therapy, United Christian Hospital, Hong Kong
| | - Y H Wong
- Operating Room, United Christian Hospital, Hong Kong
| | - K S C Fung
- Department of Pathology, United Christian Hospital, Hong Kong
| | - Y Chan
- Occupational Safety and Health Team, Hospital Authority Kowloon East Cluster, Hong Kong
| | - H S Lim
- Department of Anaesthesiology and Pain Medicine, United Christian Hospital, Hong Kong
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Odom M, Gomez JR, Danelson KA, Sarwal A. Development of a Homemade Spinal Model for Simulation to Teach Ultrasound Guidance for Lumbar Puncture. Neurocrit Care 2019; 31:550-558. [DOI: 10.1007/s12028-019-00779-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Design of lymphedema ultrasound phantom with 3D-printed patient-specific subcutaneous anatomy: A-mode analysis approach for early diagnosis. Phys Med 2018; 55:73-81. [PMID: 30471822 DOI: 10.1016/j.ejmp.2018.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 09/27/2018] [Accepted: 10/23/2018] [Indexed: 11/22/2022] Open
Abstract
The secondary lymphedema is mostly caused due to injury of lymphatic system during cancer treatment and its psychological and cosmetic issues are very critical for patients since it can cause severe thickening and swelling of lesions, mostly upper and lower limbs. Therefore, early diagnosis of the secondary lymphedema is more important to treat the symptoms in advance. The amplitude-mode (A-mode) ultrasound is suggested as an early diagnostic modality because it is relatively more cost-effective, portable, and easy to use than other previous diagnostic modalities. In order to see features of the A-mode ultrasound forearly diagnosis of lymphedema, ultrasound lymphedema phantoms were designed and fabricated with patient-specific subcutaneous honeycomb structures at the sub-stages of the international society of lymphedema (ISL) stage II and gelatin- or gelatin-salt based phantom materials. The patent-specific honeycomb structures were segmented from computed tomography (CT) venography images using various image process technologies and printed using a three dimensional (3D) printer for which its printing material shows similar acoustic impedance range with human subcutaneous tissues. The lymphedema phantoms showed similar subcutaneous anatomical features to those of patient's imagesin brightness mode (B-mode) ultrasound examination, and acoustic information originated from the stage-specific honeycomb structures was well represented in A-mode ultrasound examination. In particular, the A-mode wave form well represented stage-specific honeycomb information even with higher impedance value of fibrous fat region. Such stage-specific wave form information of A-mode ultrasound for the corresponding stage-specific lymphedema phantoms at the ISL stage II can be useful for further development of an A-mode ultrasound applications for early diagnosis of the secondary lymphedema.
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Mashari A, Montealegre-Gallegos M, Jeganathan J, Yeh L, Qua Hiansen J, Meineri M, Mahmood F, Matyal R. Low-cost three-dimensional printed phantom for neuraxial anesthesia training: Development and comparison to a commercial model. PLoS One 2018; 13:e0191664. [PMID: 29912877 PMCID: PMC6005480 DOI: 10.1371/journal.pone.0191664] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 01/09/2018] [Indexed: 02/07/2023] Open
Abstract
METHODS Anonymized CT DICOM data was segmented to create a 3D model of the lumbar spine. The 3D model was modified, placed inside a digitally designed housing unit and fabricated on a desktop 3D printer using polylactic acid (PLA) filament. The model was filled with an echogenic solution of gelatin with psyllium fiber. Twenty-two staff anesthesiologists performed a spinal and epidural on the 3D printed simulator and a commercially available Simulab phantom. Participants evaluated the tactile and ultrasound imaging fidelity of both phantoms via Likert-scale questionnaire. RESULTS The 3D printed neuraxial phantom cost $13 to print and required 25 hours of non-supervised printing and 2 hours of assembly time. The 3D printed phantom was found to be less realistic to surface palpation than the Simulab phantom due to fragility of the silicone but had significantly better fidelity for loss of resistance, dural puncture and ultrasound imaging than the Simulab phantom. CONCLUSION Low-cost neuraxial phantoms with fidelity comparable to commercial models can be produced using CT data and low-cost infrastructure consisting of FLOS software and desktop 3D printers.
