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Lee J, Chadalavada SC, Ghodadra A, Ali A, Arribas EM, Chepelev L, Ionita CN, Ravi P, Ryan JR, Santiago L, Wake N, Sheikh AM, Rybicki FJ, Ballard DH. Clinical situations for which 3D Printing is considered an appropriate representation or extension of data contained in a medical imaging examination: vascular conditions. 3D Print Med 2023; 9:34. [PMID: 38032479 PMCID: PMC10688120 DOI: 10.1186/s41205-023-00196-6] [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: 10/08/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Medical three-dimensional (3D) printing has demonstrated utility and value in anatomic models for vascular conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (3DPSIG) provides appropriateness recommendations for vascular 3D printing indications. METHODS A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with vascular indications. Each study was vetted by the authors and strength of evidence was assessed according to published appropriateness ratings. RESULTS Evidence-based recommendations for when 3D printing is appropriate are provided for the following areas: aneurysm, dissection, extremity vascular disease, other arterial diseases, acute venous thromboembolic disease, venous disorders, lymphedema, congenital vascular malformations, vascular trauma, vascular tumors, visceral vasculature for surgical planning, dialysis access, vascular research/development and modeling, and other vasculopathy. Recommendations are provided in accordance with strength of evidence of publications corresponding to each vascular condition combined with expert opinion from members of the 3DPSIG. CONCLUSION This consensus appropriateness ratings document, created by the members of the 3DPSIG, provides an updated reference for clinical standards of 3D printing for the care of patients with vascular conditions.
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Affiliation(s)
- Joonhyuk Lee
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | | | - Anish Ghodadra
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Arafat Ali
- Department of Radiology, Henry Ford Health, Detroit, MI, USA
| | - Elsa M Arribas
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Leonid Chepelev
- Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Ciprian N Ionita
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
| | - Prashanth Ravi
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Justin R Ryan
- Webster Foundation 3D Innovations Lab, Rady Children's Hospital, San Diego, CA, USA
- Department of Neurological Surgery, University of California San Diego Health, San Diego, CA, USA
| | - Lumarie Santiago
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nicole Wake
- Department of Research and Scientific Affairs, GE HealthCare, New York, NY, USA
- Center for Advanced Imaging Innovation and Research, Department of Radiology, NYU Langone Health, New York, NY, USA
| | - Adnan M Sheikh
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Frank J Rybicki
- Department of Radiology, University of Arizona - Phoenix, Phoenix, AZ, USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.
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Aguirre-Aguirre D, Gonzalez-Utrera D, Villalobos-Mendoza B, Díaz-Uribe R. Fabrication of biconvex spherical and aspherical lenses using 3D printing. APPLIED OPTICS 2023; 62:C14-C20. [PMID: 37133051 DOI: 10.1364/ao.477347] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
In this work, we present the methods of fabrication and characterization of biconvex spherical and aspherical lenses with 25 and 50 mm diameters that have been created via additive technology using a Formlabs Form 3 stereolithography 3D printer. After the prototypes are postprocessed, fabrication errors ≤2.47% for the radius of curvature, the optical power, and the focal length are obtained. We show eye fundus images captured with an indirect ophthalmoscope using the printed biconvex aspherical prototypes, proving the functionality of both the fabricated lenses and the proposed method, which is fast and low-cost.
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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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Stana J, Grab M, Kargl R, Tsilimparis N. 3D printing in the planning and teaching of endovascular procedures. RADIOLOGIE (HEIDELBERG, GERMANY) 2022; 62:28-33. [PMID: 36112173 DOI: 10.1007/s00117-022-01047-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The introduction of 3D printing in the medical field led to new possibilities in the planning of complex procedures, as well as new ways of training junior physicians. Especially in the field of vascular interventions, 3D printing has a wide range of applications. METHODOLOGICAL INNOVATIONS 3D-printed models of aortic aneurysms can be used for procedural training of endovascular aortic repair (EVAR), which can help boost the physician's confidence in the procedure, leading to a better outcome for the patient. Furthermore, it allows for a better understanding of complex anatomies and pathologies. In addition to teaching applications, the field of pre-interventional planning benefits greatly from the addition of 3D printing. Especially in the preparation for a complex endovascular aortic repair, prior orientation and test implantation of the stent grafts can further improve outcomes and reduce complications. For both teaching and planning applications, high-quality imaging datasets are required that can be transferred into a digital 3D model and subsequently printed in 3D. Thick slice thickness or suboptimal contrast agent phase can reduce the overall detail of the digital model, possibly concealing crucial anatomical details. CONCLUSION Based on the digital 3D model created for 3D printing, another new visualization technique might see future applications in the field of vascular interventions: virtual reality (VR). It enables the physician to quickly visualize a digital 3D model of the patient's anatomy in order to assess possible complications during endovascular repair. Due to the short transfer time from the radiological dataset into the VR, this technique might see use in emergency situations, where there is no time to wait for a printed model.
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Affiliation(s)
- J Stana
- Department of Vascular Surgery, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany.
| | - M Grab
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany
- Chair of Medical Materials and Implants, Technical University Munich, Munich, Germany
| | - R Kargl
- Institute for Chemistry and Technology of Biobased System, (IBioSys), Graz University of Technology, Graz, Switzerland
| | - N Tsilimparis
- Department of Vascular Surgery, LMU University Hospital, Marchioninistr. 15, 81377, Munich, Germany
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Lim J, Lee S. Influence of Light-Intensity-Dependent Droplet Directionality on Dimensions of Structures Constructed Using an In Situ Light-Guided 3D Printing Method. Polymers (Basel) 2022; 14:3839. [PMID: 36145989 PMCID: PMC9502263 DOI: 10.3390/polym14183839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
As an alternative to conventional 3D printing methods that require supports, a new 3D printing strategy that utilizes guided light in situ has been developed for fabricating freestanding overhanging structures without supports. Light intensity has been found to be a crucial factor in modifying the dimensions of structures printed using this method; however, the underlying mechanism has not been clearly identified. Therefore, the light-intensity-dependent changes in the structure dimensions were analyzed in this study to elucidate the associated mechanism. Essentially, the entire process of deposition was monitored by assessing the behavior of photocurable droplets prior to their collision with the structure using imaging analysis tools such as a high-speed camera and MATLAB®. With increasing light intensity, the instability of the ejected falling droplets increased, and the droplet directionality deteriorated. This increased the dispersion of the droplet midpoints, which caused the average midpoints of the deposited single layers to shift further away from the center of the structure. Consequently, the diameter of the structure formed by successive stacking of single layers increased, and the layer thickness per droplet decreased. These led to light-intensity-dependent differences in the diameter and height of structures that were created from the same number of droplets.
