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Mitsouras D, Liacouras P, Imanzadeh A, Giannopoulos AA, Cai T, Kumamaru KK, George E, Wake N, Caterson EJ, Pomahac B, Ho VB, Grant GT, Rybicki FJ. Medical 3D Printing for the Radiologist. Radiographics 2016; 35:1965-88. [PMID: 26562233 DOI: 10.1148/rg.2015140320] [Citation(s) in RCA: 358] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
While use of advanced visualization in radiology is instrumental in diagnosis and communication with referring clinicians, there is an unmet need to render Digital Imaging and Communications in Medicine (DICOM) images as three-dimensional (3D) printed models capable of providing both tactile feedback and tangible depth information about anatomic and pathologic states. Three-dimensional printed models, already entrenched in the nonmedical sciences, are rapidly being embraced in medicine as well as in the lay community. Incorporating 3D printing from images generated and interpreted by radiologists presents particular challenges, including training, materials and equipment, and guidelines. The overall costs of a 3D printing laboratory must be balanced by the clinical benefits. It is expected that the number of 3D-printed models generated from DICOM images for planning interventions and fabricating implants will grow exponentially. Radiologists should at a minimum be familiar with 3D printing as it relates to their field, including types of 3D printing technologies and materials used to create 3D-printed anatomic models, published applications of models to date, and clinical benefits in radiology. Online supplemental material is available for this article.
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Affiliation(s)
- Dimitris Mitsouras
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Peter Liacouras
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Amir Imanzadeh
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Andreas A Giannopoulos
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Tianrun Cai
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Kanako K Kumamaru
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Elizabeth George
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Nicole Wake
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Edward J Caterson
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Bohdan Pomahac
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Vincent B Ho
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Gerald T Grant
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
| | - Frank J Rybicki
- From the Applied Imaging Science Laboratory, Department of Radiology (D.M., A.I., A.A.G., T.C., K.K.K., E.G., F.J.R.), and Division of Plastic Surgery, Department of Surgery (E.J.C., B.P.), Brigham and Women's Hospital, Boston, Mass; 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (P.L., V.B.H., G.T.G.); Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, New York, NY (N.W.); and Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY (N.W.)
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Kueckelhaus M, Turk M, Kumamaru KK, Wo L, Bueno EM, Lian CG, Alhefzi M, Aycart MA, Fischer S, De Girolami U, Murphy GF, Rybicki FJ, Pomahac B. Transformation of Face Transplants: Volumetric and Morphologic Graft Changes Resemble Aging After Facial Allotransplantation. Am J Transplant 2016; 16:968-78. [PMID: 26639618 DOI: 10.1111/ajt.13544] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/03/2015] [Accepted: 09/18/2015] [Indexed: 01/25/2023]
Abstract
Facial allotransplantation restores normal anatomy to severely disfigured faces. Although >30 such operations performed worldwide have yielded promising short-term results, data on long-term outcomes remain scarce. Three full-face transplant recipients were followed for 40 months. Severe changes in volume and composition of the facial allografts were noted. Data from computed tomography performed 6, 18 and 36 months after transplantation were processed to separate allograft from recipient tissues and further into bone, fat and nonfat soft tissues. Skin and muscle biopsies underwent diagnostic evaluation. All three facial allografts sustained significant volume loss (mean 19.55%) between 6 and 36 months after transplant. Bone and nonfat soft tissue volumes decreased significantly over time (17.22% between months 6 and 18 and 25.56% between months 6 and 36, respectively), whereas fat did not. Histological evaluations showed atrophy of muscle fibers. Volumetric and morphometric changes in facial allografts have not been reported previously. The transformation of facial allografts in this study resembled aging through volume loss but differed substantially from regular aging. These findings have implications for risk-benefit assessment, donor selection and measures counteracting muscle and bone atrophy. Superior long-term outcomes of facial allotransplantation will be crucial to advance toward future clinical routine.
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Affiliation(s)
- M Kueckelhaus
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
| | - M Turk
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - K K Kumamaru
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - L Wo
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - E M Bueno
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - C G Lian
- Division of Dermatopathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - M Alhefzi
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - M A Aycart
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - S Fischer
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Plastic Surgery, BG University Hospital Ludwigshafen, Heidelberg University, Ludwigshafen, Germany
| | - U De Girolami
- Division of Neuropathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - G F Murphy
- Division of Dermatopathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - F J Rybicki
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - B Pomahac
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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