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Matrosic CK, Kronenberg S, Demirci H, Hayman JA, Han H, Lee C. A novel 3D-printed brachytherapy applicator and monte Carlo model for the treatment of conjunctival tumors. Brachytherapy 2024:S1538-4721(24)00112-0. [PMID: 39181747 DOI: 10.1016/j.brachy.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 07/09/2024] [Accepted: 07/17/2024] [Indexed: 08/27/2024]
Abstract
PURPOSE To develop a custom low dose rate brachytherapy applicator for the treatment of conjunctival malignancies which leverages 3D-printing technology to provide enhanced design flexibility and availability. METHODS An elliptical shell applicator inspired by ocular surgery postoperation conformer shells was developed for the placement of the applicator around the cornea of the eye, with a central hole to provide patient comfort. The applicator featured 2 concentric circles of slots for iodine-125 seeds, providing customization of the dose distribution depending on the location of the target. The applicator was modeled using computer-aided design software. The resultant model STL file was used for 3D printing of the applicator and the development of a Monte Carlo model of the applicator and its dose distribution. RESULTS The applicator was successfully 3D printed using biocompatible resin, which could be sterilized for treatment after manual source loading. A Geant4 model of the applicator was created directly from the STL model and was applied to a phantom to estimate the dose distribution delivered by the applicator. The toroidal dose distribution allowed for treatment of the conjunctiva while reducing dose to the cornea compared to traditional eye plaque designs. CONCLUSIONS A custom 3D-printed applicator was successfully developed and modeled for the treatment of conjunctival malignancies. This novel applicator design potentially provides higher quality, more customizable dose distributions for patients and the simplicity of the design makes it accessible for any clinic with 3D-printing technology.
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Affiliation(s)
- C K Matrosic
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI.
| | - S Kronenberg
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - H Demirci
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI
| | - J A Hayman
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
| | - H Han
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - C Lee
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI
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Krishnaswamy A, Kassab J, Harb SC. Beyond Simple Visualization: A New Reality for Structural Heart Interventions? J Am Heart Assoc 2024; 13:e036238. [PMID: 39041623 DOI: 10.1161/jaha.124.036238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Affiliation(s)
| | - Joseph Kassab
- Heart and Vascular Institute, Cleveland Clinic Cleveland OH USA
| | - Serge C Harb
- Heart and Vascular Institute, Cleveland Clinic Cleveland OH USA
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Capellini K, Ait-Ali L, Pak V, Cantinotti M, Murzi M, Vignali E, Fanni BM, Clemente A, Celi S, Gasparotti E. Three-dimensional printed models as an effective tool for the management of complex congenital heart disease. Front Bioeng Biotechnol 2024; 12:1369514. [PMID: 39157439 PMCID: PMC11327011 DOI: 10.3389/fbioe.2024.1369514] [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] [Received: 01/12/2024] [Accepted: 07/15/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction Three-dimensional printed models are widely used in the medical field for surgical and interventional planning. In the context of complex cardiovascular defects such as pediatric congenital heart diseases (CHDs), the adoption of 3D printed models could be an effective tool to improve decision-making. In this paper, an investigation was conducted into the characteristics of 3D printed models and their added value in understanding and managing complex pediatric congenital heart disease, also considering the associated cost. Methods Volumetric MRI and CT images of subjects with complex CHDs were retrospectively segmented, and the associated 3D models were reconstructed. Different 3D printing technologies and materials were evaluated to obtain the 3D printed models of cardiac structures. An evaluation of time and costs associated with the 3D printing procedure was also provided. A two-level 3D printed model assessment was carried out to investigate the most suitable 3D printing technology for the management of complex CHDs and the effectiveness of 3D printed models in the pre-surgical planning and surgical strategies' simulations. Results Among the different techniques, selective laser sintering resulted to be the most suitable due to its reduced time and cost and for the positive clinical feedback (procedure simulation, surface finish, and reproduction of details). Conclusion The adoption of 3D printed models contributes as an effective tool in the management of complex CHDs, enabling planning and simulations of surgical procedures in a safer way.
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Affiliation(s)
- Katia Capellini
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | | | - Vitali Pak
- Department of Pediatric Cardiac Surgery, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | | | - Michele Murzi
- Department of Adult Cardiac Surgery, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - Emanuele Vignali
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - Benigno Marco Fanni
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - Alberto Clemente
- Department of Clinical Imaging, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Simona Celi
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
| | - Emanuele Gasparotti
- BioCardioLab, Bioengineering Unit, Fondazione Toscana Gabriele Monasterio, Massa, Italy
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Chetan D, Valverde I, Yoo SJ. 3D Printed Models in Cardiology Training. JACC. ADVANCES 2024; 3:100893. [PMID: 38939682 PMCID: PMC11198327 DOI: 10.1016/j.jacadv.2024.100893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Affiliation(s)
- Devin Chetan
- Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Israel Valverde
- Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Shi-Joon Yoo
- Division of Cardiac Imaging, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
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Zabala-Travers S, García-Bayce A. Setting up a biomodeling, virtual planning, and three-dimensional printing service in Uruguay. Pediatr Radiol 2024; 54:438-449. [PMID: 38324089 DOI: 10.1007/s00247-024-05864-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/08/2024]
Abstract
Virtual surgical planning and three-dimensional (D) printing are rapidly becoming essential for challenging and complex surgeries around the world. An Ibero-American survey reported a lack of awareness of technology benefits and scarce financial resources as the two main barriers to widespread adoption of 3-D technologies. The Pereira Rossell Hospital Center is a publicly funded maternal and pediatric academic clinical center in Uruguay, a low-resource Latin American country, that successfully created and has been running a 3-D unit for 4 years. The present work is a step-by-step review of the 3-D technology implementation process in a hospital with minimal financial investment. References to training, software, hardware, and the management of human resources are included. Difficulties throughout the process and future challenges are also discussed.
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Affiliation(s)
- Silvina Zabala-Travers
- Departamento de Imagenología, Centro Hospitalario Pereira Rossell, Bulevar Artigas 1550, 11300, Montevideo, Uruguay.
| | - Andrés García-Bayce
- Departamento de Imagenología, Centro Hospitalario Pereira Rossell, Bulevar Artigas 1550, 11300, Montevideo, Uruguay
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Sun Z, Silberstein J, Vaccarezza M. Cardiovascular Computed Tomography in the Diagnosis of Cardiovascular Disease: Beyond Lumen Assessment. J Cardiovasc Dev Dis 2024; 11:22. [PMID: 38248892 PMCID: PMC10816599 DOI: 10.3390/jcdd11010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024] Open
Abstract
Cardiovascular CT is being widely used in the diagnosis of cardiovascular disease due to the rapid technological advancements in CT scanning techniques. These advancements include the development of multi-slice CT, from early generation to the latest models, which has the capability of acquiring images with high spatial and temporal resolution. The recent emergence of photon-counting CT has further enhanced CT performance in clinical applications, providing improved spatial and contrast resolution. CT-derived fractional flow reserve is superior to standard CT-based anatomical assessment for the detection of lesion-specific myocardial ischemia. CT-derived 3D-printed patient-specific models are also superior to standard CT, offering advantages in terms of educational value, surgical planning, and the simulation of cardiovascular disease treatment, as well as enhancing doctor-patient communication. Three-dimensional visualization tools including virtual reality, augmented reality, and mixed reality are further advancing the clinical value of cardiovascular CT in cardiovascular disease. With the widespread use of artificial intelligence, machine learning, and deep learning in cardiovascular disease, the diagnostic performance of cardiovascular CT has significantly improved, with promising results being presented in terms of both disease diagnosis and prediction. This review article provides an overview of the applications of cardiovascular CT, covering its performance from the perspective of its diagnostic value based on traditional lumen assessment to the identification of vulnerable lesions for the prediction of disease outcomes with the use of these advanced technologies. The limitations and future prospects of these technologies are also discussed.
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Affiliation(s)
- Zhonghua Sun
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6102, Australia
| | - Jenna Silberstein
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
| | - Mauro Vaccarezza
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia; (J.S.); (M.V.)
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth, WA 6102, Australia
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Bulbul Z, El Rassi I, Hamade R, Tamim H, Bitar F. Three-dimensional printing of mitral valve models using echocardiographic data improves the knowledge of cardiology fellow physicians in training. Front Cardiovasc Med 2023; 10:1307994. [PMID: 38124899 PMCID: PMC10731368 DOI: 10.3389/fcvm.2023.1307994] [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] [Received: 10/19/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Background High fidelity three-dimensional Mitral valve models (3D MVM) printed from echocardiography are currently being used in preparation for surgical repair. Aim We hypothesize that printed 3DMVM could have relevance to cardiologists in training by improving their understanding of normal anatomy and pathology. Methods Sixteen fellow physicians in pediatric and adult cardiology training were recruited. 3D echocardiography (3DE) video clips of six mitral valves (one normal and five pathological) were displayed and the fellows were asked to name the prolapsing segments in each. Following that, three still images of 3D MVMs in different projections: enface, profile and tilted corresponding to the same MVs seen in the clip were presented on a screen. Participating physicians were presented with a comprehensive questionnaire aimed at assessing whether the 3D MVM has improved their understanding of valvular anatomy. Finally, a printed 3D MVM of each of the valves was handed out, and the same questionnaire was re-administered to identify any further improvement in the participants' perception of the anatomy. Results The correct diagnosis using the echocardiography video clip of the Mitral valve was attained by 45% of the study participants. Both pediatric and adult trainees, regardless of the year of training demonstrated improved understanding of the anatomy of MV after observing the corresponding model image. Significant improvement in their understanding was noted after participants had seen and physically examined the printed model. Conclusion Printed 3D MVM has a beneficial impact on the cardiology trainees' understanding of MV anatomy and pathology compared to 3DE images.
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Affiliation(s)
- Ziad Bulbul
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
| | - Issam El Rassi
- Pediatric Cardiac Surgery, Al Jalila Hospital, Dubai, United Arab Emirates
| | - Ramsey Hamade
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Department of Biostatistics, American University of Beirut, Beirut, Lebanon
| | - Fadi Bitar
- Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
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Tarca A, Woo N, Bain S, Crouchley D, McNulty E, Yim D. 3D Printed Cardiac Models as an Adjunct to Traditional Teaching of Anatomy in Congenital Heart Disease-A Randomised Controlled Study. Heart Lung Circ 2023; 32:1443-1450. [PMID: 38007317 DOI: 10.1016/j.hlc.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 09/07/2023] [Accepted: 09/29/2023] [Indexed: 11/27/2023]
Abstract
INTRODUCTION Three-dimensional (3D) printed cardiac models are increasingly being used for medical education, simulation and training, communication, surgical planning and research. Given the complexities of congenital cardiac anatomy, 3D printing is well suited as an adjunct to traditional teaching methods. This study aims to explore the influence of 3D printed cardiac models as a teaching aid for nurses and paediatric trainees. We hypothesise that using 3D models as an adjunct to didactic teaching methods improves knowledge and confidence levels of participants, regardless of their cardiology experience. METHOD A prospective randomised study was performed recruiting paediatric nurses and doctors at a tertiary paediatric hospital. All participants undertook traditional congenital cardiac teaching describing normal cardiac anatomy and seven congenital lesions of increasing complexity (atrial septal defect, ventricular septal defect, vascular ring, partial anomalous pulmonary venous return, tetralogy of Fallot, transposition of the great arteries, and double outlet right ventricle). The intervention group received an additional recorded demonstration while handling 3D printed models of a normal heart and the same lesions. Pre- and post-intervention assessments were completed using a subjective Likert-scale questionnaire and objective multiple-choice examination. RESULTS A total of 73 health practitioners (30 cardiac nurses and 43 paediatric trainees) were included. Subjective knowledge and confidence levels substantially improved in the intervention group (both p<0.001), with no differences observed in the control group. Greater improvement in both subjective and objective post-test scores was observed in the intervention group. A pronounced difference between pre- and post-teaching objective examination scores was found in both groups (p=0.002), with larger improvements observed in the intervention group. The mean score in the intervention group after teaching increased by 4.27 (21.4% improvement), as opposed to 2.28 (11.4% improvement) in the control group. There was no difference in pre-test score or post-test improvement based on previous cardiology experience. DISCUSSION Three-dimensional (3D) printed cardiac models, when used as an adjunct to traditional teaching methods, substantially improve knowledge and confidence levels of health professionals on a range of congenital cardiac lesions. These models enhance the learners' educational experience and understanding of cardiac anatomy by overcoming the limitation of two-dimensional representations of 3D structures.