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Affiliation(s)
- Jongkyeong Lim
- Department of Mechanical Engineering, Gachon University, Seongnam 13120, Korea
| | - Sangmin Lee
- Division of Mechanical, Automotive and Robot Component Engineering, Dong-Eui University, Busan 47340, Korea
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Little CD, Mackle EC, Maneas E, Chong D, Nikitichev D, Constantinou J, Tsui J, Hamilton G, Rakhit RD, Mastracci TM, Desjardins AE. A patient-specific multi-modality abdominal aortic aneurysm imaging phantom. Int J Comput Assist Radiol Surg 2022; 17:1611-1617. [PMID: 35397710 PMCID: PMC9463301 DOI: 10.1007/s11548-022-02612-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022]
Abstract
Purpose Multimodality imaging of the vascular system is a rapidly growing area of innovation and research, which is increasing with awareness of the dangers of ionizing radiation. Phantom models that are applicable across multiple imaging modalities facilitate testing and comparisons in pre-clinical studies of new devices. Additionally, phantom models are of benefit to surgical trainees for gaining experience with new techniques. We propose a temperature-stable, high-fidelity method for creating complex abdominal aortic aneurysm phantoms that are compatible with both radiation-based, and ultrasound-based imaging modalities, using low cost materials. Methods Volumetric CT data of an abdominal aortic aneurysm were acquired. Regions of interest were segmented to form a model compatible with 3D printing. The novel phantom fabrication method comprised a hybrid approach of using 3D printing of water-soluble materials to create wall-less, patient-derived vascular structures embedded within tailored tissue-mimicking materials to create realistic surrounding tissues. A non-soluble 3-D printed spine was included to provide a radiological landmark. Results The phantom was found to provide realistic appearances with intravascular ultrasound, computed tomography and transcutaneous ultrasound. Furthermore, the utility of this phantom as a training model was demonstrated during a simulated endovascular aneurysm repair procedure with image fusion. Conclusion With the hybrid fabrication method demonstrated here, complex multimodality imaging patient-derived vascular phantoms can be successfully fabricated. These have potential roles in the benchtop development of emerging imaging technologies, refinement of novel minimally invasive surgical techniques and as clinical training tools.
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Affiliation(s)
- Callum D Little
- Wellcome Trust-EPSRC Centre for Interventional and Surgical Sciences, London, W1W 7TS, UK
- Department of Medical Physics and Bioengineering, University College London, London, WC1E 6BT, UK
- Department of Cardiology, Royal Free Hospital, London, NW3 2QG, UK
| | - Eleanor C Mackle
- Wellcome Trust-EPSRC Centre for Interventional and Surgical Sciences, London, W1W 7TS, UK
- Department of Medical Physics and Bioengineering, University College London, London, WC1E 6BT, UK
| | - Efthymios Maneas
- Wellcome Trust-EPSRC Centre for Interventional and Surgical Sciences, London, W1W 7TS, UK
- Department of Medical Physics and Bioengineering, University College London, London, WC1E 6BT, UK
| | - Debra Chong
- Wellcome Trust-EPSRC Centre for Interventional and Surgical Sciences, London, W1W 7TS, UK
- Department of Vascular Surgery, Royal Free Hospital, London, NW3 2QG, UK
| | - Daniil Nikitichev
- Wellcome Trust-EPSRC Centre for Interventional and Surgical Sciences, London, W1W 7TS, UK
| | - Jason Constantinou
- Department of Vascular Surgery, Royal Free Hospital, London, NW3 2QG, UK
| | - Janice Tsui
- Wellcome Trust-EPSRC Centre for Interventional and Surgical Sciences, London, W1W 7TS, UK
- Department of Vascular Surgery, Royal Free Hospital, London, NW3 2QG, UK
| | - George Hamilton
- Wellcome Trust-EPSRC Centre for Interventional and Surgical Sciences, London, W1W 7TS, UK
- Department of Vascular Surgery, Royal Free Hospital, London, NW3 2QG, UK
| | - Roby D Rakhit
- Department of Cardiology, Royal Free Hospital, London, NW3 2QG, UK
| | - Tara M Mastracci
- Division of Surgery and Interventional Science, University College London, London, W1W 7TY, UK
| | - Adrien E Desjardins
- Wellcome Trust-EPSRC Centre for Interventional and Surgical Sciences, London, W1W 7TS, UK.
- Department of Medical Physics and Bioengineering, University College London, London, WC1E 6BT, UK.
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Andriole KP. SPIE Medical Imaging 50th anniversary: history of the Picture Archiving and Communication Systems Conference. J Med Imaging (Bellingham) 2022; 9:S12210. [PMID: 36259081 PMCID: PMC9558896 DOI: 10.1117/1.jmi.9.s1.s12210] [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] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
To commemorate the SPIE Medical Imaging 50th anniversary, this article provides a brief review of the Picture Archiving and Communication Systems (PACS) and Informatics conferences. Important topics and advances, contributing researchers from both academia and industry, and key papers are noted.
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Affiliation(s)
- Katherine P. Andriole
- Brigham and Women’s Hospital, Harvard Medical School, Department of Radiology, Boston, Massachusetts, United States
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Pal AK, Mohanty AK, Misra M. Additive manufacturing technology of polymeric materials for customized products: recent developments and future prospective. RSC Adv 2021; 11:36398-36438. [PMID: 35494368 PMCID: PMC9043570 DOI: 10.1039/d1ra04060j] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/09/2021] [Indexed: 12/12/2022] Open
Abstract
The worldwide demand for additive manufacturing (AM) is increasing due to its ability to produce more challenging customized objects based on the process parameters for engineering applications. The processing of conventional materials by AM processes is a critically demanded research stream, which has generated a path-breaking scenario in the rapid manufacturing and upcycling of plastics. The exponential growth of AM in the worldwide polymer market is expected to exceed 20 billion US dollars by 2021 in areas of automotive, medical, aerospace, energy and customized consumer products. The development of functional polymers and composites by 3D printing-based technologies has been explored significantly due to its cost-effective, easier integration into customized geometries, higher efficacy, higher precision, freedom of material utilization as compared to traditional injection molding, and thermoforming techniques. Since polymers are the most explored class of materials in AM to overcome the limitations, this review describes the latest research conducted on petroleum-based polymers and their composites using various AM techniques such as fused filament fabrication (FFF), selective laser sintering (SLS), and stereolithography (SLA) related to 3D printing in engineering applications such as biomedical, automotive, aerospace and electronics.