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Affiliation(s)
- Azad Mashari
- Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mario Montealegre-Gallegos
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jelliffe Jeganathan
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Lu Yeh
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Joshua Qua Hiansen
- Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada
| | - Massimiliano Meineri
- Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Robina Matyal
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
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Maneas E, Xia W, Ogunlade O, Fonseca M, Nikitichev DI, David AL, West SJ, Ourselin S, Hebden JC, Vercauteren T, Desjardins AE. Gel wax-based tissue-mimicking phantoms for multispectral photoacoustic imaging. BIOMEDICAL OPTICS EXPRESS 2018; 9. [PMID: 29541509 PMCID: PMC5846519 DOI: 10.1364/boe.9.001151] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Tissue-mimicking phantoms are widely used for the calibration, evaluation and standardisation of medical imaging systems, and for clinical training. For photoacoustic imaging, tissue-mimicking materials (TMMs) that have tuneable optical and acoustic properties, high stability, and mechanical robustness are highly desired. In this study, gel wax is introduced as a TMM that satisfies these criteria for developing photoacoustic imaging phantoms. The reduced scattering and optical absorption coefficients were independently tuned with the addition of TiO2 and oil-based inks. The frequency-dependent acoustic attenuation obeyed a power law; for native gel wax, it varied from 0.71 dB/cm at 3 MHz to 9.93 dB/cm at 12 MHz. The chosen oil-based inks, which have different optical absorption spectra in the range of 400 to 900 nm, were found to have good photostability under pulsed illumination with photoacoustic excitation light. Optically heterogeneous phantoms that comprised of inclusions with different concentrations of carbon black and coloured inks were fabricated, and multispectral photoacoustic imaging was performed with an optical parametric oscillator and a planar Fabry-Pérot sensor. We conclude that gel wax is well suited as a TMM for multispectral photoacoustic imaging.
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Affiliation(s)
- Efthymios Maneas
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ,
UK
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
| | - Wenfeng Xia
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ,
UK
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
| | - Olumide Ogunlade
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
| | - Martina Fonseca
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
| | - Daniil I. Nikitichev
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ,
UK
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
| | - Anna L. David
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ,
UK
- Institute for Women’s Health, University College London, 86-96 Chenies Mews, London WC1E 6HX,
UK
- Department of Development and Regeneration, KU Leuven (Katholieke Universiteit),
Belgium
| | - Simeon J. West
- Department of Anaesthesia, University College Hospital, Main Theatres, Maple Bridge Link Corridor, Podium 3, 235 Euston Road, London NW1 2BU,
UK
| | - Sebastien Ourselin
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ,
UK
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
| | - Jeremy C. Hebden
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
| | - Tom Vercauteren
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ,
UK
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
- Translational Imaging Group, Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
| | - Adrien E. Desjardins
- Wellcome / EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ,
UK
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT,
UK
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A Review of Current Clinical Applications of Three-Dimensional Printing in Spine Surgery. Asian Spine J 2018; 12:171-177. [PMID: 29503698 PMCID: PMC5821924 DOI: 10.4184/asj.2018.12.1.171] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 08/07/2017] [Accepted: 08/08/2017] [Indexed: 12/19/2022] Open
Abstract
Three-dimensional (3D) printing is a transformative technology with a potentially wide range of applications in the field of orthopaedic spine surgery. This article aims to review the current applications, limitations, and future developments of 3D printing technology in orthopaedic spine surgery. Current preoperative applications of 3D printing include construction of complex 3D anatomic models for improved visual understanding, preoperative surgical planning, and surgical simulations for resident education. Intraoperatively, 3D printers have been successfully used in surgical guidance systems and in the creation of patient specific implantable devices. Furthermore, 3D printing is revolutionizing the field of regenerative medicine and tissue engineering, allowing construction of biocompatible scaffolds suitable for cell growth and vasculature. Advances in printing technology and evidence of positive clinical outcomes are needed before there is an expansion of 3D printing applied to the clinical setting.