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Affiliation(s)
- Adrian Tarca
- Children's Cardiac Centre, Perth Children's Hospital, Perth, WA, Australia
| | - Ngai Woo
- Children's Cardiac Centre, Perth Children's Hospital, Perth, WA, Australia
| | - Shahira Bain
- Nursing Education, Perth Children's Hospital, Perth, WA, Australia
| | - David Crouchley
- Children's Cardiac Centre, Perth Children's Hospital, Perth, WA, Australia
| | - Eamonn McNulty
- Medical Illustrations, Perth Children's Hospital, Perth, WA, Australia
| | - Deane Yim
- Children's Cardiac Centre, Perth Children's Hospital, Perth, WA, Australia.
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Padovani P, Singh Y, Pass RH, Vasile CM, Nield LE, Baruteau AE. E-Health: A Game Changer in Fetal and Neonatal Cardiology? J Clin Med 2023; 12:6865. [PMID: 37959330 PMCID: PMC10650296 DOI: 10.3390/jcm12216865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Technological advancements have greatly impacted the healthcare industry, including the integration of e-health in pediatric cardiology. The use of telemedicine, mobile health applications, and electronic health records have demonstrated a significant potential to improve patient outcomes, reduce healthcare costs, and enhance the quality of care. Telemedicine provides a useful tool for remote clinics, follow-up visits, and monitoring for infants with congenital heart disease, while mobile health applications enhance patient and parents' education, medication compliance, and in some instances, remote monitoring of vital signs. Despite the benefits of e-health, there are potential limitations and challenges, such as issues related to availability, cost-effectiveness, data privacy and security, and the potential ethical, legal, and social implications of e-health interventions. In this review, we aim to highlight the current application and perspectives of e-health in the field of fetal and neonatal cardiology, including expert parents' opinions.
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Affiliation(s)
- Paul Padovani
- CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, 44000 Nantes, France;
- CHU Nantes, INSERM, CIC FEA 1413, Nantes Université, 44000 Nantes, France
| | - Yogen Singh
- Division of Neonatology, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Robert H. Pass
- Department of Pediatric Cardiology, Mount Sinai Kravis Children’s Hospital, New York, NY 10029, USA;
| | - Corina Maria Vasile
- Department of Pediatric and Adult Congenital Cardiology, University Hospital of Bordeaux, 33600 Bordeaux, France;
| | - Lynne E. Nield
- Division of Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON M5S 1A1, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | - Alban-Elouen Baruteau
- CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, 44000 Nantes, France;
- CHU Nantes, INSERM, CIC FEA 1413, Nantes Université, 44000 Nantes, France
- CHU Nantes, CNRS, INSERM, L’Institut du Thorax, Nantes Université, 44000 Nantes, France
- INRAE, UMR 1280, PhAN, Nantes Université, 44000 Nantes, France
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Luxford JC, Cheng TL, Mervis J, Anderson J, Clarke J, Croker S, Nusem E, Bray L, Gunasekera H, Scott KM. An Opportunity to See the Heart Defect Physically: Medical Student Experiences of Technology-Enhanced Learning with 3D Printed Models of Congenital Heart Disease. MEDICAL SCIENCE EDUCATOR 2023; 33:1095-1107. [PMID: 37886275 PMCID: PMC10597946 DOI: 10.1007/s40670-023-01840-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 10/28/2023]
Abstract
Three-dimensional (3D) printing is increasingly used in medical education and paediatric cardiology. A technology-enhanced learning (TEL) module was designed to accompany 3D printed models of congenital heart disease (CHD) to aid in the teaching of medical students. There are few studies evaluating the attitudes and perceptions of medical students regarding their experience of learning about CHD using 3D printing. This study aimed to explore senior medical students' experiences in learning about paediatric cardiology through a workshop involving 3D printed models of CHD supported by TEL in the form of online case-based learning. A mixed-methods evaluation was undertaken involving a post-workshop questionnaire (n = 94 students), and focus groups (n = 16 students). Focus group and free-text questionnaire responses underwent thematic analysis. Questionnaire responses demonstrated widespread user satisfaction; 91 (97%) students agreed that the workshop was a valuable experience. The highest-level satisfaction was for the physical 3D printed models, the clinical case-based learning, and opportunity for peer collaboration. Thematic analysis identified five key themes: a variable experience of prior learning, interplay between physical and online models, flexible and novel workshop structure, workshop supported the learning outcomes, and future opportunities for learning using 3D printing. A key novel finding was that students indicated the module increased their confidence to teach others about CHD and recommended expansion to other parts of the curriculum. 3D printed models of CHD are a valuable learning resource and contribute to the richness and enjoyment of medical student learning, with widespread satisfaction. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-023-01840-w.
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Affiliation(s)
- Jack C. Luxford
- Faculty of Medicine and Health, Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney, NSW Australia
- Heart Centre for Children, The Children’s Hospital at Westmead, Sydney, Australia
| | - Tegan L. Cheng
- Sydney School of Health Sciences, The University of Sydney, Sydney, NSW Australia
- EPIC Lab, The Children’s Hospital at Westmead, Sydney, Australia
| | - Jonathan Mervis
- Heart Centre for Children, The Children’s Hospital at Westmead, Sydney, Australia
| | - Jennifer Anderson
- Faculty of Medicine and Health, Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney, NSW Australia
| | - Jillian Clarke
- Discipline of Medical Imaging, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Sarah Croker
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Erez Nusem
- School of Architecture, The University of Queensland, Brisbane, QLD Australia
| | - Liam Bray
- Faculty of Architecture, Design and Planning, The University of Sydney, Sydney, NSW Australia
| | - Hasantha Gunasekera
- Faculty of Medicine and Health, Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney, NSW Australia
| | - Karen M. Scott
- Faculty of Medicine and Health, Children’s Hospital Westmead Clinical School, The University of Sydney, Sydney, NSW Australia
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Salavitabar A, Zampi JD, Thomas C, Zanaboni D, Les A, Lowery R, Yu S, Whiteside W. Augmented Reality Visualization of 3D Rotational Angiography in Congenital Heart Disease: A Comparative Study to Standard Computer Visualization. Pediatr Cardiol 2023:10.1007/s00246-023-03278-8. [PMID: 37725124 DOI: 10.1007/s00246-023-03278-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/12/2023] [Indexed: 09/21/2023]
Abstract
Augmented reality (AR) visualization of 3D rotational angiography (3DRA) provides 3D representations of cardiac structures with full visualization of the procedural environment. The purpose of this study was to evaluate the feasibility of converting 3DRAs of congenital heart disease patients to AR models, highlight the workflow for 3DRA optimization for AR visualization, and assess physicians' perceptions of their use. This single-center study prospectively evaluated 30 retrospectively-acquired 3DRAs that were converted to AR, compared to Computer Models (CM). Median patient age 6.5 years (0.24-38.8) and weight 20.6 kg (3.4-107.0). AR and CM quality were graded highly. RV pacing was associated with higher quality of both model types (p = 0.02). Visualization and identification of structures were graded as "very easy" in 81.1% (n = 73) and 67.8% (n = 61) of AR and CM, respectively. Fifty-nine (66%) grades 'Agreed' or 'Strongly Agreed' that AR models provided superior appreciation of 3D relationships; AR was found to be least beneficial in visualization of aortic arch obstruction. AR models were thought to be helpful in identifying pathology and assisting in interventional planning in 85 assessments (94.4%). There was significant potential seen in the opportunity for patient/family counseling and trainee/staff education with AR models. It is feasible to convert 3D models of 3DRAs into AR models, which are of similar image quality as compared to CM. AR models provided additional benefits to visualization of 3D relationships in most anatomies. Future directions include integration of interventional simulation, peri-procedural counseling of patients and families, and education of trainees and staff with AR models.
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Affiliation(s)
- Arash Salavitabar
- Cardiac Catheterization & Interventional Therapies, The Heart Center, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.
| | - Jeffrey D Zampi
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Courtney Thomas
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Dominic Zanaboni
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Andrea Les
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Ray Lowery
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Sunkyung Yu
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Wendy Whiteside
- University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
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Yaprak F, Ozer MA, Govsa F, Cinkooglu A, Pinar Y, Gokmen G. Prespecialist perceptions of three-dimensional heart models in anatomical education. Surg Radiol Anat 2023; 45:1165-1175. [PMID: 37537403 DOI: 10.1007/s00276-023-03211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/18/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE This article aims to discuss the use of three-dimensional (3D) printed models of vascular variation cases as an educational tool for undergraduate and postgraduate anatomy students. METHODS This advanced study involved ten anatomy assistants who were provided with five distinct cases of congenital cardiovascular variations, each accompanied by a computed tomography angiography (CT-A) and 1:1 solid model format. The residents were asked to generate perceptions for both formats and then compare these perceptions based on identifying the variation, defining the structural features, and evaluating relevant educational perspectives. RESULTS The vascular origin measurement values compared to the statistically evaluated real values of the related cases showed that models were 1:1 identical copies. Qualitative assessment feedback from five stations supported the usefulness of 3D models as educational tools for organ anatomy, simulation of variational structures, and overall medical education and anatomy training. Models showcasing different anatomical variations such as aortic arch with Type 2 pattern, a right-sided aortic arch with Type 2 pattern, an aberrant right subclavian artery, arteria lusoria in thorax, and a left coronary artery originating from pulmonary trunk in an Alcapa type pattern allow for better analysis due to their complex anatomies, thus optimizing the study of variation-specific anatomy. The perception level in the 3D model contained higher points in all of the nine parameters, namely identification of cardiovascular variations, defining the vessel with anomaly, aortic arch branch count and appearance order, feasibility of using it in peers and student education. 3D models received a score 9.1 points, while CT-A images were rated at 4.8 out of 10. CONCLUSION 3D printed anatomical models of variational cardiovascular anatomy serve as essential components of anatomy training and postgraduate clinical perception by granting demonstrative feedback and a superior comprehension of the visuospatial relationship between the anatomical structures.
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Affiliation(s)
- Fulya Yaprak
- Department of Anatomy, Digital Imaging and 3D Modelling Laboratory, Faculty of Medicine, Ege University, Izmir, Turkey
- Department of Anatomy, Faculty of Medicine, Izmir Democracy University, Izmir, Turkey
| | - Mehmet Asim Ozer
- Department of Anatomy, Digital Imaging and 3D Modelling Laboratory, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Figen Govsa
- Department of Anatomy, Digital Imaging and 3D Modelling Laboratory, Faculty of Medicine, Ege University, Izmir, Turkey.
| | - Akin Cinkooglu
- Department of Radiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Yelda Pinar
- Department of Anatomy, Digital Imaging and 3D Modelling Laboratory, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Gokhan Gokmen
- Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Solidum JGN, Ceriales JA, Ong EP, Ornos EDB, Relador RJL, Quebral EPB, Lapeña JFF, Tantengco OAG, Lee KY. Nanomedicine and nanoparticle-based delivery systems in plastic and reconstructive surgery. Maxillofac Plast Reconstr Surg 2023; 45:15. [PMID: 36995508 PMCID: PMC10060935 DOI: 10.1186/s40902-023-00383-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Nanotechnology and nanomedicine are rising novel fields in plastic and reconstructive surgery (PRS). The use of nanomaterials often goes with regenerative medicine. Due to their nanoscale, these materials stimulate repair at the cellular and molecular levels. Nanomaterials may be placed as components of nanocomposite polymers allowing enhancement of overall biochemical and biomechanical properties with improved scaffold properties, cellular attachment, and tissue regeneration. They may also be formulated as nanoparticle-based delivery systems for controlled release of signal factors or antimicrobials, for example. However, more studies on nanoparticle-based delivery systems still need to be done in this field. Nanomaterials are also used as frameworks for nerves, tendons, and other soft tissues. MAIN BODY In this mini-review, we focus on nanoparticle-based delivery systems and nanoparticles targeting cells for response and regeneration in PRS. Specifically, we investigate their roles in various tissue regeneration, skin and wound healing, and infection control. Cell surface-targeted, controlled-release, and inorganic nanoparticle formulations with inherent biological properties have enabled enhanced wound healing, tumor visualization/imaging, tissue viability, and decreased infection, and graft/transplantation rejection through immunosuppression. CONCLUSIONS Nanomedicine is also now being applied with electronics, theranostics, and advanced bioengineering technologies. Overall, it is a promising field that can improve patient clinical outcomes in PRS.