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Affiliation(s)
- Akhilesh Kumar Pal
- Bioproducts Discovery and Development Centre, Department of Plant Agriculture, University of Guelph Crop Science Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
| | - Amar K Mohanty
- Bioproducts Discovery and Development Centre, Department of Plant Agriculture, University of Guelph Crop Science Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
- School of Engineering, University of Guelph Thornbrough Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
| | - Manjusri Misra
- Bioproducts Discovery and Development Centre, Department of Plant Agriculture, University of Guelph Crop Science Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
- School of Engineering, University of Guelph Thornbrough Building, 50 Stone Road East Guelph Ontario N1G 2W1 Canada
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Sommer KN, Bhurwani MMS, Tutino V, Siddiqui A, Davies J, Snyder K, Levy E, Mokin M, Ionita CN. Use of patient specific 3D printed neurovascular phantoms to simulate mechanical thrombectomy. 3D Print Med 2021; 7:32. [PMID: 34568987 PMCID: PMC8474770 DOI: 10.1186/s41205-021-00122-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/11/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The ability of the patient specific 3D printed neurovascular phantoms to accurately replicate the anatomy and hemodynamics of the chronic neurovascular diseases has been demonstrated by many studies. Acute occurrences, however, may still require further development and investigation and therefore we studied acute ischemic stroke (AIS). The efficacy of endovascular procedures such as mechanical thrombectomy (MT) for the treatment of large vessel occlusion (LVO), can be improved by testing the performance of thrombectomy devices and techniques using patient specific 3D printed neurovascular models. METHODS 3D printed phantoms were connected to a flow loop with physiologically relevant flow conditions, including input flow rate and fluid temperature. A simulated blood clot was introduced into the model and placed in the proximal Middle Cerebral Artery (MCA) region. Clot location, composition, length, and arterial angulation were varied and MTs were simulated using stent retrievers. Device placement relative to the clot and the outcome of the thrombectomy were recorded for each situation. Digital subtraction angiograms (DSA) were captured before and after LVO simulation. Recanalization outcome was evaluated using DSA as either 'no recanalization' or 'recanalization'. Forty-two 3DP neurovascular phantom benchtop experiments were performed. RESULTS Clot angulation within the MCA region had the most significant impact on the MT outcome, with a p-value of 0.016. Other factors such as clot location, clot composition, and clot length correlated weakly with the MT outcome. CONCLUSIONS This project allowed us to gain knowledge of how such characteristics influence thrombectomy success and can be used in making clinical decisions when planning the procedure and selecting specific thrombectomy tools and approaches.
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Affiliation(s)
- Kelsey N. Sommer
- grid.273335.30000 0004 1936 9887Department of Biomedical Engineering, University at Buffalo, Buffalo, NY 14228 USA ,grid.273335.30000 0004 1936 9887Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14208 USA
| | - Mohammad Mahdi Shiraz Bhurwani
- grid.273335.30000 0004 1936 9887Department of Biomedical Engineering, University at Buffalo, Buffalo, NY 14228 USA ,grid.273335.30000 0004 1936 9887Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14208 USA
| | - Vincent Tutino
- grid.273335.30000 0004 1936 9887Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14208 USA ,grid.273335.30000 0004 1936 9887Department of Neurosurgery, University at Buffalo, Buffalo, NY 14208 USA ,grid.273335.30000 0004 1936 9887Department of Pathology and Anatomical Sciences, University at Buffalo, Buffalo, 14208 USA
| | - Adnan Siddiqui
- grid.273335.30000 0004 1936 9887Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14208 USA ,grid.273335.30000 0004 1936 9887Department of Neurosurgery, University at Buffalo, Buffalo, NY 14208 USA
| | - Jason Davies
- grid.273335.30000 0004 1936 9887Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14208 USA ,grid.273335.30000 0004 1936 9887Department of Neurosurgery, University at Buffalo, Buffalo, NY 14208 USA ,grid.273335.30000 0004 1936 9887Department of Biomedical Informatics, University at Buffalo, Buffalo, 14208 USA
| | - Kenneth Snyder
- grid.273335.30000 0004 1936 9887Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14208 USA ,grid.273335.30000 0004 1936 9887Department of Neurosurgery, University at Buffalo, Buffalo, NY 14208 USA
| | - Elad Levy
- grid.273335.30000 0004 1936 9887Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14208 USA ,grid.273335.30000 0004 1936 9887Department of Neurosurgery, University at Buffalo, Buffalo, NY 14208 USA
| | - Maxim Mokin
- grid.170693.a0000 0001 2353 285XDepartment of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL 33620 USA
| | - Ciprian N. Ionita
- grid.273335.30000 0004 1936 9887Department of Biomedical Engineering, University at Buffalo, Buffalo, NY 14228 USA ,grid.273335.30000 0004 1936 9887Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14208 USA ,grid.273335.30000 0004 1936 9887Department of Neurosurgery, University at Buffalo, Buffalo, NY 14208 USA
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Aseni P, Santaniello T, Rizzetto F, Gentili L, Pezzotta F, Cavaliere F, Vertemati M, Milani P. Hybrid Additive Fabrication of a Transparent Liver with Biosimilar Haptic Response for Preoperative Planning. Diagnostics (Basel) 2021; 11:1734. [PMID: 34574075 PMCID: PMC8471167 DOI: 10.3390/diagnostics11091734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 12/15/2022] Open
Abstract
Due to the complexity of liver surgery, the interest in 3D printing is constantly increasing among hepatobiliary surgeons. The aim of this study was to produce a patient-specific transparent life-sized liver model with tissue-like haptic properties by combining additive manufacturing and 3D moulding. A multistep pipeline was adopted to obtain accurate 3D printable models. Semiautomatic segmentation and registration of routine medical imaging using 3D Slicer software allowed to obtain digital objects representing the structures of interest (liver parenchyma, vasculo-biliary branching, and intrahepatic lesion). The virtual models were used as the source data for a hybrid fabrication process based on additive manufacturing using soft resins and casting of tissue-mimicking silicone-based blend into 3D moulds. The model of the haptic liver reproduced with high fidelity the vasculo-biliary branching and the relationship with the intrahepatic lesion embedded into the transparent parenchyma. It offered high-quality haptic perception and a remarkable degree of surgical and anatomical information. Our 3D transparent model with haptic properties can help surgeons understand the spatial changes of intrahepatic structures during surgical manoeuvres, optimising preoperative surgical planning.