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17
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Maneas E, Xia W, Nikitichev DI, Daher B, Manimaran M, Wong RYJ, Chang CW, Rahmani B, Capelli C, Schievano S, Burriesci G, Ourselin S, David AL, Finlay MC, West SJ, Vercauteren T, Desjardins AE. Anatomically realistic ultrasound phantoms using gel wax with 3D printed moulds. Phys Med Biol 2018; 63:015033. [PMID: 29186007 PMCID: PMC5802334 DOI: 10.1088/1361-6560/aa9e2c] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Here we describe methods for creating tissue-mimicking ultrasound phantoms based on patient anatomy using a soft material called gel wax. To recreate acoustically realistic tissue properties, two additives to gel wax were considered: paraffin wax to increase acoustic attenuation, and solid glass spheres to increase backscattering. The frequency dependence of ultrasound attenuation was well described with a power law over the measured range of 3–10 MHz. With the addition of paraffin wax in concentrations of 0 to 8 w/w%, attenuation varied from 0.72 to 2.91 dB cm−1 at 3 MHz and from 6.84 to 26.63 dB cm−1 at 10 MHz. With solid glass sphere concentrations in the range of 0.025–0.9 w/w%, acoustic backscattering consistent with a wide range of ultrasonic appearances was achieved. Native gel wax maintained its integrity during compressive deformations up to 60%; its Young’s modulus was 17.4 ± 1.4 kPa. The gel wax with additives was shaped by melting and pouring it into 3D printed moulds. Three different phantoms were constructed: a nerve and vessel phantom for peripheral nerve blocks, a heart atrium phantom, and a placental phantom for minimally-invasive fetal interventions. In the first, nerves and vessels were represented as hyperechoic and hypoechoic tubular structures, respectively, in a homogeneous background. The second phantom comprised atria derived from an MRI scan of a patient with an intervening septum and adjoining vena cavae. The third comprised the chorionic surface of a placenta with superficial fetal vessels derived from an image of a post-partum human placenta. Gel wax is a material with widely tuneable ultrasound properties and mechanical characteristics that are well suited for creating patient-specific ultrasound phantoms in several clinical disciplines.
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Affiliation(s)
- Efthymios Maneas
- Department of Medical Physics and Biomedical Engineering, University College London, Gower Street, London WC1E 6BT, United Kingdom. Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, Charles Bell House, 67-73 Riding House Street, London W1W 7EJ, United Kingdom. These authors contributed equally to this work
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18
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Bücking TM, Hill ER, Robertson JL, Maneas E, Plumb AA, Nikitichev DI. From medical imaging data to 3D printed anatomical models. PLoS One 2017; 12:e0178540. [PMID: 28562693 PMCID: PMC5451060 DOI: 10.1371/journal.pone.0178540] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 05/15/2017] [Indexed: 12/17/2022] Open
Abstract
Anatomical models are important training and teaching tools in the clinical environment and are routinely used in medical imaging research. Advances in segmentation algorithms and increased availability of three-dimensional (3D) printers have made it possible to create cost-efficient patient-specific models without expert knowledge. We introduce a general workflow that can be used to convert volumetric medical imaging data (as generated by Computer Tomography (CT)) to 3D printed physical models. This process is broken up into three steps: image segmentation, mesh refinement and 3D printing. To lower the barrier to entry and provide the best options when aiming to 3D print an anatomical model from medical images, we provide an overview of relevant free and open-source image segmentation tools as well as 3D printing technologies. We demonstrate the utility of this streamlined workflow by creating models of ribs, liver, and lung using a Fused Deposition Modelling 3D printer.