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Affiliation(s)
- Jea Giezl N Solidum
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Jeremy A Ceriales
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Erika P Ong
- College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Eric David B Ornos
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Ruth Joy L Relador
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Elgin Paul B Quebral
- MD-PhD (Molecular Medicine) Program, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Jose Florencio F Lapeña
- Department of Otolaryngology - Head and Neck Surgery, Section of Craniomaxillofacial Plastic and Restorative Surgery, College of Medicine - Philippine General Hospital, University of the Philippines Manila, Ermita, Manila, 1000, Philippines
| | - Ourlad Alzeus G Tantengco
- Department of Physiology, College of Medicine, University of the Philippines Manila, Ermita, Manila, 1000, Philippines.
- Department of Biology, College of Science, De La Salle University, Manila, 1004, Philippines.
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
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14
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A multimedia paediatric cardiology assessment tool for medical students and general paediatric trainees: development and validation. Cardiol Young 2023; 33:444-448. [PMID: 35411842 DOI: 10.1017/s1047951122001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Understanding how cardiovascular structure and physiology guide management is critically important in paediatric cardiology. However, few validated educational tools are available to assess trainee knowledge. To address this deficit, paediatric cardiologists and fellows from four institutions collaborated to develop a multimedia assessment tool for use with medical students and paediatric residents. This tool was developed in support of a novel 3-dimensional virtual reality curriculum created by our group. METHODS Educational domains were identified, and questions were iteratively developed by a group of clinicians from multiple centres to assess understanding of key concepts. To evaluate content validity, content experts completed the assessment and reviewed items, rating item relevance to educational domains using a 4-point Likert scale. An item-level content validity index was calculated for each question, and a scale-level content validity index was calculated for the assessment tool, with scores of ≥0.78 and ≥0.90, respectively, representing excellent content validity. RESULTS The mean content expert assessment score was 92% (range 88-97%). Two questions yielded ≤50% correct content expert answers. The item-level content validity index for 29 out of 32 questions was ≥0.78, and the scale-level content validity index was 0.92. Qualitative feedback included suggestions for future improvement. Questions with ≤50% content expert agreement and item-level content validity index scores <0.78 were removed, yielding a 27-question assessment tool. CONCLUSIONS We describe a multi-centre effort to create and validate a multimedia assessment tool which may be implemented within paediatric trainee cardiology curricula. Future efforts may focus on content refinement and expansion to include additional educational domains.
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Sun Z, Wong YH, Yeong CH. Patient-Specific 3D-Printed Low-Cost Models in Medical Education and Clinical Practice. MICROMACHINES 2023; 14:464. [PMID: 36838164 PMCID: PMC9959835 DOI: 10.3390/mi14020464] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
3D printing has been increasingly used for medical applications with studies reporting its value, ranging from medical education to pre-surgical planning and simulation, assisting doctor-patient communication or communication with clinicians, and the development of optimal computed tomography (CT) imaging protocols. This article presents our experience of utilising a 3D-printing facility to print a range of patient-specific low-cost models for medical applications. These models include personalized models in cardiovascular disease (from congenital heart disease to aortic aneurysm, aortic dissection and coronary artery disease) and tumours (lung cancer, pancreatic cancer and biliary disease) based on CT data. Furthermore, we designed and developed novel 3D-printed models, including a 3D-printed breast model for the simulation of breast cancer magnetic resonance imaging (MRI), and calcified coronary plaques for the simulation of extensive calcifications in the coronary arteries. Most of these 3D-printed models were scanned with CT (except for the breast model which was scanned using MRI) for investigation of their educational and clinical value, with promising results achieved. The models were confirmed to be highly accurate in replicating both anatomy and pathology in different body regions with affordable costs. Our experience of producing low-cost and affordable 3D-printed models highlights the feasibility of utilizing 3D-printing technology in medical education and clinical practice.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth 6845, Australia
- Curtin Health Innovation Research Institute (CHIRI), Faculty of Health Sciences, Curtin University, Perth 6845, Australia
- School of Medicine and Medical Advancement for Better Quality of Life Impact Lab, Taylor’s University, Subang Jaya 47500, Malaysia
| | - Yin How Wong
- School of Medicine and Medical Advancement for Better Quality of Life Impact Lab, Taylor’s University, Subang Jaya 47500, Malaysia
| | - Chai Hong Yeong
- School of Medicine and Medical Advancement for Better Quality of Life Impact Lab, Taylor’s University, Subang Jaya 47500, Malaysia
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16
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Patient-Specific 3D-Printed Models in Pediatric Congenital Heart Disease. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020319. [PMID: 36832448 PMCID: PMC9955978 DOI: 10.3390/children10020319] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
Three-dimensional (3D) printing technology has become increasingly used in the medical field, with reports demonstrating its superior advantages in both educational and clinical value when compared with standard image visualizations or current diagnostic approaches. Patient-specific or personalized 3D printed models serve as a valuable tool in cardiovascular disease because of the difficulty associated with comprehending cardiovascular anatomy and pathology on 2D flat screens. Additionally, the added value of using 3D-printed models is especially apparent in congenital heart disease (CHD), due to its wide spectrum of anomalies and its complexity. This review provides an overview of 3D-printed models in pediatric CHD, with a focus on educational value for medical students or graduates, clinical applications such as pre-operative planning and simulation of congenital heart surgical procedures, and communication between physicians and patients/parents of patients and between colleagues in the diagnosis and treatment of CHD. Limitations and perspectives on future research directions for the application of 3D printing technology into pediatric cardiology practice are highlighted.
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17
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Capelli C, Bertolini M, Schievano S. 3D-printed and computational models: a combined approach for patient-specific studies. 3D Print Med 2023. [DOI: 10.1016/b978-0-323-89831-7.00011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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18
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Fidvi S, Holder J, Li H, Parnes GJ, Shamir SB, Wake N. Advanced 3D Visualization and 3D Printing in Radiology. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1406:103-138. [PMID: 37016113 DOI: 10.1007/978-3-031-26462-7_6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Since the discovery of X-rays in 1895, medical imaging systems have played a crucial role in medicine by permitting the visualization of internal structures and understanding the function of organ systems. Traditional imaging modalities including Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasound (US) present fixed two-dimensional (2D) images which are difficult to conceptualize complex anatomy. Advanced volumetric medical imaging allows for three-dimensional (3D) image post-processing and image segmentation to be performed, enabling the creation of 3D volume renderings and enhanced visualization of pertinent anatomic structures in 3D. Furthermore, 3D imaging is used to generate 3D printed models and extended reality (augmented reality and virtual reality) models. A 3D image translates medical imaging information into a visual story rendering complex data and abstract ideas into an easily understood and tangible concept. Clinicians use 3D models to comprehend complex anatomical structures and to plan and guide surgical interventions more precisely. This chapter will review the volumetric radiological techniques that are commonly utilized for advanced 3D visualization. It will also provide examples of 3D printing and extended reality technology applications in radiology and describe the positive impact of advanced radiological image visualization on patient care.
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Affiliation(s)
- Shabnam Fidvi
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA.
| | - Justin Holder
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
| | - Hong Li
- Department of Radiology, Jacobi Medical Center, Bronx, NY, USA
| | | | | | - Nicole Wake
- GE Healthcare, Aurora, OH, USA
- Center for Advanced Imaging Innovation and Research, NYU Langone Health, New York, NY, USA
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19
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Bindschadler M, Buddhe S, Ferguson MR, Jones T, Friedman SD, Otto RK. HEARTBEAT4D: An Open-source Toolbox for Turning 4D Cardiac CT into VR/AR. J Digit Imaging 2022; 35:1759-1767. [PMID: 35614275 PMCID: PMC9712868 DOI: 10.1007/s10278-022-00659-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 04/20/2022] [Accepted: 05/18/2022] [Indexed: 11/30/2022] Open
Abstract
Four-dimensional data sets are increasingly common in MRI and CT. While clinical visualization often focuses on individual temporal phases capturing the tissue(s) of interest, it may be possible to gain additional insight through exploring animated 3D reconstructions of physiological motion made possible by augmented or virtual reality representations of 4D patient imaging. Cardiac CT acquisitions can provide sufficient spatial resolution and temporal data to support advanced visualization, however, there are no open-source tools readily available to facilitate the transformation from raw medical images to dynamic and interactive augmented or virtual reality representations. To address this gap, we developed a workflow using free and open-source tools to process 4D cardiac CT imaging starting from raw DICOM data and ending with dynamic AR representations viewable on a phone, tablet, or computer. In addition to assembling the workflow using existing platforms (3D Slicer and Unity), we also contribute two new features: 1. custom software which can propagate a segmentation created for one cardiac phase to all others and export to surface files in a fully automated fashion, and 2. a user interface and linked code for the animation and interactive review of the surfaces in augmented reality. Validation of the surface-based areas demonstrated excellent correlation with radiologists' image-based areas (R > 0.99). While our tools were developed specifically for 4D cardiac CT, the open framework will allow it to serve as a blueprint for similar applications applied to 4D imaging of other tissues and using other modalities. We anticipate this and related workflows will be useful both clinically and for educational purposes.
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Affiliation(s)
- M Bindschadler
- Department of Neurology, Seattle, WA, USA
- Department of Radiology, Seattle Childrens, Seattle, WA, USA
| | - S Buddhe
- Department of Pediatrics, Seattle Children's Heart Center and the University of Washington, Seattle, WA, USA
| | - M R Ferguson
- Department of Radiology, University of Washington, Seattle, WA, USA
- Department of Radiology, Seattle Childrens, Seattle, WA, USA
| | - T Jones
- Department of Pediatrics, Seattle Children's Heart Center and the University of Washington, Seattle, WA, USA
| | - S D Friedman
- Department of Neurology, Seattle, WA, USA
- Department of Improvement and Innovation, Seattle, WA, USA
| | - R K Otto
- Department of Radiology, University of Washington, Seattle, WA, USA.
- Department of Radiology, Seattle Childrens, Seattle, WA, USA.
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20
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Ding X, Wen J, Yue X, Zhao Y, Qi C, Wang D, Wei X. Effect of comprehensive nursing intervention for congenital heart disease in children: A meta-analysis. Medicine (Baltimore) 2022; 101:e31184. [PMID: 36253978 PMCID: PMC9575750 DOI: 10.1097/md.0000000000031184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This meta-analysis aimed to assess the impact of nursing interventions (e.g., educational and empathic interviewing, motor exercise, therapeutic play interventions) on the perioperative outcome of children with congenital heart disease (CHD). METHODS We searched PubMed, Embase, Web of Science, Scopus, Cochrane, EBSCO, The Chinese National Knowledge Infrastructure, Wan Fang Data and the VIP Chinese Journal Service platform from the date of database creation to August 2021. Our study adhered to the recommendations of the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RevMan 5.4 and Stata 16.0 were used to complete the meta-analysis. RESULTS This meta-analysis showed that comprehensive nursing intervention reduced both the length of hospital stay (weighted mean difference [WMD] = -1.982, 95%CI [-2.329, -1.634], P < .001) and the related risk of post-operative complications [OR = 0.345, 95%CI (0.225, 0.528), P < .001]. In addition, nursing intervention increased parental satisfaction with the care provided [OR = 0.308, 95%CI (1.923, 6.863), P < .001]. Nursing interventions have also had a positive impact in reducing preoperative anxiety [WMD = -6.721, 95% CI (-7.194, -6.249), P < .001] and postoperative pain [WMD = -7.103, 95% CI (-7.103, -7.663), P < .001] in children. CONCLUSIONS This meta-analysis confirms the beneficial effects of comprehensive nursing interventions in terms of reduced complication rates and shorter hospital stays. The effectiveness of comprehensive nursing in reducing anxiety and pain levels was also demonstrated. The findings support the implementation of comprehensive care interventions in the perioperative period for children with CHD to improve clinical outcomes.