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Affiliation(s)
- Paolo Aseni
- Department of Emergency, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy;
- Department of Biomedical and Clinical Sciences “L. Sacco”, Università degli Studi di Milano, Via Giovanni Battista Grassi 74, 20157 Milano, Italy
| | - Tommaso Santaniello
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Francesco Rizzetto
- Department of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162 Milano, Italy;
- Postgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Lorenzo Gentili
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Federico Pezzotta
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Francesco Cavaliere
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
| | - Maurizio Vertemati
- Department of Biomedical and Clinical Sciences “L. Sacco”, Università degli Studi di Milano, Via Giovanni Battista Grassi 74, 20157 Milano, Italy
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
| | - Paolo Milani
- Centro Interdisciplinare Materiali e Interfacce Nanostrutturati (CIMaINa), Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy; (T.S.); (L.G.); (F.P.); (F.C.)
- Dipartimento di Fisica “A. Pontremoli”, Università degli Studi di Milano, Via Celoria 16, 20133 Milano, Italy
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Sparks AJ, Smith CM, Allman AB, Senko JL, Meess KM, Ducharme RW, Springer ME, Waqas M, Siddiqui AH. Compliant vascular models 3D printed with the Stratasys J750: a direct characterization of model distensibility using intravascular ultrasound. 3D Print Med 2021; 7:28. [PMID: 34477997 PMCID: PMC8414686 DOI: 10.1186/s41205-021-00114-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 07/03/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE The purpose of this study is to evaluate biomechanical accuracy of 3D printed anatomical vessels using a material jetting printer (J750, Stratasys, Rehovot, Israel) by measuring distensibility via intravascular ultrasound. MATERIALS AND METHODS The test samples are 3D printed tubes to simulate arterial vessels (aorta, carotid artery, and coronary artery). Each vessel type is defined by design geometry of the vessel inner diameter and wall thickness. Vessel inner diameters are aorta = 30mm, carotid = 7mm, and coronary = 3mm. Vessel wall thickness are aorta = 3mm, carotid = 1.5mm, and coronary = 1mm. Each vessel type was printed in 3 different material options. Material options are user-selected from the J750 printer software graphical user interface as blood vessel wall anatomy elements in 'compliant', 'slightly compliant', and 'rigid' options. Three replicates of each vessel type were printed in each of the three selected material options, for a total of 27 models. The vessels were connected to a flow loop system where pressure was monitored via a pressure wire and cross-sectional area was measured with intravascular ultrasound (IVUS). Distensibility was calculated by comparing the % difference in cross-sectional area vs. pulse pressure to clinical literature values. Target clinical ranges for normal and diseased population distensibility are 10.3-44 % for the aorta, 5.1-10.1 % for carotid artery, and 0.5-6 % for coronary artery. RESULTS Aorta test vessels had the most clinically representative distensibility when printed in user-selected 'compliant' and 'slightly compliant' material. All aorta test vessels of 'compliant' material (n = 3) and 2 of 3 'slightly compliant' vessels evaluated were within target range. Carotid vessels were most clinically represented in distensibility when printed in 'compliant' and 'slightly compliant' material. For carotid test vessels, 2 of 3 'compliant' material samples and 1 of 3 'slightly compliant' material samples were within target range. Coronary arteries were most clinically represented in distensibility when printed in 'slightly compliant' and 'rigid' material. For coronary test vessels, 1 of 3 'slightly compliant' materials and 3 of 3 'rigid' material samples fell within target range. CONCLUSIONS This study suggests that advancements in materials and 3D printing technology introduced with the J750 Digital Anatomy 3D Printer can enable anatomical models with clinically relevant distensibility.
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Affiliation(s)
| | | | | | | | | | | | | | - Muhammad Waqas
- Department of Neurosurgery, University at Buffalo, State University of New York, 100 High Street, Suite B4, Buffalo, NY, 14203, USA
| | - Adnan H Siddiqui
- The Jacobs Institute, Buffalo, New York, USA.
- Department of Neurosurgery, University at Buffalo, State University of New York, 100 High Street, Suite B4, Buffalo, NY, 14203, USA.
- Canon Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, New York, USA.
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12
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Paccione E, Ionita CN. Challenges in hemodynamics assessment in complex neurovascular geometries using computational fluid dynamics and benchtop flow simulation in 3D printed patient specific phantoms. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2021; 11600. [PMID: 33814673 DOI: 10.1117/12.2582169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Purpose Complex hemodynamics assessments, as those related to carotid stenosis, are not always easily straightforward due to multifaceted challenges presented by the collateral flow in the Circle of Willis (CoW) and brain flow autoregulation. Advanced computational and benchtop methods to investigate hemodynamics aspects related to such complex flows are often used, however both have limitations and could lead to results which may diverge. In this study we investigated these aspects by performing correlated computational fluid dynamics (CFD) simulations and benchtop experiments in patient specific 3D printed phantoms. Materials and Methods To investigate the flow in patients with carotid stenosis, we built two patient specific phantoms which contained the arterial lesion of interest, all main arteries leading to the brain, the CoW and main arteries branching from it. Each phantom was connected to a generic aortic arch. A programmable pump was connected and flow parameters were measured proximal and distal to the lesion and the contralateral arteries. The patient 3D geometry was used to perform a set of CFD simulations where inflow boundary conditions matched the experimental ones. Flow conditions were recorded at the same locations as the experimental setup. Further exploration into the translation from experimental to CFD was also performed by customizing vascular segmentation and physically manipulating arterial compliance properties. Results We initially observed significant differences between the CFD recordings and the experimental setup. Most of the differences were due to changes in phantom geometry when subjected to physiological pressures and simplistic outflow boundary conditions in the CFD simulations which do not account for pulsatility and nonlinear phenomena. Further work confirms the need for dynamic mesh behavior within CFD simulations attempting to computationally mimic 3D-printed benchtop experiments. Additionally, CFD simulation may benefit from considering geometry specific to a 3D-printed vascular phantom.