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Affiliation(s)
- Thore M. Bücking
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
- * E-mail:
| | - Emma R. Hill
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - James L. Robertson
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Efthymios Maneas
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Andrew A. Plumb
- Centre for Medical Imaging, University College London, London, United Kingdom
| | - Daniil I. Nikitichev
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
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Füzesi K, Gyöngy M. Comparison of Two Inexpensive Rapid Prototyping Methods for Manufacturing Filament Target Ultrasound Phantoms. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:712-720. [PMID: 28034541 DOI: 10.1016/j.ultrasmedbio.2016.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 06/06/2023]
Abstract
Current use of 3-D printers to manufacture ultrasound phantoms is limited to relatively expensive photopolymer jetting printers. The present work investigates the feasibility of using two common and inexpensive 3-D printer technologies, fused deposition modeling (FDM) and digital light processing (DLP), to print custom filament target phantoms. Acoustic characteristics obtained from printed solid blocks indicated that the printing materials-acrylonitrile butadiene styrene and polylactic acid for FDM and a photopolymer for DLP printing-were appropriate for use as scatterers. A regular grid of filaments was printed to study printing accuracy. As a proof of concept of the phantom manufacturing process, a complex pattern of filament targets was placed in de-ionized water to create a phantom, which was then imaged using an ultrasound imager. The pattern was clearly identifiable, although multiple reflections were observed, which underscores the importance of future work to enhance printing resolution. This goal is deemed possible using improvement of the DLP printing setup.
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Affiliation(s)
- Krisztián Füzesi
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary.
| | - Miklós Gyöngy
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
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20
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Chao I, Young J, Coles-Black J, Chuen J, Weinberg L, Rachbuch C. The application of three-dimensional printing technology in anaesthesia: a systematic review. Anaesthesia 2017; 72:641-650. [DOI: 10.1111/anae.13812] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2016] [Indexed: 01/17/2023]
Affiliation(s)
- I. Chao
- Department of Anaesthesia; Box Hill Hospital; Eastern Health; Melbourne Victoria Australia
| | - J. Young
- Department of Anaesthesia and Acute Pain Medicine; St Vincent's Hospital; Melbourne Victoria Australia
| | - J. Coles-Black
- Melbourne Medical School; The University of Melbourne; Parkville Victoria Australia
| | - J. Chuen
- Austin Health; Melbourne Victoria Australia
| | | | - C. Rachbuch
- Department of Anaesthesia; Box Hill Hospital; Eastern Health; Melbourne Victoria Australia
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Krishna S, Small K, Maetani T, Chepelev L, Schwarz BA, Sheikh A. Musculoskeletal 3D Printing. 3D Print Med 2017. [DOI: 10.1007/978-3-319-61924-8_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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22
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Tomasello F, Conti A, La Torre D. 3D printing in Neurosurgery. World Neurosurg 2016; 91:633-4. [DOI: 10.1016/j.wneu.2016.04.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 04/12/2016] [Indexed: 10/21/2022]
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Nikitichev DI, Barburas A, McPherson K, Mari JM, West SJ, Desjardins AE. Construction of 3-Dimensional Printed Ultrasound Phantoms With Wall-less Vessels. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:1333-9. [PMID: 27162278 DOI: 10.7863/ultra.15.06012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/15/2015] [Indexed: 05/08/2023]
Abstract
Ultrasound phantoms are invaluable as training tools for vascular access procedures. We developed ultrasound phantoms with wall-less vessels using 3-dimensional printed chambers. Agar was used as a soft tissue-mimicking material, and the wall-less vessels were created with rods that were retracted after the agar was set. The chambers had integrated luer connectors to allow for fluid injections with clinical syringes. Several variations on this design are presented, which include branched and stenotic vessels. The results show that 3-dimensional printing can be well suited to the construction of wall-less ultrasound phantoms, with designs that can be readily customized and shared electronically.