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Affiliation(s)
- Xueying Ding
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Jiaxuan Wen
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Xinxin Yue
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Yudan Zhao
- Department of Cardiology, Affiliated Medical College of Weifang Medical College, Weifang, Shandong province, China
| | - Cuiping Qi
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Di Wang
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
| | - Xiuhong Wei
- School of Nursing, Weifang Medical University, Weifang , Shandong province, China
- *Correspondence: Xiuhong Wei, School of Nursing, Weifang Medical University, 7166 Baotong West Street, Weifang 261053, Shandong province, China (e-mail: )
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21
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Sun Z, Wee C. 3D Printed Models in Cardiovascular Disease: An Exciting Future to Deliver Personalized Medicine. MICROMACHINES 2022; 13:1575. [PMID: 36295929 PMCID: PMC9610217 DOI: 10.3390/mi13101575] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
3D printing has shown great promise in medical applications with increased reports in the literature. Patient-specific 3D printed heart and vascular models replicate normal anatomy and pathology with high accuracy and demonstrate superior advantages over the standard image visualizations for improving understanding of complex cardiovascular structures, providing guidance for surgical planning and simulation of interventional procedures, as well as enhancing doctor-to-patient communication. 3D printed models can also be used to optimize CT scanning protocols for radiation dose reduction. This review article provides an overview of the current status of using 3D printing technology in cardiovascular disease. Limitations and barriers to applying 3D printing in clinical practice are emphasized while future directions are highlighted.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth 6845, Australia
| | - Cleo Wee
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth 6845, Australia
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22
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Cornejo J, Cornejo-Aguilar JA, Vargas M, Helguero CG, Milanezi de Andrade R, Torres-Montoya S, Asensio-Salazar J, Rivero Calle A, Martínez Santos J, Damon A, Quiñones-Hinojosa A, Quintero-Consuegra MD, Umaña JP, Gallo-Bernal S, Briceño M, Tripodi P, Sebastian R, Perales-Villarroel P, De la Cruz-Ku G, Mckenzie T, Arruarana VS, Ji J, Zuluaga L, Haehn DA, Paoli A, Villa JC, Martinez R, Gonzalez C, Grossmann RJ, Escalona G, Cinelli I, Russomano T. Anatomical Engineering and 3D Printing for Surgery and Medical Devices: International Review and Future Exponential Innovations. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6797745. [PMID: 35372574 PMCID: PMC8970887 DOI: 10.1155/2022/6797745] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 12/26/2022]
Abstract
Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients' needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions.
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Affiliation(s)
- José Cornejo
- Facultad de Ingeniería, Universidad San Ignacio de Loyola, La Molina, Lima 15024, Peru
- Department of Medicine and Biology & Department of Physics and Engineering, Bioastronautics and Space Mechatronics Research Group, Lima 15024, Peru
| | | | | | | | - Rafhael Milanezi de Andrade
- Robotics and Biomechanics Laboratory, Department of Mechanical Engineering, Universidade Federal do Espírito Santo, Brazil
| | | | | | - Alvaro Rivero Calle
- Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
| | - Jaime Martínez Santos
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Aaron Damon
- Department of Neurosurgery, Mayo Clinic, FL, USA
| | | | | | - Juan Pablo Umaña
- Cardiovascular Surgery, Instituto de Cardiología-Fundación Cardioinfantil, Universidad del Rosario, Bogotá DC, Colombia
| | | | - Manolo Briceño
- Villamedic Group, Lima, Peru
- Clínica Internacional, Lima, Peru
| | | | - Raul Sebastian
- Department of Surgery, Northwest Hospital, Randallstown, MD, USA
| | | | - Gabriel De la Cruz-Ku
- Universidad Científica del Sur, Lima, Peru
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jiakai Ji
- Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, Bronx, NY, USA
| | - Laura Zuluaga
- Department of Urology, Fundación Santa Fe de Bogotá, Colombia
| | | | - Albit Paoli
- Howard University Hospital, Washington, DC, USA
| | | | | | - Cristians Gonzalez
- Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut of Image-Guided Surgery (IHU-Strasbourg), Strasbourg, France
| | | | - Gabriel Escalona
- Experimental Surgery and Simulation Center, Department of Digestive Surgery, Catholic University of Chile, Santiago, Chile
| | - Ilaria Cinelli
- Aerospace Human Factors Association, Aerospace Medical Association, VA, USA
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23
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PARK CHUNKYU, KIM JUNGHUN. DEVELOPMENT OF A THREE-DIMENSIONAL-PRINTED HEART MODEL REPLICATING THE ELASTICITY, TEAR RESISTANCE, AND HARDNESS OF PIG HEART USING AGILUS AND TANGO. J MECH MED BIOL 2022. [DOI: 10.1142/s0219519422400073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study proposes a manufacturing method for reproducing some physical properties of the heart by comparing the elasticity, tear resistance, and hardness of a pig heart and three-dimensional printing materials, Agilus and Tango. A Digital Force Gauge was used to analyze elastic modulus and tear resistance, whereas a Shore A hardness meter was used to measure hardness. Agilus and Tango had 10 and 5 times higher elasticity, respectively, 2 and 4 times higher tear resistance, and a higher Shore A hardness than the pig heart. In summary, the pig heart had a more similar elasticity and Shore A hardness than the Tango sample, whereas more tear resistance was similar to the Agilus sample. Therefore, we proposed elasticity and tear resistance equations that can be used to build a heart model and a conversion table for heart fabrication at various thicknesses.
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Affiliation(s)
- CHUN-KYU PARK
- Department of Biomedical Engineering, Kyungpook National University, Sangyeok-dong, Buk-gu, Daegu, Republic of Korea
| | - JUNGHUN KIM
- Bio-Medical Research Institute, Kyungpook National University Hospital, Sangyeok-dong, Buk-gu, Daegu, Republic of Korea
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24
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Meyer-Szary J, Luis MS, Mikulski S, Patel A, Schulz F, Tretiakow D, Fercho J, Jaguszewska K, Frankiewicz M, Pawłowska E, Targoński R, Szarpak Ł, Dądela K, Sabiniewicz R, Kwiatkowska J. The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals-Cross-Sectional Multispecialty Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3331. [PMID: 35329016 PMCID: PMC8953417 DOI: 10.3390/ijerph19063331] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/18/2022] [Accepted: 03/05/2022] [Indexed: 12/19/2022]
Abstract
Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and education, development of surgical guides and other tools, patient-specific implants, bioprinted organs or structures, and counseling of patients. It was evident that pre-procedural planning and rehearsing of unusual or difficult procedures and training of medical professionals in these procedures are extremely useful and transformative.
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Affiliation(s)
- Jarosław Meyer-Szary
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Marlon Souza Luis
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- First Doctoral School, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Szymon Mikulski
- Department of Head and Neck Surgery, Singapore General Hospital, Singapore 169608, Singapore
| | - Agastya Patel
- First Doctoral School, Medical University of Gdańsk, 80-211 Gdańsk, Poland
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Finn Schulz
- University Clinical Centre in Gdańsk, 80-952 Gdańsk, Poland
| | - Dmitry Tretiakow
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Justyna Fercho
- Neurosurgery Department, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Kinga Jaguszewska
- Department of Gynecology, Obstetrics and Neonatology, Division of Gynecology and Obstetrics, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Mikołaj Frankiewicz
- Department of Urology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Ewa Pawłowska
- Department of Oncology and Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Radosław Targoński
- 1st Department of Cardiology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Łukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, Poland
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Katarzyna Dądela
- Department of Pediatric Cardiology, University Children's Hospital, Faculty of Medicine, Jagiellonian University Medical College, 30-663 Krakow, Poland
| | - Robert Sabiniewicz
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Joanna Kwiatkowska
- Department of Pediatric Cardiology and Congenital Heart Defects, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
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Campbell CS, Patey C, Dubrowski A, Norman P, Bartellas M. Casting Into The Future: Effectiveness of a 3D-Printed Fishhook Removal Task Trainer. Cureus 2022; 14:e22609. [PMID: 35371625 PMCID: PMC8958115 DOI: 10.7759/cureus.22609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/05/2022] Open
Abstract
While participation in both recreational and commercial fisheries is common, it is not risk-free. Puncture wounds caused by fishhooks are commonly incurred by people who fish recreationally and commercially. Despite literature that details the challenges of treating fishhook injuries and specific techniques for fishhook removal, only a single publication focuses on teaching fishhook removal techniques to medical trainees and staff physicians. The aim of this technical report is to investigate the efficacy of using a 3D-printed task trainer for simulating and teaching fishhook removal techniques. To facilitate this, the 3D-printed Fishhook Emergency Removal Simulator (FISH-ER 3D) was designed by the Memorial University of Newfoundland (MUN) MED 3D Network and satellite research partner, Carbonear Institute for Rural Reach and Innovation by the Sea (CIRRIS). A sample of 22 medical residents and staff physicians were asked to evaluate the task trainer by way of a practical session, which was then followed by an evaluation survey. The overall realism of the 3D-printed task trainer components was ranked as “realistic” or “very realistic” by 86% of the evaluators. The majority of evaluators rated acquiring and performing various fishhook removal techniques using the simulator as “easy” or “somewhat easy”. Most evaluators found that using the task trainer increased user competence and confidence with fishhook removal techniques, and 100% of the evaluators rated the task trainer as a “very valuable” or “valuable” training tool. The results of this report demonstrate support for the FISH-ER 3D as an efficacious simulator for building competence in fishhook removal techniques.
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An Interactive, Multimodal Curriculum to Teach Pediatric Cardiology to House Staff. Pediatr Cardiol 2022; 43:1359-1364. [PMID: 35238959 PMCID: PMC8893060 DOI: 10.1007/s00246-022-02859-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/23/2022] [Indexed: 11/24/2022]
Abstract
Pediatricians must be able to diagnose, triage, and manage infants and children with congenital heart disease. The pediatric cardiology division at the Medical University of South Carolina updated their curriculum for pediatric residents to a format supported by constructivist learning theory. The purpose of this study is to determine if shorter, interactive learning with fellow and faculty involvement improved pediatric cardiology knowledge demonstrated through test scores and resident satisfaction. A curriculum of short lectures and interactive workshops was delivered over 6 weeks in August and September 2018. Residents answered a 10-question pretest prior to the curriculum, followed by a post-test immediately after the last session and a delayed post-test 8 months later. Residents also provided summative feedback on the educational sessions. Sixty-six residents were eligible to participate in the curriculum with 44 (67%) completing the pretest, 40 (61%) completing the post-test, and 33 (50%) completing the delayed post-test. The mean score increased significantly from 56 to 68% between the pretest and post-test (p = 0.0018). The delayed post-test mean score remained high at 71% without significant change (p = 0.46). Overall feedback was positive highlighting the interactive nature of lectures and the participation of cardiology fellows. Using an interactive, multimodal educational series, pediatric residents had a significant increase in pediatric cardiology test scores and demonstrated good retention.
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Pollak U, Feinstein Y, Mannarino CN, McBride ME, Mendonca M, Keizman E, Mishaly D, van Leeuwen G, Roeleveld PP, Koers L, Klugman D. The horizon of pediatric cardiac critical care. Front Pediatr 2022; 10:863868. [PMID: 36186624 PMCID: PMC9523119 DOI: 10.3389/fped.2022.863868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/22/2022] [Indexed: 11/21/2022] Open
Abstract
Pediatric Cardiac Critical Care (PCCC) is a challenging discipline where decisions require a high degree of preparation and clinical expertise. In the modern era, outcomes of neonates and children with congenital heart defects have dramatically improved, largely by transformative technologies and an expanding collection of pharmacotherapies. Exponential advances in science and technology are occurring at a breathtaking rate, and applying these advances to the PCCC patient is essential to further advancing the science and practice of the field. In this article, we identified and elaborate on seven key elements within the PCCC that will pave the way for the future.