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Affiliation(s)
- Eric Paccione
- University Dept. of Biomedical Engineering, University at Buffalo, Buffalo, NY
| | - Ciprian N Ionita
- University Dept. of Biomedical Engineering, University at Buffalo, Buffalo, NY.,Canon Stroke and Vascular Research Center, Buffalo, NY
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13
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Sommer KN, Bhurwani MMS, Mokin M, Ionita CN. Evaluation of challenges and limitations of mechanical thrombectomy using 3D printed neurovascular phantoms. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2021; 11601:116010B. [PMID: 34334874 PMCID: PMC8323489 DOI: 10.1117/12.2580962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The mechanical thrombectomy (MT) efficacy, for large vessel occlusion (LVO) treatment in patients with stroke, could be improved if better teaching and practicing surgical tools were available. We propose a novel approach that uses 3D printing (3DP) to generate patient anatomical vascular variants for simulation of diverse clinical scenarios of LVO treated with MT. 3DP phantoms were connected to a flow loop with physiologically relevant flow conditions, including input flow rate and fluid temperature. A simulated blood clot was introduced into the model and placed in the Middle Cerebral Artery region. Clot location, composition (hard or soft clot), length, and arterial angulation were varied and MTs were simulated using stent retrievers. Device placement relative to the clot and the outcome of the thrombectomy were recorded for each situation. Angiograms were captured before and after LVO simulation and after the MT. Recanalization outcome was evaluated using the Thrombolysis in Cerebral Infarction (TICI) scale. Forty-two 3DP neurovascular phantom benchtop experiments were performed. Clot mechanical properties, hard versus soft, had the highest impact on the MT outcome, with 18/42 proving to be successful with full or partial clot retrieval. Other factors such as device manufacturer and the tortuosity of the 3DP model correlated weakly with the MT outcome. We demonstrated that 3DP can become a comprehensive tool for teaching and practicing various surgical procedures for MT in LVO patients. This platform can help vascular surgeons understand the endovascular devices limitations and patient vascular geometry challenges, to allow surgical approach optimization.
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Affiliation(s)
- Kelsey N Sommer
- Department of Biomedical Engineering, University at Buffalo NY 14228,Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208
| | - Mohammad Mahdi Shiraz Bhurwani
- Department of Biomedical Engineering, University at Buffalo NY 14228,Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208
| | - Maxim Mokin
- Department of Neurosurgery, University of South Florida, Tampa, Florida 33620
| | - Ciprian N Ionita
- Department of Biomedical Engineering, University at Buffalo NY 14228,Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208
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14
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Shannon A, O'Connell A, O'Sullivan A, Byrne M, Clifford S, O'Sullivan KJ, O'Sullivan L. A Radiopaque Nanoparticle-Based Ink Using PolyJet 3D Printing for Medical Applications. 3D PRINTING AND ADDITIVE MANUFACTURING 2020; 7:259-268. [PMID: 36654671 PMCID: PMC9586492 DOI: 10.1089/3dp.2019.0160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The aim of this study was to develop a 3D printable radiopaque ink and successfully print a finished artifact. Radiopaque 3D printing would be hugely beneficial to improve the visibility of medical devices and implants, as well as allowing more realistic phantoms and calibration aids to be produced. Most 3D printing technologies are polymer based. Polymers are naturally radiolucent, allowing X-rays to pass through, showing up as faint dark gray regions on X-ray detectors, as for soft tissues. During this study, a 3D printable ultraviolet (UV) curable resin containing zirconium oxide (ZrO2) nanoparticles was developed. 5 wt.% ZrO2 was dispersed in a base resin using a high-shear mixer. Particles remained in suspension for 6-8 h at room temperature, allowing time for 3D printing. A model of a hand including radiopaque bones and a test block demonstrating a range of internal radiopaque features were successfully 3D printed. Radiopacity was demonstrated in the 3D-printed models, and there was good dispersion of ZrO2 within the resin matrix. The impregnated resin remained UV curable and viscosity was not compromised. In this study, 3D-printed radiopaque features demonstrated clear radiopacity under X-ray and microcomputed tomography imaging.
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Affiliation(s)
- Alice Shannon
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
| | - Aine O'Connell
- Radiology Department, University Hospital Limerick, Limerick, Ireland
| | - Aidan O'Sullivan
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
- Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Michael Byrne
- School of Engineering, University of Limerick, Limerick, Ireland
| | - Seamus Clifford
- School of Engineering, University of Limerick, Limerick, Ireland
| | - Kevin J. O'Sullivan
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
- Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Leonard O'Sullivan
- Design Factors Research Group, School of Design, University of Limerick, Limerick, Ireland
- Health Research Institute and Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
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Wang H, Song H, Yang Y, Cao Q, Hu Y, Chen J, Guo J, Wang Y, Jia D, Cao S, Zhou Q. Three-dimensional printing for cardiovascular diseases: from anatomical modeling to dynamic functionality. Biomed Eng Online 2020; 19:76. [PMID: 33028306 PMCID: PMC7542711 DOI: 10.1186/s12938-020-00822-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/28/2020] [Indexed: 12/16/2022] Open
Abstract
Three-dimensional (3D) printing is widely used in medicine. Most research remains focused on forming rigid anatomical models, but moving from static models to dynamic functionality could greatly aid preoperative surgical planning. This work reviews literature on dynamic 3D heart models made of flexible materials for use with a mock circulatory system. Such models allow simulation of surgical procedures under mock physiological conditions, and are; therefore, potentially very useful to clinical practice. For example, anatomical models of mitral regurgitation could provide a better display of lesion area, while dynamic 3D models could further simulate in vitro hemodynamics. Dynamic 3D models could also be used in setting standards for certain parameters for function evaluation, such as flow reserve fraction in coronary heart disease. As a bridge between medical image and clinical aid, 3D printing is now gradually changing the traditional pattern of diagnosis and treatment.
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Affiliation(s)
- Hao Wang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hongning Song
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yuanting Yang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Quan Cao
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yugang Hu
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jinling Chen
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Juan Guo
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yijia Wang
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Dan Jia
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Sheng Cao
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qing Zhou
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Datta S, Jana S, Das A, Chakraborty A, Chowdhury AR, Datta P. Bioprinting of radiopaque constructs for tissue engineering and understanding degradation behavior by use of Micro-CT. Bioact Mater 2020; 5:569-576. [PMID: 32373763 PMCID: PMC7195521 DOI: 10.1016/j.bioactmat.2020.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 04/05/2020] [Accepted: 04/22/2020] [Indexed: 12/17/2022] Open
Abstract
Bioprinting has emerged as a potential technique to fabricate tissue engineering constructs and in vitro models directly using living cells as a raw material for fabrication, conforming to the heterogeneity and architectural complexity of the tissues. In several of tissue engineering and in vitro disease modelling or surgical planning applications, it is desirable to have radiopaque constructs for monitoring and evaluation. In the present work, enhanced radiopaque constructs are generated by substituting Calcium ions with Barium ions for crosslinking of alginate hydrogels. The constructs are characterized for their structural integrity and followed by cell culture studies to evaluate their biocompatibility. This was followed by the radiopacity evaluation. The radiological images obtained by micro-CT technique was further applied to investigate the degradation behavior of the scaffolds. In conclusion, it is observed that barium crosslinking can provide a convenient means to obtain radiopaque constructs with potential for multi-faceted applications.