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Affiliation(s)
- Daniil I Nikitichev
- Department of Medical Physics and Biomedical Engineering, University College London, London, England
| | - Anamaria Barburas
- Department of Medical Physics and Biomedical Engineering, University College London, London, England
| | | | - Jean-Martial Mari
- Department of Medical Physics and Biomedical Engineering, University College London, London, EnglandUniversity of French Polynesia, Tahiti, French Polynesia
| | | | - Adrien E Desjardins
- Department of Medical Physics and Biomedical Engineering, University College London, London, England
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Kim YH. Ultrasound Phantoms to Protect Patients from Novices. Korean J Pain 2016; 29:73-7. [PMID: 27103961 PMCID: PMC4837122 DOI: 10.3344/kjp.2016.29.2.73] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/10/2016] [Accepted: 03/14/2016] [Indexed: 11/05/2022] Open
Abstract
With the growing use of ultrasound for pain management, we are interested in how to teach and practice ultrasound-guided procedures. Ethically, we should not insert a needle in a patient until after much practice on a phantom. Several types of phantoms have been introduced for ultrasound training, including water, agar/gelatin, elastomeric rubber, and meat phantoms and cadavers. The ideal phantom is similar to human tissue, is readily available and inexpensive, can be used repeatedly, provides tactile feedback, will hold a needle in place, does not generate needle tracks, and is not a health hazard. Several studies have shown the effectiveness of phantoms for improving the proficiency of novices. We hope that the application of phantoms in education leads to improved proficiency and increased patient safety.
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Affiliation(s)
- Young Hoon Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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O’Brien EK, Wayne DB, Barsness KA, McGaghie WC, Barsuk JH. Use of 3D Printing for Medical Education Models in Transplantation Medicine: a Critical Review. CURRENT TRANSPLANTATION REPORTS 2016. [DOI: 10.1007/s40472-016-0088-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Naftulin JS, Kimchi EY, Cash SS. Streamlined, Inexpensive 3D Printing of the Brain and Skull. PLoS One 2015; 10:e0136198. [PMID: 26295459 PMCID: PMC4546422 DOI: 10.1371/journal.pone.0136198] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 07/31/2015] [Indexed: 12/12/2022] Open
Abstract
Neuroimaging technologies such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) collect three-dimensional data (3D) that is typically viewed on two-dimensional (2D) screens. Actual 3D models, however, allow interaction with real objects such as implantable electrode grids, potentially improving patient specific neurosurgical planning and personalized clinical education. Desktop 3D printers can now produce relatively inexpensive, good quality prints. We describe our process for reliably generating life-sized 3D brain prints from MRIs and 3D skull prints from CTs. We have integrated a standardized, primarily open-source process for 3D printing brains and skulls. We describe how to convert clinical neuroimaging Digital Imaging and Communications in Medicine (DICOM) images to stereolithography (STL) files, a common 3D object file format that can be sent to 3D printing services. We additionally share how to convert these STL files to machine instruction gcode files, for reliable in-house printing on desktop, open-source 3D printers. We have successfully printed over 19 patient brain hemispheres from 7 patients on two different open-source desktop 3D printers. Each brain hemisphere costs approximately $3–4 in consumable plastic filament as described, and the total process takes 14–17 hours, almost all of which is unsupervised (preprocessing = 4–6 hr; printing = 9–11 hr, post-processing = <30 min). Printing a matching portion of a skull costs $1–5 in consumable plastic filament and takes less than 14 hr, in total. We have developed a streamlined, cost-effective process for 3D printing brain and skull models. We surveyed healthcare providers and patients who confirmed that rapid-prototype patient specific 3D models may help interdisciplinary surgical planning and patient education. The methods we describe can be applied for other clinical, research, and educational purposes.
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Affiliation(s)
- Jason S. Naftulin
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Eyal Y. Kimchi
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Sydney S. Cash
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
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