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Affiliation(s)
- Uri Pollak
- Section of Pediatric Critical Care, Hadassah University Medical Center, Jerusalem, Israel.,Faculty of Medicine, the Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yael Feinstein
- Pediatric Intensive Care Unit, Soroka University Medical Center, Be'er Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Candace N Mannarino
- Divisions of Cardiology and Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Mary E McBride
- Divisions of Cardiology and Critical Care Medicine, Departments of Pediatrics and Medical Education, Northwestern University Feinberg School of Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Malaika Mendonca
- Pediatric Intensive Care Unit, Children's Hospital, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Eitan Keizman
- Department of Cardiac Surgery, The Leviev Cardiothoracic and Vascular Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - David Mishaly
- Pediatric and Congenital Cardiac Surgery, Edmond J. Safra International Congenital Heart Center, The Chaim Sheba Medical Center, The Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel
| | - Grace van Leeuwen
- Pediatric Cardiac Intensive Care Unit, Sidra Medicine, Ar-Rayyan, Qatar.,Department of Pediatrics, Weill Cornell Medicine, Ar-Rayyan, Qatar
| | - Peter P Roeleveld
- Department of Pediatric Intensive Care, Leiden University Medical Center, Leiden, Netherlands
| | - Lena Koers
- Department of Pediatric Intensive Care, Leiden University Medical Center, Leiden, Netherlands
| | - Darren Klugman
- Pediatrics Cardiac Critical Care Unit, Blalock-Taussig-Thomas Pediatric and Congenital Heart Center, Johns Hopkins Medicine, Baltimore, MD, United States
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Asif A, Lee E, Caputo M, Biglino G, Shearn AIU. Role of 3D printing technology in paediatric teaching and training: a systematic review. BMJ Paediatr Open 2021; 5:10.1136/bmjpo-2021-001050. [PMID: 35290958 PMCID: PMC8655595 DOI: 10.1136/bmjpo-2021-001050] [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: 02/05/2021] [Accepted: 05/15/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND In the UK, undergraduate paediatric training is brief, resulting in trainees with a lower paediatric knowledge base compared with other aspects of medicine. With congenital conditions being successfully treated at childhood, adult clinicians encounter and will need to understand these complex pathologies. Patient-specific 3D printed (3DP) models have been used in clinical training, especially for rarer, complex conditions. We perform a systematic review to evaluate the evidence base in using 3DP models to train paediatricians, surgeons, medical students and nurses. METHODS Online databases PubMed, Web of Science and Embase were searched between January 2010 and April 2020 using search terms relevant to "paediatrics", "education", "training" and "3D printing". Participants were medical students, postgraduate trainees or clinical staff. Comparative studies (patient-specific 3DP models vs traditional teaching methods) and non-comparative studies were included. Outcomes gauged objective and subjective measures: test scores, time taken to complete tasks, self-reported confidence and personal preferences on 3DP models. If reported, the cost of and time taken to produce the models were noted. RESULTS From 587 results, 15 studies fit the criteria of the review protocol, with 5/15 being randomised controlled studies and 10/15 focussing on cardiovascular conditions. Participants using 3DP models demonstrated improved test scores and faster times to complete procedures and identify anatomical landmarks compared with traditional teaching methods (2D diagrams, lectures, videos and supervised clinical events). User feedback was positive, reporting greater user self-confidence in understanding concepts with users wishing for integrated use of 3DP in regular teaching. Four studies reported the costs and times of production, which varied depending on model complexity and printer. 3DP models were cheaper than 'off-the-shelf' models available on the market and had the benefit of using real-world pathologies. These mostly non-randomised and single-centred studies did not address bias or report long-term or clinically translatable outcomes. CONCLUSIONS 3DP models were associated with greater user satisfaction and good short-term educational outcomes, with low-quality evidence. Multicentred, randomised studies with long-term follow-up and clinically assessed outcomes are needed to fully assess their benefits in this setting. PROSPERO REGISTRATION NUMBER CRD42020179656.
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Affiliation(s)
- Ashar Asif
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Elgin Lee
- Children's Services Directorate, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Massimo Caputo
- Bristol Medical School, University of Bristol, Bristol, UK.,Bristol Heart Institute, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - Giovanni Biglino
- Bristol Heart Institute, University Hospitals Bristol and Weston NHS Trust, Bristol, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew Ian Underwood Shearn
- Bristol Medical School, University of Bristol, Bristol, UK .,Bristol Heart Institute, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
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Feasibility and accuracy of printed models of complex cardiac defects in small infants from cardiac computed tomography. Pediatr Radiol 2021; 51:1983-1990. [PMID: 34129069 DOI: 10.1007/s00247-021-05110-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 03/04/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Three-dimensional (3-D) printed models are increasingly used to enhance understanding of complex anatomy in congenital heart disease. OBJECTIVE To assess feasibility and accuracy of 3-D printed models obtained from cardiac CT scans in young children with complex congenital heart diseases. MATERIALS AND METHODS We included children with conotruncal heart anomalies who were younger than 2 years and had a cardiac CT scan in the course of their follow-up. We used cardiac CT scan datasets to generate 3-D models. To assess the models' accuracy, we compared four diameters for each child between the CT images and the printed models, including the largest diameters (Dmax) of ventricular septal defects and aortic annulus and their minimal diameters (Dmin). RESULTS We obtained images from 14 children with a mean age of 5.5 months (range 1-24 months) and a mean weight of 6.7 kg (range 3.4-14.5 kg). We generated 3-D models for all children. Mean measurement difference between CT images and 3-D models was 0.13 mm for Dmin and 0.12 mm for Dmax for ventricular septal defect diameters, and it was 0.16 mm for Dmin and -0.13 mm for Dmax for aortic annulus diameter, indicating a non-clinically significant difference. CONCLUSION Three-dimensional printed models could be feasibly generated from cardiac CT scans in a small pediatric population with complex congenital heart diseases. This technique is highly accurate and reliably reflects the same structural dimensions when compared to CT source images.
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Mufarrih SH, Mahmood F, Qureshi NQ, Yunus R, Quraishi I, Baribeau V, Sharkey A, Matyal R, Khabbaz KR. Three-Dimensional Printing of Patient-Specific Heart Valves: Separating Facts From Fiction and Myth From Reality. J Cardiothorac Vasc Anesth 2021; 36:2643-2655. [PMID: 34654635 DOI: 10.1053/j.jvca.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/05/2021] [Accepted: 09/08/2021] [Indexed: 11/11/2022]
Abstract
The development of prosthetic heart valves by Dr. Charles Hufnagel in 1952 was a major clinical innovation; however, it was not an ideal solution. Mechanical prosthetic heart valves are rigid, immunogenic, require anticoagulation, do not grow with the patient, and have a finite life.1 An ideal prosthetic valve should overcome all these limitations. Considering the prevalence of valvular heart disorders, there is considerable interest in the creation of patient-specific heart valves. Following the introduction of three-dimensional (3D) printing in 1986 by Chuck Hill, rapid advances in multimodality 3D imaging and modeling have led to a generation of tangible replicas of patient-specific anatomy. The science of organogenesis has gained importance for a multitude of valid reasons: as an alternate source of organs, for realistic drug testing, as an alternative to animal testing, and for transplants that grow with the patient. What scientists imagined to be seemingly impossible in the past now seems just a step away from becoming a reality. However, due to the disruptive nature of this technology, often there are commercially-motivated claims of originality and overstatement of the scope and applicability of 3D printing. It often is difficult to separate fact from fiction and myth from reality. In this manuscript, the authors have reviewed the historic perspective, status of the basic techniques of organogenesis with specific reference to heart valves, and their potential.
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Affiliation(s)
- Syed Hamza Mufarrih
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Nada Qaisar Qureshi
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Rayaan Yunus
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Ibrahim Quraishi
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Vincent Baribeau
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Aidan Sharkey
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Robina Matyal
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Kamal R Khabbaz
- Department of Surgery, Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
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Karsenty C, Guitarte A, Dulac Y, Briot J, Hascoet S, Vincent R, Delepaul B, Vignaud P, Djeddai C, Hadeed K, Acar P. The usefulness of 3D printed heart models for medical student education in congenital heart disease. BMC MEDICAL EDUCATION 2021; 21:480. [PMID: 34496844 PMCID: PMC8424617 DOI: 10.1186/s12909-021-02917-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/28/2021] [Indexed: 05/29/2023]
Abstract
BACKGROUND Three-dimensional (3D) printing technology enables the translation of 2-dimensional (2D) medical imaging into a physical replica of a patient's individual anatomy and may enhance the understanding of congenital heart defects (CHD). We aimed to evaluate the usefulness of a spectrum of 3D-printed models in teaching CHD to medical students. RESULTS We performed a prospective, randomized educational procedure to teach fifth year medical students four CHDs (atrial septal defect (ASD, n = 74), ventricular septal defect (VSD, n = 50), coarctation of aorta (CoA, n = 118) and tetralogy of Fallot (ToF, n = 105)). Students were randomized into printing groups or control groups. All students received the same 20 min lecture with projected digital 2D images. The printing groups also manipulated 3D printed models during the lecture. Both groups answered an objective survey (Multiple-choice questionnaire) twice, pre- and post-test, and completed a post-lecture subjective survey. Three hundred forty-seven students were included and both teaching groups for each CHD were comparable in age, sex and pre-test score. Overall, objective knowledge improved after the lecture and was higher in the printing group compared to the control group (16.3 ± 2.6 vs 14.8 ± 2.8 out of 20, p < 0.0001). Similar results were observed for each CHD (p = 0.0001 ASD group; p = 0.002 VSD group; p = 0.0005 CoA group; p = 0.003 ToF group). Students' opinion of their understanding of CHDs was higher in the printing group compared to the control group (respectively 4.2 ± 0.5 vs 3.8 ± 0.4 out of 5, p < 0.0001). CONCLUSION The use of 3D printed models in CHD lectures improve both objective knowledge and learner satisfaction for medical students. The practice should be mainstreamed.
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Affiliation(s)
- Clement Karsenty
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France.
- Institut Des Maladies Métaboliques Et Cardiovasculaires, Université de Toulouse, INSERM U1048, I2MC, 1, Avenue Jean Poulhès-BP84225, Toulouse, France.
| | - Aitor Guitarte
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France
| | - Yves Dulac
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France
| | - Jerome Briot
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France
| | - Sebastien Hascoet
- Department of Pediatric and Adult Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph Reference Center of Complex Congenital Heart Diseases M3C, Le Plessis Robinson, France
| | - Remi Vincent
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France
| | - Benoit Delepaul
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France
| | - Paul Vignaud
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France
| | - Camelia Djeddai
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France
| | - Khaled Hadeed
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France
| | - Philippe Acar
- Pediatric cardiology unit, Children Hospital, CHU Toulouse, 330 Avenue de Grande Bretagne TSA 70034, 31059, Toulouse cedex 9, France
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Awori J, Friedman SD, Chan T, Howard C, Seslar S, Soriano BD, Buddhe S. 3D models improve understanding of congenital heart disease. 3D Print Med 2021; 7:26. [PMID: 34471999 PMCID: PMC8411549 DOI: 10.1186/s41205-021-00115-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/27/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction Understanding congenital heart disease (CHD) is vital for medical personnel and parents of affected children. While traditional 2D schematics serve as the typical approach used, several studies have shown these models to be limiting in understanding complex structures. Recent world-emphasis has shifted to 3D printed models as a complement to 2D imaging to bridge knowledge and create new opportunities for experiential learning. We sought to systematically compare 3D digital and physical models for medical personnel and parent education compared to traditional methods. Methods 3D printed and digital models were made out of MRI and CT data for 20 common CHD. Fellows and nurse practitioners used these models to explore intra-cardiac pathologies following traditional teaching. The models were also used for parent education in outpatient settings after traditional education. The participants were then asked to fill out a Likert scale questionnaire to assess their understanding and satisfaction with different teaching techniques. These ratings were compared using paired t-tests and Pearson’s correlation. Results Twenty-five medical personnel (18 fellows; 2 nurses; 4 nurse practitioners and one attending) and twenty parents participated in the study. The diagnosis varied from simple mitral valve pathology to complex single ventricle palliation. Parent and medical personnel perceived understanding with digital models was significantly higher than traditional (p = 0.01). Subjects also felt that physical models were overall more useful than digital ones (p = 0.001). Physicians using models for parent education also perceived the models to be useful, not significantly impacting their clinical workflow. Conclusions 3D models, both digital and printed, enhance medical personnel and parental perceived understanding of CHD. Supplementary Information The online version contains supplementary material available at 10.1186/s41205-021-00115-7.