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Affiliation(s)
- Sudipto Datta
- Centre for Healthcare Science and Technology, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103, WB, India
| | - Shuvodeep Jana
- Indian Institute of Technology, Kharagpur, West Bengal, India
| | - Ankita Das
- Centre for Healthcare Science and Technology, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103, WB, India
| | - Arindam Chakraborty
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103, WB, India
| | - Amit Roy Chowdhury
- Centre for Healthcare Science and Technology, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103, WB, India
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103, WB, India
| | - Pallab Datta
- Centre for Healthcare Science and Technology, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103, WB, India
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17
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Sommer KN, Iyer V, Kumamaru KK, Rava RA, Ionita CN. Method to simulate distal flow resistance in coronary arteries in 3D printed patient specific coronary models. 3D Print Med 2020; 6:19. [PMID: 32761497 PMCID: PMC7410153 DOI: 10.1186/s41205-020-00072-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 07/24/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Three-dimensional printing (3DP) offers a unique opportunity to build flexible vascular patient-specific coronary models for device testing, treatment planning, and physiological simulations. By optimizing the 3DP design to replicate the geometrical and mechanical properties of healthy and diseased arteries, we may improve the relevance of using such models to simulate the hemodynamics of coronary disease. We developed a method to build 3DP patient specific coronary phantoms, which maintain a significant part of the coronary tree, while preserving geometrical accuracy of the atherosclerotic plaques and allows for an adjustable hydraulic resistance. METHODS Coronary computed tomography angiography (CCTA) data was used within Vitrea (Vital Images, Minnetonka, MN) cardiac analysis application for automatic segmentation of the aortic root, Left Anterior Descending (LAD), Left Circumflex (LCX), Right Coronary Artery (RCA), and calcifications. Stereolithographic (STL) files of the vasculature and calcium were imported into Autodesk Meshmixer for 3D model optimization. A base with three chambers was built and interfaced with the phantom to allow fluid collection and independent distal resistance adjustment of the RCA, LAD and LCX and branching arteries. For the 3DP we used Agilus for the arterial wall, VeroClear for the base and a Vero blend for the calcifications, respectively. Each chamber outlet allowed interface with catheters of varying lengths and diameters for simulation of hydraulic resistance of both normal and hyperemic coronary flow conditions. To demonstrate the manufacturing approach appropriateness, models were tested in flow experiments. RESULTS Models were used successfully in flow experiments to simulate normal and hyperemic flow conditions. The inherent mean resistance of the chamber for the LAD, LCX, and RCA, were 1671, 1820, and 591 (dynes ∙ sec/ cm5), respectively. This was negligible when compared with estimates in humans, with the chamber resistance equating to 0.65-5.86%, 1.23-6.86%, and 0.05-1.67% of the coronary resistance for the LAD, LCX, and RCA, respectively at varying flow rates and activity states. Therefore, the chamber served as a means to simulate the compliance of the distal coronary trees and to allow facile coupling with a set of known resistance catheters to simulate various physical activity levels. CONCLUSIONS We have developed a method to create complex 3D printed patient specific coronary models derived from CCTA, which allow adjustable distal capillary bed resistances. This manufacturing approach permits comprehensive coronary model development which may be used for physiologically relevant flow simulations.
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Affiliation(s)
- Kelsey N Sommer
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA
| | - Vijay Iyer
- University at Buffalo Cardiology, University at Buffalo Jacobs School of Medicine, Buffalo, NY, USA
| | | | - Ryan A Rava
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA
| | - Ciprian N Ionita
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA.
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA.
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18
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Khural M, Gullipalli R, Dubrowski A. Evaluating the Use of a Generic Three-Dimensionally (3D) Printed Abdominal Aortic Aneurysm Model as an Adjunct Patient Education Tool. Cureus 2020; 12:e8533. [PMID: 32665880 PMCID: PMC7352734 DOI: 10.7759/cureus.8533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
An abdominal aortic aneurysm (AAA) is a serious medical condition that requires invasive surgery or endovascular treatment with stent grafts. This procedure is primarily carried out by vascular surgeons and interventional radiologists. Current methods of educating patients about their procedure have been inadequate, causing unnecessary stress in patients who have this condition and seek treatment. In this study, we evaluate a three-dimensionally (3D) printed AAA model to use as an adjunct patient education tool, thus allowing patients to make a more knowledgeable decision when providing informed consent. The physical attributes and realism of the model are evaluated through the use of a quantitative and qualitative survey completed by physicians at St. Clare’s Mercy Hospital in St. John’s, Newfoundland. These physicians are referred to as “Experts” in our study and also rate and comment on the necessity of having patient-specific versus generic 3D AAA models for patient education purposes. The aim of this study is to determine whether our 3D printed AAA model is ready to be used as an adjunct patient education tool and to seek suggestions for improvements that can be made in the model. Furthermore, having generic 3D AAA models would significantly decrease healthcare costs as compared to patient-specific models. Thus, we also investigate if generic models would suffice from the perspective of the physicians.
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Affiliation(s)
- Manveer Khural
- Medicine, Memorial University of Newfoundland, St. John's, CAN
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19
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Tomov ML, Cetnar A, Do K, Bauser‐Heaton H, Serpooshan V. Patient-Specific 3-Dimensional-Bioprinted Model for In Vitro Analysis and Treatment Planning of Pulmonary Artery Atresia in Tetralogy of Fallot and Major Aortopulmonary Collateral Arteries. J Am Heart Assoc 2019; 8:e014490. [PMID: 31818221 PMCID: PMC6951056 DOI: 10.1161/jaha.119.014490] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/07/2019] [Indexed: 12/12/2022]
Abstract
Background Tetralogy of Fallot with major aortopulmonary collateral arteries is a heterogeneous form of pulmonary artery (PA) stenosis that requires multiple forms of intervention. We present a patient-specific in vitro platform capable of sustained flow that can be used to train proceduralists and surgical teams in current interventions, as well as in developing novel therapeutic approaches to treat various vascular anomalies. Our objective is to develop an in vitro model of PA stenosis based on patient data that can be used as an in vitro phantom to model cardiovascular disease and explore potential interventions. Methods and Results From patient-specific scans obtained via computer tomography or 3-dimensional (3D) rotational angiography, we generated digital 3D models of the arteries. Subsequently, in vitro models of tetralogy of Fallot with major aortopulmonary collateral arteries were first 3D printed using biocompatible resins and next bioprinted using gelatin methacrylate hydrogel to simulate neonatal vasculature or second-order branches of an older patient with tetralogy of Fallot with major aortopulmonary collateral arteries. Printed models were used to study creation of extraluminal connection between an atretic PA and a major aortopulmonary collateral artery using a catheter-based interventional method. Following the recanalization, engineered PA constructs were perfused and flow was visualized using contrast agents and x-ray angiography. Further, computational fluid dynamics modeling was used to analyze flow in the recanalized model. Conclusions New 3D-printed and computational fluid dynamics models for vascular atresia were successfully created. We demonstrated the unique capability of a printed model to develop a novel technique for establishing blood flow in atretic vessels using clinical imaging, together with 3D bioprinting-based tissue engineering techniques. Additive biomanufacturing technologies can enable fabrication of functional vascular phantoms to model PA stenosis conditions that can help develop novel clinical applications.
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Affiliation(s)
- Martin L. Tomov
- Department of Biomedical EngineeringEmory University School of Medicine and Georgia Institute of TechnologyAtlantaGA
| | - Alexander Cetnar
- Department of Biomedical EngineeringEmory University School of Medicine and Georgia Institute of TechnologyAtlantaGA
| | - Katherine Do
- Department of PediatricsEmory University School of MedicineAtlantaGA
| | - Holly Bauser‐Heaton
- Department of PediatricsEmory University School of MedicineAtlantaGA
- Children's Healthcare of AtlantaAtlantaGA
- Sibley Heart Center at Children's Healthcare of AtlantaAtlantaGA
| | - Vahid Serpooshan
- Department of Biomedical EngineeringEmory University School of Medicine and Georgia Institute of TechnologyAtlantaGA
- Department of PediatricsEmory University School of MedicineAtlantaGA
- Children's Healthcare of AtlantaAtlantaGA
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Ferda J, Baxa J, Ferdova E, Kucera R, Topolcan O, Molacek J. Abdominal aortic aneurysm in prostate cancer patients: the "road map" from incidental detection to advanced predictive, preventive, and personalized approach utilizing common follow-up for both pathologies. EPMA J 2019; 10:415-423. [PMID: 31832115 PMCID: PMC6882970 DOI: 10.1007/s13167-019-00193-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/01/2019] [Indexed: 12/16/2022]
Abstract
Abdominal aortic aneurysm (AAA) is often a hidden pathological process showing no clinical symptoms. Genetic burden, smoking, male gender, age > 65 years, and white race have been identified as the main risk factors. A regular screening program has been introduced but is, as yet, unclear and is not performed in most countries. Prostate cancer is the most frequent male malignant disease in Western countries. Prostate cancer is a disease of older age with a median primary diagnosis of over 60 years. In recent years, advanced imaging methods have been established as important diagnostic tools in prostate cancer diagnostics. The incidental detection of AAA during diagnostic imaging performed due to prostate cancer diagnosis could reveal some asymptomatic aneurysms. Using our experience, the incidental detection of AAA during 18F-fluoromethylcholine PET/CT imaging, performed due to the staging, follow-up, and restaging of the prostate cancer, was reworked into a regular tool of secondary prevention within the framework of personalized medicine strategies. Experience with this type of AAA detection is demonstrated by a cohort of 500 patients who underwent 18F-fluorometylcholine PET/CT examination due to the staging or restaging of prostate cancer. A total of 28 aneurysms were detected (26 aneurysms < 50 mm, 2 aneurysms > 50 mm). In 2 cases (diameter < 50 mm), serious complications were found (penetrating aortic ulcer). The detection and monitoring of AAA in patients undergoing 18F-fluorometylcholine PET/CT due to the prostate cancer offers the possibility of a secondary prevention of AAA, patient stratification, and common follow-up for both pathologies.
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Affiliation(s)
- Jiri Ferda
- Department of Imaging Methods, University Hospital and Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Jan Baxa
- Department of Imaging Methods, University Hospital and Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Eva Ferdova
- Department of Imaging Methods, University Hospital and Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Radek Kucera
- Department of Immunochemistry Diagnostics, University Hospital and Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Ondrej Topolcan
- Department of Immunochemistry Diagnostics, University Hospital and Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Jiri Molacek
- Department of Surgery, University Hospital and Faculty of Medicine in Pilsen, Pilsen, Czech Republic
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Goudie C, Kinnin J, Bartellas M, Gullipalli R, Dubrowski A. The Use of 3D Printed Vasculature for Simulation-based Medical Education Within Interventional Radiology. Cureus 2019; 11:e4381. [PMID: 31218145 PMCID: PMC6553672 DOI: 10.7759/cureus.4381] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 04/02/2019] [Indexed: 11/21/2022] Open
Abstract
Three-dimensional (3D) printing has become a useful tool within the field of medicine as a way to produce custom anatomical models for teaching, surgical planning, and patient education. This technology is quickly becoming a key component in simulation-based medical education (SBME) to teach hands-on spatial perception and tactile feedback. Within fields such as interventional radiology (IR), this approach to SBME is also thought to be an ideal instructional method, providing an accurate and economical means to study human anatomy and vasculature. Such anatomical details can be extracted from patient-specific and anonymized CT or MRI scans for the purpose of teaching or analyzing patient-specific anatomy. There is evidence that 3D printing in IR can also optimize procedural training, so learners can rehearse procedures under fluoroscopy while receiving immediate supervisory feedback. Such training advancements in IR hold the potential to reduce procedural operating time, thus reducing the amount of time a patient is exposed to radiation and anaesthetia. Using a program evaluation approach, the purpose of this technical report is to describe the development and application of 3D-printed vasculature models within a radiology interest group to determine their efficacy as supplementary learning tools to traditional, lecture-based teaching. The study involved 30 medical students of varying years in their education, involved in the interest group at Memorial University of Newfoundland (MUN). The session was one hour in length and began with a Powerpoint presentation demonstrating the insertion of guide wires and stents using 3D-printed vasculature models. Participants had the opportunity to use the models to attempt several procedures demonstrated during the lecture. These attempts were supervised by an educational expert/facilitator. A survey was completed by all 30 undergraduate medical students and returned to the facilitators, who compiled the quantitative data to evaluate the efficacy of the 3D-printed models as an adjunct to the traditional didactic teaching within IR. The majority of feedback was positive, supporting the use of 3D=printed vasculature as an additional tactile training method for medical students within an IR academic setting. The hands-on experience provides a valuable training approach, with more opportunities for the rehearsal of high-acuity, low-occurrence (HALO) procedures performed in IR.