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Affiliation(s)
- Jonathan Awori
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA.
| | - Seth D Friedman
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Titus Chan
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Christopher Howard
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Steve Seslar
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Brian D Soriano
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
| | - Sujatha Buddhe
- Division of Pediatric Cardiology and Radiology, Seattle Children's Hospital, Seattle, WA, USA
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Cernica D, Benedek I, Polexa S, Tolescu C, Benedek T. 3D Printing-A Cutting Edge Technology for Treating Post-Infarction Patients. Life (Basel) 2021; 11:910. [PMID: 34575059 PMCID: PMC8468787 DOI: 10.3390/life11090910] [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] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/25/2021] [Accepted: 08/28/2021] [Indexed: 02/06/2023] Open
Abstract
The increasing complexity of cardiovascular interventions requires advanced peri-procedural imaging and tailored treatment. Three-dimensional printing technology represents one of the most significant advances in the field of cardiac imaging, interventional cardiology or cardiovascular surgery. Patient-specific models may provide substantial information on intervention planning in complex cardiovascular diseases, and volumetric medical imaging from CT or MRI can be translated into patient-specific 3D models using advanced post-processing applications. 3D printing and additive manufacturing have a great variety of clinical applications targeting anatomy, implants and devices, assisting optimal interventional treatment and post-interventional evaluation. Although the 3D printing technology still lacks scientific evidence, its benefits have been shown in structural heart diseases as well as for treatment of complex arrhythmias and corrective surgery interventions. Recent development has enabled transformation of conventional 3D printing into complex 3D functional living tissues contributing to regenerative medicine through engineered bionic materials such hydrogels, cell suspensions or matrix components. This review aims to present the most recent clinical applications of 3D printing in cardiovascular medicine, highlighting also the potential for future development of this revolutionary technology in the medical field.
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Affiliation(s)
- Daniel Cernica
- Center of Advanced Research in Multimodal Cardiovascular Imaging, Cardio Med Medical Center, 540124 Targu Mures, Romania; (D.C.); (I.B.); (C.T.); (T.B.)
- Cardiology Department, University of Medicine, Pharmacy, Sciences and Technologies “George Emil Palade”, 540142 Targu Mures, Romania
| | - Imre Benedek
- Center of Advanced Research in Multimodal Cardiovascular Imaging, Cardio Med Medical Center, 540124 Targu Mures, Romania; (D.C.); (I.B.); (C.T.); (T.B.)
- Cardiology Department, University of Medicine, Pharmacy, Sciences and Technologies “George Emil Palade”, 540142 Targu Mures, Romania
| | - Stefania Polexa
- Center of Advanced Research in Multimodal Cardiovascular Imaging, Cardio Med Medical Center, 540124 Targu Mures, Romania; (D.C.); (I.B.); (C.T.); (T.B.)
- Cardiology Department, University of Medicine, Pharmacy, Sciences and Technologies “George Emil Palade”, 540142 Targu Mures, Romania
| | - Cosmin Tolescu
- Center of Advanced Research in Multimodal Cardiovascular Imaging, Cardio Med Medical Center, 540124 Targu Mures, Romania; (D.C.); (I.B.); (C.T.); (T.B.)
- Cardiology Department, University of Medicine, Pharmacy, Sciences and Technologies “George Emil Palade”, 540142 Targu Mures, Romania
| | - Theodora Benedek
- Center of Advanced Research in Multimodal Cardiovascular Imaging, Cardio Med Medical Center, 540124 Targu Mures, Romania; (D.C.); (I.B.); (C.T.); (T.B.)
- Cardiology Department, University of Medicine, Pharmacy, Sciences and Technologies “George Emil Palade”, 540142 Targu Mures, Romania
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Hopfner C, Jakob A, Tengler A, Grab M, Thierfelder N, Brunner B, Thierij A, Haas NA. Design and 3D printing of variant pediatric heart models for training based on a single patient scan. 3D Print Med 2021; 7:25. [PMID: 34463879 PMCID: PMC8406574 DOI: 10.1186/s41205-021-00116-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/15/2021] [Indexed: 11/24/2022] Open
Abstract
Background 3D printed models of pediatric hearts with congenital heart disease have been proven helpful in simulation training of diagnostic and interventional catheterization. However, anatomically accurate 3D printed models are traditionally based on real scans of clinical patients requiring specific imaging techniques, i.e., CT or MRI. In small children both imaging technologies are rare as minimization of radiation and sedation is key. 3D sonography does not (yet) allow adequate imaging of the entire heart for 3D printing. Therefore, an alternative solution to create variant 3D printed heart models for teaching and hands-on training has been established. Methods In this study different methods utilizing image processing and computer aided design software have been established to overcome this shortage and to allow unlimited variations of 3D heart models based on single patient scans. Patient-specific models based on a CT or MRI image stack were digitally modified to alter the original shape and structure of the heart. Thereby, 3D hearts showing various pathologies were created. Training models were adapted to training level and aims of hands-on workshops, particularly for interventional cardiology. Results By changing the shape and structure of the original anatomy, various training models were created of which four examples are presented in this paper: 1. Design of perimembranous and muscular ventricular septal defect on a heart model with patent ductus arteriosus, 2. Series of heart models with atrial septal defect showing the long-term hemodynamic effect of the congenital heart defect on the right atrial and ventricular wall, 3. Implementation of simplified heart valves and addition of the myocardium to a right heart model with pulmonary valve stenosis, 4. Integration of a constructed 3D model of the aortic valve into a pulsatile left heart model with coarctation of the aorta. All presented models have been successfully utilized and evaluated in teaching or hands-on training courses. Conclusions It has been demonstrated that non-patient-specific anatomical variants can be created by modifying existing patient-specific 3D heart models. This way, a range of pathologies can be modeled based on a single CT or MRI dataset. Benefits of designed 3D models for education and training purposes have been successfully applied in pediatric cardiology but can potentially be transferred to simulation training in other medical fields as well.
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Affiliation(s)
- Carina Hopfner
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany.
| | - Andre Jakob
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Anja Tengler
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Maximilian Grab
- Department of Cardiac Surgery, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Nikolaus Thierfelder
- Department of Cardiac Surgery, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Barbara Brunner
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Alisa Thierij
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Nikolaus A Haas
- Department of Pediatric Cardiology and Pediatric Intensive Care, LMU Klinikum, Campus Großhadern, Marchioninistr. 15, 81377, Munich, Germany
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35
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, GPO Box U1987, Perth, Australia
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Michiels C, Jambon E, Sarrazin J, Boulenger de Hauteclocque A, Ricard S, Grenier N, Faessel M, Bos F, Bernhard JC. [Comprehensive review of 3D printing use in medicine: Comparison with practical applications in urology]. Prog Urol 2021; 31:762-771. [PMID: 34154961 DOI: 10.1016/j.purol.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/17/2021] [Accepted: 04/02/2021] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Over the past few years, 3D printing has evolved rapidly. This has resulted in an increasing number of scientific publications reporting on the medical use of 3D printing. These applications can range from patient information, preoperative planning, education, or 3D printing of patient-specific surgical implants. The objective of this review was to give an overview of the different applications in urology and other disciplines based on a selection of publications. METHODS In the current narrative review the Medline database was searched to identify all the related reports discussing the use of 3D printing in the medical field and more specifically in Urology. 3D printing applications were categorized so they could be searched more thoroughly within the Medline database. RESULTS Three-dimensional printing can help improve pre-operative patient information, anatomy and medical trainee education. The 3D printed models may assist the surgeon in preoperative planning or become patient-specific surgical simulation models. In urology, kidney cancer surgery is the most concerned by 3D printing-related publications, for preoperative planning, but also for surgical simulation and surgical training. CONCLUSION 3D printing has already proven useful in many medical applications, including urology, for patient information, education, pre-operative planning and surgical simulation. All areas of urology are involved and represented in the literature. Larger randomized controlled studies will certainly allow 3D printing to benefit patients in routine clinical practice.
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Affiliation(s)
- C Michiels
- Service de chirurgie urologique et transplantation rénale, CHU Bordeaux, place Amélie Raba Léon, 33076 Bordeaux cedex, France.
| | - E Jambon
- Service d'imagerie et radiologie interventionnelle, CHU Bordeaux, France.
| | - J Sarrazin
- Fablab et Technoshop Coh@bit, IUT, Université de Bordeaux, France.
| | - A Boulenger de Hauteclocque
- Service de chirurgie urologique et transplantation rénale, CHU Bordeaux, place Amélie Raba Léon, 33076 Bordeaux cedex, France.
| | - S Ricard
- Service de chirurgie urologique et transplantation rénale, CHU Bordeaux, place Amélie Raba Léon, 33076 Bordeaux cedex, France; Réseau français de recherche sur le cancer du rein UroCCR, Bordeaux, France
| | - N Grenier
- Service d'imagerie et radiologie interventionnelle, CHU Bordeaux, France
| | - M Faessel
- Fablab et Technoshop Coh@bit, IUT, Université de Bordeaux, France.
| | - F Bos
- Fablab et Technoshop Coh@bit, IUT, Université de Bordeaux, France.
| | - J C Bernhard
- Service de chirurgie urologique et transplantation rénale, CHU Bordeaux, place Amélie Raba Léon, 33076 Bordeaux cedex, France; Réseau français de recherche sur le cancer du rein UroCCR, Bordeaux, France.
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Gómez-Ciriza G, Gómez-Cía T, Rivas-González JA, Velasco Forte MN, Valverde I. Affordable Three-Dimensional Printed Heart Models. Front Cardiovasc Med 2021; 8:642011. [PMID: 34150862 PMCID: PMC8211988 DOI: 10.3389/fcvm.2021.642011] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/29/2021] [Indexed: 12/24/2022] Open
Abstract
This is a 7-years single institution study on low-cost cardiac three-dimensional (3D) printing based on the use of free open-source programs and affordable printers and materials. The process of 3D printing is based on several steps (image acquisition, segmentation, mesh optimization, slicing, and three-dimensional printing). The necessary technology and the processes to set up an affordable three-dimensional printing laboratory are hereby described in detail. Their impact on surgical and interventional planning, medical training, communication with patients and relatives, patients' perception on care, and new cardiac device development was analyzed. A total of 138 low-cost heart models were designed and printed from 2013 to 2020. All of them were from different congenital heart disease patients. The average time for segmentation and design of the hearts was 136 min; the average time for printing and cleaning the models was 13.5 h. The average production cost of the models was €85.7 per model. This is the most extensive series of 3D printed cardiac models published to date. In this study, the possibility of manufacturing three-dimensional printed heart models in a low-cost facility fulfilling the highest requirements from a technical and clinical point of view is demonstrated.
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Affiliation(s)
- Gorka Gómez-Ciriza
- Fabrication Laboratory, Virgen del Rocio University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - Tomás Gómez-Cía
- Fabrication Laboratory, Virgen del Rocio University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain.,Plastic Surgery and Burns Unit, Virgen del Rocio University Hospital, Seville, Spain
| | - José Antonio Rivas-González
- Fabrication Laboratory, Virgen del Rocio University Hospital, Institute of Biomedicine of Seville (IBIS), Seville, Spain
| | - Mari Nieves Velasco Forte
- Division of Imaging Sciences and Biomedical Engineering, King's College London, The Rayne Institute, St. Thomas' Hospital, London, United Kingdom
| | - Israel Valverde
- Division of Imaging Sciences and Biomedical Engineering, King's College London, The Rayne Institute, St. Thomas' Hospital, London, United Kingdom.,Cardiovascular Pathology Unit, Institute of Biomedicine of Seville (IBIS), Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares, Hospital Virgen de Rocio/Consejo Superior de Investigaciones Científicas/University of Seville, Seville, Spain.,Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
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Revels JW, Wang SS, Gharai LR, Febbo J, Fadl S, Bastawrous S. The role of CT in planning percutaneous structural heart interventions: Where to measure and why. Clin Imaging 2021; 76:247-264. [PMID: 33991744 DOI: 10.1016/j.clinimag.2021.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/05/2021] [Accepted: 04/12/2021] [Indexed: 11/18/2022]
Abstract
As research continues to demonstrate successes in the use of percutaneous trans-vascular techniques in structural heart intervention, both the subspecialty trained and non-subspecialty trained cardiac imager find themselves performing and reporting larger amounts of information regarding cardiovascular findings. It is therefore imperative that the imager gains understanding and appreciation for how these various measurements are obtained, as well as their implication in a patient's care. Cardiac gated computed tomography (CT) has solidified its role and ability at providing high resolution images that can be used to obtain the key measurements used in structural heart intervention planning. This manuscript aims to provide an overview of what measurements are necessary to report when interpreting CT examinations purposed for structural heart intervention. This includes a review on indications and brief discussion on complications related to these procedures.
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Affiliation(s)
- Jonathan W Revels
- Department of Radiology, University of New Mexico, MSC 10 5530, 1 University of New Mexico, Albuquerque, NM 87131, USA. https://twitter.com/JRevRad1
| | - Sherry S Wang
- Department of Radiology and Imaging Sciences, University of Utah, 30 North 1900 East #1A71, Salt Lake City, UT 84132, USA. https://twitter.com/drsherrywang
| | - Leila R Gharai
- Department of Radiology, Virginia Commonwealth University, West Hospital, 1200 East Broad Street, North Wing, Room 2-013, Box 980470, Richmond, VA 23298-0470, USA
| | - Jennifer Febbo
- Department of Radiology, University of New Mexico, MSC 10 5530, 1 University of New Mexico, Albuquerque, NM 87131, USA. https://twitter.com/JennFebb
| | - Shaimaa Fadl
- Department of Radiology, Virginia Commonwealth University, West Hospital, 1200 East Broad Street, North Wing, Room 2-013, Box 980470, Richmond, VA 23298-0470, USA
| | - Sarah Bastawrous
- Department of Radiology, University of Washington, Puget Sound Veterans Administration Hospital, 1959 NE Pacific Street, Room BB308, Box 357115, Seattle, WA 98195, USA. https://twitter.com/sbastawrous1
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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.
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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
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Kozak MF, Afiune JY, Grosse-Wortmann L. Current Use of Pediatric Cardiac Magnetic Resonance Imaging in Brazil. Arq Bras Cardiol 2021; 116:305-312. [PMID: 33656080 PMCID: PMC7909959 DOI: 10.36660/abc.20190860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 06/10/2020] [Indexed: 11/23/2022] Open
Abstract
Fundamento Dados sobre o uso de ressonância magnética cardíaca (RMC) em crianças no Brasil são escassos. Objetivos Buscamos oferecer informações sobre as práticas atuais de RMC pediátricas no Brasil. Métodos Um questionário foi enviado a médicos solicitantes de RMC de todo o país, cobrindo informações sobre si próprios, sobre seus serviços de RMC, contexto clínico dos pacientes e sobre os obstáculos para a realização de RMC em crianças. Para a análise estatística, um p < 0,05 bilateral foi considerado significativo. Resultados A pesquisa obteve 142 respostas. Foi relatado que a RMC está disponível para 79% dos respondentes, dos quais 52% raramente ou nunca a utilizam. As indicações mais comuns são cardiomiopatias (84%), pós-operatório de correção de tetralogia de Fallot (81%) e malformações do arco aórtico (53%). A complexidade do exame se correlacionou à relação RMC/cirurgia (Rho = 0,48, IC 95% = 0,32-0,62, p < 0,0001) e ao número de exames de RMC (Rho = 0,52, IC 95% = 0,38-0,64, p < 0,0001). A complexidade da RMC esteve associada à sua realização por cardiologistas pediátricos (RC 2,04, IC 95% 1,2-3,89, p < 0,01). Os principais obstáculos ao uso mais frequente de RMC foram o alto custo (65%), a necessidade de sedação (60%) e o número insuficiente de profissionais qualificados (55%). Conclusão A RMC pediátrica não é usada frequentemente no Brasil. A presença de um cardiologista pediátrico a frente dos exames esteve associado ao uso de RMC em pacientes mais complexos. O treinamento de especialistas em RMC pediátrica e a educação dos médicos solicitantes são passos importantes na direção de um uso mais abrangente de RMC no Brasil. (Arq Bras Cardiol. 2021; 116(2):305-312)
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Affiliation(s)
- Marcelo Felipe Kozak
- Instituto de Cardiologia do Distrito Federal - Cardiologia Pediátrica, Brasília, DF - Brasil.,Hospital da Criança de Brasília José de Alencar - Ecocardiografia, Brasília, DF - Brasil
| | - Jorge Yussef Afiune
- Instituto de Cardiologia do Distrito Federal - Cardiologia Pediátrica, Brasília, DF - Brasil
| | - Lars Grosse-Wortmann
- Doernbecher Children's Hospital, Oregon Health and Science University - Division of Pediatric Cardiology, Department of Pediatrics, Portland, Oregon - EUA.,The Hospital for Sick Children, University of Toronto - Department of Pediatrics, Toronto, Ontario - Canadá
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Kim JH, Park CK, Park JE, Lee JM. 3D print material study to reproduce the function of pig heart tissue. Technol Health Care 2021; 29:27-34. [PMID: 33682742 PMCID: PMC8150471 DOI: 10.3233/thc-218003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Three-dimensional (3D) printing technology for heart simulation can be represented as complex anatomical structures, and objective information can be provided. OBJECTIVE: We studied 3D print material to find a material with the same elastic coefficient as pig elastic coefficient. METHODS: Pig heart sample, Agilus sample, Tango sample, TPU sample, and silicone sample were studied. The elastic coefficient of each specimen was measured using an elastic coefficient measuring instrument. The analysis was performed using the average value of ten specimens of the same size. We suggested an equation to find the elastic coefficient of material by the thickness using the elastic coefficient of Agilus, Tango, and silicone. RESULTS: The sample with similar elasticity to the pig sample did not show the same coefficient of elasticity at the same sample size. In Tango, the 0.5 mm high elastic force was about 3 times higher than the pig sample 7 mm elastic force. CONCLUSIONS: The study was conducted using 3D print material and silicone which can reproduce the elasticity of pig heart. However, no material is currently available to reproduce pig heart sample of the same size. However, if the heart is developed considering only elasticity, it can be sufficiently reproduced using the research results.
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Affiliation(s)
- Jung-Hun Kim
- Bio-Medical Research institute, Kyungpook National University Hospital, Sangyeok-dong, Buk-gu, Daegu, South Korea.,Bio-Medical Research institute, Kyungpook National University Hospital, Sangyeok-dong, Buk-gu, Daegu, South Korea
| | - Chun-Kyu Park
- Department of Biomedical Engineering, Kyungpook National University, Sangyeok-dong, Buk-gu, Daegu, South Korea.,Bio-Medical Research institute, Kyungpook National University Hospital, Sangyeok-dong, Buk-gu, Daegu, South Korea
| | - Ji-Eun Park
- Nonlinear Dynamics Laboratory, Kyungpook National University, Sangyeok-dong, Buk-gu, Daegu, South Korea
| | - Jong-Min Lee
- Department of Radiology, School of Medicine, Kyungpook National University, Sangyeok-dong, Buk-gu, Daegu, South Korea
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Cano-Zárate R, Hernández-Barajas EK, Hernández-Barajas HH, Meave-González A, Espínola-Zavaleta N. [Impact of 3D printing in surgical planning of congenital heart disease]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 91:1-6. [PMID: 33661871 PMCID: PMC8258902 DOI: 10.24875/acm.20000395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introducción Los defectos cardíacos congénitos constituyen el 30% de todas las anomalías congénitas. La prevalencia es de 8/1,000 recién nacidos vivos, sin predominio de género. Para una planificación quirúrgica óptima es esencial una evaluación precisa de la anatomía en los defectos cardíacos congénitos. Las modalidades de imagen como el ecocardiograma, la angiografía por cateterismo cardíaco, la tomografía computarizada (TC) o la resonancia magnética (RM) se utilizan de forma regular para el diagnóstico de las cardiopatías congénitas. Estos métodos pueden proporcionar reconstrucciones virtuales en reconstrucción volumétrica o 3D, pero no réplicas táctiles reales de la anatomía cardíaca. Objetivo Realizar modelos de corazón impresos en 3D con la finalidad de proporcionar réplicas táctiles 3D reales de la anatomía cardíaca para visualizar de forma detallada todas las perspectivas posibles de las estructuras extracardíacas o intracardíacas. Métodos Los datos de la imagen se obtuvieron en formato DICOM, se editaron en el paquete de software "3D slicer 4.3" y se exportaron para la impresión en formato de archivo (.stl). Resultados y conclusiones Con la impresión 3D se puede evaluar de forma detallada la anatomía intracardíaca y extracardíaca con modelos cardíacos en tiempo real. Esta técnica es de gran utilidad, sobre todo en los defectos cardíacos congénitos complejos, ya que permite hacer una planificación precisa del procedimiento quirúrgico. Introduction Congenital heart disease makes up for 30% of all congenital anomalies. The prevalence is 8/1,000 live newborns, without predominance of gender. Imaging methods such as echocardiography, angiography, computed tomography or magnetic resonance imaging must be routinely used in congenital heart disease. The mentioned methods can provide virtual reconstructions in volumetric reconstruction or in three dimensional (3D), but only 3D-printed heart models can provide real 3D tactile replicas of cardiac anatomy. Objective To make 3D printed heart models in order to provide real 3D tactile replicas of the cardiac anatomy that allow a detailed visualization from all possible perspectives, either of extracardiac or intracardiac structures. Methods This information is useful for surgical decision making, especially in patients with complex cardiac defects. DICOM, edited in a software package “3D slicer 4.3” and exported for printing in file format (.stl). Results and conclusions With 3D printing, the intracardiac and extracardiac anatomy can be evaluated in detail with real-scale cardiac models of the patient, avoiding unexpected findings. This technique is very useful especially in complex congenital heart defects, since it allows precise planning of the surgical procedure.
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Affiliation(s)
- Roberto Cano-Zárate
- Departamento de Resonancia Magnética, Instituto Nacional de Cardiología Ignacio Chávez
| | | | | | - Aloha Meave-González
- Departamento de Resonancia Magnética, Instituto Nacional de Cardiología Ignacio Chávez
| | - Nilda Espínola-Zavaleta
- Departamento de Cardiología Nuclear, Instituto Nacional de Cardiología Ignacio Chávez. Ciudad de México, México
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Castillo Romero C, Ricciardi G. Nikaidoh Procedure: The Wet Lab Trainee's Perspective. World J Pediatr Congenit Heart Surg 2021; 12:124-127. [PMID: 33407032 DOI: 10.1177/2150135120957644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Congenital heart surgeons' training is complex and challenging. The learning curve is long and the increasing complexity of pathologies is demanding. In order to develop adequate surgical-skill competencies, "in vivo" and simulation-based practicing are paramount. Simulation can be performed either on a computer screen or animal hearts and prosthetic models. In this article, we illustrate a porcine Wet Lab simulation for the Nikaidoh operation to point out its potential advantage to learn complex congenital surgery procedures.