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Affiliation(s)
- Christine Goudie
- Medical Education and Simulation, Memorial University of Newfoundland, St. John's, CAN
| | - Jason Kinnin
- Radiology, University of Saskatchewan College of Medicine, Saskatoon, USA
| | | | | | - Adam Dubrowski
- Emergency Medicine, Memorial University of Newfoundland, St. John's, CAN
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22
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Chepelev L, Wake N, Ryan J, Althobaity W, Gupta A, Arribas E, Santiago L, Ballard DH, Wang KC, Weadock W, Ionita CN, Mitsouras D, Morris J, Matsumoto J, Christensen A, Liacouras P, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): guidelines for medical 3D printing and appropriateness for clinical scenarios. 3D Print Med 2018; 4:11. [PMID: 30649688 PMCID: PMC6251945 DOI: 10.1186/s41205-018-0030-y] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/19/2018] [Indexed: 02/08/2023] Open
Abstract
Medical three-dimensional (3D) printing has expanded dramatically over the past three decades with growth in both facility adoption and the variety of medical applications. Consideration for each step required to create accurate 3D printed models from medical imaging data impacts patient care and management. In this paper, a writing group representing the Radiological Society of North America Special Interest Group on 3D Printing (SIG) provides recommendations that have been vetted and voted on by the SIG active membership. This body of work includes appropriate clinical use of anatomic models 3D printed for diagnostic use in the care of patients with specific medical conditions. The recommendations provide guidance for approaches and tools in medical 3D printing, from image acquisition, segmentation of the desired anatomy intended for 3D printing, creation of a 3D-printable model, and post-processing of 3D printed anatomic models for patient care.
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Affiliation(s)
- Leonid Chepelev
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Nicole Wake
- Center for Advanced Imaging Innovation and Research (CAI2R), Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY USA
- Sackler Institute of Graduate Biomedical Sciences, NYU School of Medicine, New York, NY USA
| | | | - Waleed Althobaity
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Ashish Gupta
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Elsa Arribas
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Lumarie Santiago
- Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO USA
| | - Kenneth C Wang
- Baltimore VA Medical Center, University of Maryland Medical Center, Baltimore, MD USA
| | - William Weadock
- Department of Radiology and Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI USA
| | - Ciprian N Ionita
- Department of Neurosurgery, State University of New York Buffalo, Buffalo, NY USA
| | - Dimitrios Mitsouras
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | | | | | - Andy Christensen
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Peter Liacouras
- 3D Medical Applications Center, Walter Reed National Military Medical Center, Washington, DC, USA
| | - Frank J Rybicki
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
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23
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Principles of three-dimensional printing and clinical applications within the abdomen and pelvis. Abdom Radiol (NY) 2018; 43:2809-2822. [PMID: 29619525 DOI: 10.1007/s00261-018-1554-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Improvements in technology and reduction in costs have led to widespread interest in three-dimensional (3D) printing. 3D-printed anatomical models contribute to personalized medicine, surgical planning, and education across medical specialties, and these models are rapidly changing the landscape of clinical practice. A physical object that can be held in one's hands allows for significant advantages over standard two-dimensional (2D) or even 3D computer-based virtual models. Radiologists have the potential to play a significant role as consultants and educators across all specialties by providing 3D-printed models that enhance clinical care. This article reviews the basics of 3D printing, including how models are created from imaging data, clinical applications of 3D printing within the abdomen and pelvis, implications for education and training, limitations, and future directions.
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24
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Torres I, De Luccia N. Artificial vascular models for endovascular training (3D printing). Innov Surg Sci 2018; 3:225-234. [PMID: 31579786 PMCID: PMC6604582 DOI: 10.1515/iss-2018-0020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/17/2018] [Indexed: 12/27/2022] Open
Abstract
The endovascular technique has led to a revolution in the care of patients with vascular disease; however, acquiring and maintaining proficiency over a broad spectrum of procedures is challenging. Three-dimensional (3D) printing technology allows the production of models that can be used for endovascular training. This article aims to explain the process and technologies available to produce vascular models for endovascular training, using 3D printing technology. The data are based on the group experience and a review of the literature. Different 3D printing methods are compared, describing their advantages, disadvantages and potential roles in surgical training. The process of 3D printing a vascular model based on an imaging examination consists of the following steps: image acquisition, image post-processing, 3D printing and printed model post-processing. The entire process can take a week. Prospective studies have shown that 3D printing can improve surgical planning, especially in complex endovascular procedures, and allows the production of efficient simulators for endovascular training, improving residents’ surgical performance and self-confidence.
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Affiliation(s)
- Inez Torres
- Discipline of Vascular and Endovascular Surgery, Department of Surgery, São Paulo University Medical School, Rua Oscar Freire, 1546, ap 33, Pinheiros, São Paulo - SP 05409-010, Brazil
| | - Nelson De Luccia
- Discipline of Vascular and Endovascular Surgery, Department of Surgery, São Paulo University Medical School, São Paulo, Brazil
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Tappa K, Jammalamadaka U. Novel Biomaterials Used in Medical 3D Printing Techniques. J Funct Biomater 2018; 9:E17. [PMID: 29414913 PMCID: PMC5872103 DOI: 10.3390/jfb9010017] [Citation(s) in RCA: 193] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 01/27/2018] [Accepted: 01/27/2018] [Indexed: 12/19/2022] Open
Abstract
The success of an implant depends on the type of biomaterial used for its fabrication. An ideal implant material should be biocompatible, inert, mechanically durable, and easily moldable. The ability to build patient specific implants incorporated with bioactive drugs, cells, and proteins has made 3D printing technology revolutionary in medical and pharmaceutical fields. A vast variety of biomaterials are currently being used in medical 3D printing, including metals, ceramics, polymers, and composites. With continuous research and progress in biomaterials used in 3D printing, there has been a rapid growth in applications of 3D printing in manufacturing customized implants, prostheses, drug delivery devices, and 3D scaffolds for tissue engineering and regenerative medicine. The current review focuses on the novel biomaterials used in variety of 3D printing technologies for clinical applications. Most common types of medical 3D printing technologies, including fused deposition modeling, extrusion based bioprinting, inkjet, and polyjet printing techniques, their clinical applications, different types of biomaterials currently used by researchers, and key limitations are discussed in detail.
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Affiliation(s)
- Karthik Tappa
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Udayabhanu Jammalamadaka
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA.
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26
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Greenberg SB, Lang SM, Gauss CH, Lensing SY, Ali S, Lyons KA. Normal pulmonary artery and branch pulmonary artery sizes in children. Int J Cardiovasc Imaging 2018; 34:967-974. [DOI: 10.1007/s10554-018-1303-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/11/2018] [Indexed: 01/31/2023]
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