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Affiliation(s)
- César Castillo Romero
- Department of Cardio-Thoracic Surgery, 37767Instituto Mexicano del Seguro Social, UMAE Hospital de Cardiología, Mexico City, Mexico
| | - Gabriella Ricciardi
- Department of Cardio-Thoracic Surgery, 4501Leiden Universitair Medisch Centrum, Leiden, the Netherlands
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Yoo SJ, Hussein N, Peel B, Coles J, van Arsdell GS, Honjo O, Haller C, Lam CZ, Seed M, Barron D. 3D Modeling and Printing in Congenital Heart Surgery: Entering the Stage of Maturation. Front Pediatr 2021; 9:621672. [PMID: 33614554 PMCID: PMC7892770 DOI: 10.3389/fped.2021.621672] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/06/2021] [Indexed: 12/05/2022] Open
Abstract
3D printing allows the most realistic perception of the surgical anatomy of congenital heart diseases without the requirement of physical devices such as a computer screen or virtual headset. It is useful for surgical decision making and simulation, hands-on surgical training (HOST) and cardiovascular morphology teaching. 3D-printed models allow easy understanding of surgical morphology and preoperative surgical simulation. The most common indications for its clinical use include complex forms of double outlet right ventricle and transposition of the great arteries, anomalous systemic and pulmonary venous connections, and heterotaxy. Its utility in congenital heart surgery is indisputable, although it is hard to "scientifically" prove the impact of its use in surgery because of many confounding factors that contribute to the surgical outcome. 3D-printed models are valuable resources for morphology teaching. Educational models can be produced for almost all different variations of congenital heart diseases, and replicated in any number. HOST using 3D-printed models enables efficient education of surgeons in-training. Implementation of the HOST courses in congenital heart surgical training programs is not an option but an absolute necessity. In conclusion, 3D printing is entering the stage of maturation in its use for congenital heart surgery. It is now time for imagers and surgeons to find how to effectively utilize 3D printing and how to improve the quality of the products for improved patient outcomes and impact of education and training.
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Affiliation(s)
- Shi Joon Yoo
- Department of Diagnostic Imaging, The University of Toronto, Toronto, ON, Canada
- Department of Paediatrics–Division of Cardiology, The University of Toronto, Toronto, ON, Canada
- Center for Image Guided Innovation and Therapeutic Intervention, The University of Toronto, Toronto, ON, Canada
| | - Nabil Hussein
- Center for Image Guided Innovation and Therapeutic Intervention, The University of Toronto, Toronto, ON, Canada
- Department of Surgery-Division of Cardiovascular Surgery, Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada
| | - Brandon Peel
- Center for Image Guided Innovation and Therapeutic Intervention, The University of Toronto, Toronto, ON, Canada
| | - John Coles
- Department of Surgery-Division of Cardiovascular Surgery, Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada
| | - Glen S. van Arsdell
- Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, United States
- Department of Surgery, Mattel Children's Hospital at UCLA, Los Angeles, CA, United States
| | - Osami Honjo
- Department of Surgery-Division of Cardiovascular Surgery, Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada
| | - Christoph Haller
- Department of Surgery-Division of Cardiovascular Surgery, Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada
| | - Christopher Z. Lam
- Department of Diagnostic Imaging, The University of Toronto, Toronto, ON, Canada
| | - Mike Seed
- Department of Diagnostic Imaging, The University of Toronto, Toronto, ON, Canada
- Department of Paediatrics–Division of Cardiology, The University of Toronto, Toronto, ON, Canada
| | - David Barron
- Department of Surgery-Division of Cardiovascular Surgery, Hospital for Sick Children, The University of Toronto, Toronto, ON, Canada
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V S S, Panigrahy N, Rath SN. Recent approaches in clinical applications of 3D printing in neonates and pediatrics. Eur J Pediatr 2021; 180:323-332. [PMID: 33025224 DOI: 10.1007/s00431-020-03819-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 01/17/2023]
Abstract
Neonates and pediatric populations are vulnerable subjects in terms of health. Proper screening and early optimal treatment would reduce infant and child mortality, improving the quality of life. Researchers and clinicians all over the world are in pursuit of innovations to improve the medical care delivery system. Infant morphometrics changes drastically due to the rapid somatic growth in infancy and childhood, demanding for patient-specific customization of treatment intervention accordingly. 3D printing is a radical technology that allows the generation of physical 3D products from digital images and addresses the patient-specific requirement. The combination of cost-effective and on-demand customization offers a boundless opportunity for the enhancement of neonates and pediatric health.Conclusion: The advanced technology of 3D printing proposes a pioneering breakthrough in bringing physiologically and anatomically appropriate treatment strategies addressing the unmet needs of child health problems. What is Known: • The potential application of 3D printing is observed across a multitude of fields within medicine and surgery. • The unprecedented effect of this technology on pediatric healthcare is still very much a work in progress. What is New: • The recent clinical applications of 3D printing provide better treatment modalities to infants and children. • The review provides an overview of the comparison between conventional treatment methods and 3DP regarding specific applications.
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Affiliation(s)
- Sukanya V S
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad (IITH), Kandi , Sangareddy, Telangana, 502285, India
| | | | - Subha Narayan Rath
- Department of Biomedical Engineering, Indian Institute of Technology Hyderabad (IITH), Kandi , Sangareddy, Telangana, 502285, India.
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Mowers KL, Fullerton JB, Hicks D, Singh GK, Johnson MC, Anwar S. 3D Echocardiography Provides Highly Accurate 3D Printed Models in Congenital Heart Disease. Pediatr Cardiol 2021; 42:131-141. [PMID: 33083888 DOI: 10.1007/s00246-020-02462-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 09/16/2020] [Indexed: 01/22/2023]
Abstract
Cardiac 3D printing is mainly performed from magnetic resonance imaging (MRI) and computed tomography (CT) 3D datasets, though anatomic detail of atrioventricular (AV) valves may be limited. 3D echo provides excellent visualization of AV valves. Thus, we tested the feasibility and accuracy of 3D printing from 3D echo in this pilot series of subjects with congenital heart disease (CHD), with a focus on valve anatomy. Five subjects with CHD were identified. 3D echo data were converted to 3D printable files and printed in collaboration with 3D Systems Healthcare (Golden, Colorado). A novel technique for valve modeling was utilized using commercially available software. Two readers (KM, SA) independently measured valve structures from 3D models and compared to source echo images. 3D printing was feasible for all cases. Table 1 shows measurements comparing 2D echo to 3D models. Bland Altman analysis showed close agreement and no significant bias between 2D and digital 3D models (mean difference 0.0, 95% CI 1.1 to - 1.1) or 2D vs printed 3D models, though with wider limits of agreement (mean difference - 0.3, 95% CI 1.9 to - 2.6). Accuracy of 3D models compared to 2D was within < 0.5 mm. This pilot study shows 3D echo datasets can be used to reliably print AV and semilunar valve structures in CHD. The 3D models are highly accurate compared to the source echo images. This is a novel and value-added technique that adds incremental information on cardiac anatomy over current methods.
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Affiliation(s)
- K L Mowers
- Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | | | - D Hicks
- Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - G K Singh
- Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - M C Johnson
- Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - S Anwar
- School of Medicine, University of California, 1975 4th Street Second Floor, Room# A2421, UCSF Box 4029, San Francisco, CA, 94143, USA.
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Cilingiroglu M, Marmagkiolis K. Role of simulators on structural training. Catheter Cardiovasc Interv 2020; 95:1210-1211. [PMID: 32421243 DOI: 10.1002/ccd.28914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 11/08/2022]
Abstract
Structural heart interventions are a rapidly evolving field in the treatment of complex heart diseases. While the number of dedicated fellowship programs keep increasing, there are important limitations on the number and diversity in certain structural heart procedures. Procedural specific simulation technology offer a safer, comprehensive and controlled training opportunity.
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Affiliation(s)
- Mehmet Cilingiroglu
- Department of Cardiology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.,Bahcesehir University, School of Medicine, Istanbul, Turkey
| | - Konstantinos Marmagkiolis
- Department of Cardiology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.,HCA Northside Hospital, St. Petersburg, FL, USA
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Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions. Biomolecules 2020; 10:biom10111577. [PMID: 33233652 PMCID: PMC7699768 DOI: 10.3390/biom10111577] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/19/2020] [Accepted: 11/19/2020] [Indexed: 01/09/2023] Open
Abstract
Three-dimensional (3D) printing has been increasingly used in medicine with applications in many different fields ranging from orthopaedics and tumours to cardiovascular disease. Realistic 3D models can be printed with different materials to replicate anatomical structures and pathologies with high accuracy. 3D printed models generated from medical imaging data acquired with computed tomography, magnetic resonance imaging or ultrasound augment the understanding of complex anatomy and pathology, assist preoperative planning and simulate surgical or interventional procedures to achieve precision medicine for improvement of treatment outcomes, train young or junior doctors to gain their confidence in patient management and provide medical education to medical students or healthcare professionals as an effective training tool. This article provides an overview of patient-specific 3D printed models with a focus on the applications in cardiovascular disease including: 3D printed models in congenital heart disease, coronary artery disease, pulmonary embolism, aortic aneurysm and aortic dissection, and aortic valvular disease. Clinical value of the patient-specific 3D printed models in these areas is presented based on the current literature, while limitations and future research in 3D printing including bioprinting of cardiovascular disease are highlighted.
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Al-Dulimi Z, Wallis M, Tan DK, Maniruzzaman M, Nokhodchi A. 3D printing technology as innovative solutions for biomedical applications. Drug Discov Today 2020; 26:360-383. [PMID: 33212234 DOI: 10.1016/j.drudis.2020.11.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/13/2020] [Accepted: 11/11/2020] [Indexed: 12/30/2022]
Abstract
3D printing was once predicted to be the third industrial revolution. Today, the use of 3D printing is found across almost all industries. This article discusses the latest 3D printing applications in the biomedical industry.
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Affiliation(s)
- Zaisam Al-Dulimi
- Arundel Building, Pharmaceutics Research Laboratory, School of Life Sciences, University of Sussex, Brighton, BN1 9QJ, UK
| | - Melissa Wallis
- Arundel Building, Pharmaceutics Research Laboratory, School of Life Sciences, University of Sussex, Brighton, BN1 9QJ, UK
| | - Deck Khong Tan
- Arundel Building, Pharmaceutics Research Laboratory, School of Life Sciences, University of Sussex, Brighton, BN1 9QJ, UK
| | - Mohammed Maniruzzaman
- Pharmaceutical Engineering and 3D Printing (PharmE3D) Lab, Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, University of Texas at Austin, PHR 4.214A, 2409 University Avenue, Stop A1920, Austin, TX 78712, USA.
| | - Ali Nokhodchi
- Arundel Building, Pharmaceutics Research Laboratory, School of Life Sciences, University of Sussex, Brighton, BN1 9QJ, UK.
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50
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Utility of three-dimensional printed heart models for education on complex congenital heart diseases. Cardiol Young 2020; 30:1637-1642. [PMID: 33161936 DOI: 10.1017/s1047951120003753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the feasibility and effects of education on complex congenital heart diseases using patient-specific three-dimensional printed heart models. METHODS Three-dimensional printed heart models were created using computed tomography data obtained from 11 patients with complex congenital heart disease. Fourteen kinds of heart models, encompassing nine kinds of complex congenital heart disease were printed. Using these models, a series of educational hands-on seminars, led by an experienced paediatric cardiac surgeon and a paediatric cardiologist, were conducted for medical personnel who were involved in the care of congenital heart disease patients. Contents of the seminars included anatomy, three-dimensional structure, pathophysiology, and surgery for each diagnosis. Likert-type (10-point scale) questionnaires were used before and after each seminar to evaluate the effects of education. RESULTS Between November 2019 and June 2020, a total of 16 sessions of hands-on seminar were conducted. The total number of questionnaire responses was 75. Overall, participants reported subjective improvement in understanding anatomy (4.8 ± 2.1 versus 8.4 ± 1.1, p < 0.001), three-dimensional structure (4.6 ± 2.2 versus 8.9 ± 1.0, p < 0.001), pathophysiology (4.8 ± 2.2 versus 8.5 ± 1.0, p < 0.001), and surgery (4.9 ± 2.3 versus 8.8 ± 0.9, p < 0.001) of the congenital heart disease investigated. CONCLUSIONS The utilisation of three-dimensional printed heart models for education on complex congenital heart disease was feasible and improved medical personnel's understanding of complex congenital heart disease. This education tool may be an effective alternative to conventional education tools for complex congenital heart disease.
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