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Sanchez-Garcia J, Lopez-Verdugo F, Shorti R, Krong J, Zendejas I, Contreras AG, Botha J, Rodriguez-Davalos MI. Training the Next Generation of Transplant Surgeons With a 3-Dimensional Trainer: A Pilot Study. Transplant Direct 2024; 10:e1691. [PMID: 39131239 PMCID: PMC11315563 DOI: 10.1097/txd.0000000000001691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 06/05/2024] [Accepted: 06/24/2024] [Indexed: 08/13/2024] Open
Abstract
Background In the United States, no published guidelines promote exposure to technical variants (ie, living donor or split liver) during transplant fellowship. Simulation with hands-on liver models may improve training in transplantation. This pilot study addressed 3 overall goals (material and model creation tools, recruitment rates and assessment of workload, and protocol adherence). Methods A patient-specific hands-on liver model was constructed from clinical imaging, and it needed to be resilient and realistic. Multiple types of materials were tested between January 2020 and August 2022. Participants were recruited stepwise. A left lateral segmentectomy simulation was conducted between August 2022 and December 2022 to assess protocol adherence. Results Digital anatomy 3-dimensional printing was considered the best option for the hands-on liver model. The recruitment rate was 100% and 47% for junior attendings and surgical residents, respectively. Ten participants were included and completed all the required surveys. Seven (70%) and 6 (60%) participants "agreed" that the overall quality of the model and the material were acceptable for surgical simulation. Five participants (50%) "agreed" that the training improved their surgical skills. Nine participants (90%) "strongly agreed" that similar sessions should be included in surgical training programs. Conclusions Three-dimensional hands-on liver models have the advantage of tactile feedback and were rated favorably as a potential training tool. Study enrollment for further studies is possible with the support of leadership. Rigorous multicenter designs should be developed to measure the actual impact of 3-dimensional hands-on liver models on surgical training.
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Affiliation(s)
- Jorge Sanchez-Garcia
- Liver Transplant Service, Intermountain Primary Children’s Hospital, Salt Lake City, UT
| | - Fidel Lopez-Verdugo
- Liver Transplant Service, Intermountain Primary Children’s Hospital, Salt Lake City, UT
| | - Rami Shorti
- Advanced Visualization Engineering, Intermountain Health, Salt Lake City, UT
| | - Jake Krong
- Transplant Research Department, Intermountain Medical Center, Salt Lake City, UT
| | - Ivan Zendejas
- Liver Transplant Service, Intermountain Primary Children’s Hospital, Salt Lake City, UT
| | - Alan G. Contreras
- Liver Transplant Service, Intermountain Primary Children’s Hospital, Salt Lake City, UT
| | - Jean Botha
- Liver Transplant Service, Intermountain Primary Children’s Hospital, Salt Lake City, UT
| | - Manuel I. Rodriguez-Davalos
- Liver Transplant Service, Intermountain Primary Children’s Hospital, Salt Lake City, UT
- Division of Transplantation and Advanced Hepatobiliary Surgery, University of Utah School of Medicine, Salt Lake City, UT
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SUN ZH. Cardiovascular computed tomography in cardiovascular disease: An overview of its applications from diagnosis to prediction. J Geriatr Cardiol 2024; 21:550-576. [PMID: 38948894 PMCID: PMC11211902 DOI: 10.26599/1671-5411.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Cardiovascular computed tomography angiography (CTA) is a widely used imaging modality in the diagnosis of cardiovascular disease. Advancements in CT imaging technology have further advanced its applications from high diagnostic value to minimising radiation exposure to patients. In addition to the standard application of assessing vascular lumen changes, CTA-derived applications including 3D printed personalised models, 3D visualisations such as virtual endoscopy, virtual reality, augmented reality and mixed reality, as well as CT-derived hemodynamic flow analysis and fractional flow reserve (FFRCT) greatly enhance the diagnostic performance of CTA in cardiovascular disease. The widespread application of artificial intelligence in medicine also significantly contributes to the clinical value of CTA in cardiovascular disease. Clinical value of CTA has extended from the initial diagnosis to identification of vulnerable lesions, and prediction of disease extent, hence improving patient care and management. In this review article, as an active researcher in cardiovascular imaging for more than 20 years, I will provide an overview of cardiovascular CTA in cardiovascular disease. It is expected that this review will provide readers with an update of CTA applications, from the initial lumen assessment to recent developments utilising latest novel imaging and visualisation technologies. It will serve as a useful resource for researchers and clinicians to judiciously use the cardiovascular CT in clinical practice.
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Affiliation(s)
- Zhong-Hua SUN
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Australia
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth 6012, Australia
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Sanchez-Garcia J, Lopez-Verdugo F, Shorti R, Krong J, Kastenberg ZJ, Walters S, Gagnon A, Paci P, Zendejas I, Alonso D, Fujita S, Contreras AG, Botha J, Esquivel CO, Rodriguez-Davalos MI. Three-dimensional Liver Model Application for Liver Transplantation. Transplantation 2024; 108:464-472. [PMID: 38259179 DOI: 10.1097/tp.0000000000004730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Children are removed from the liver transplant waitlist because of death or progressive illness. Size mismatch accounts for 30% of organ refusal. This study aimed to demonstrate that 3-dimensional (3D) technology is a feasible and accurate adjunct to organ allocation and living donor selection process. METHODS This prospective multicenter study included pediatric liver transplant candidates and living donors from January 2020 to February 2023. Patient-specific, 3D-printed liver models were used for anatomic planning, real-time evaluation during organ procurement, and surgical navigation. The primary outcome was to determine model accuracy. The secondary outcome was to determine the impact of outcomes in living donor hepatectomy. Study groups were analyzed using propensity score matching with a retrospective cohort. RESULTS Twenty-eight recipients were included. The median percentage error was -0.6% for 3D models and had the highest correlation to the actual liver explant (Pearson's R = 0.96, P < 0.001) compared with other volume calculation methods. Patient and graft survival were comparable. From 41 living donors, the median percentage error of the allograft was 12.4%. The donor-matched study group had lower central line utilization (21.4% versus 75%, P = 0.045), shorter length of stay (4 versus 7 d, P = 0.003), and lower mean comprehensive complication index (3 versus 21, P = 0.014). CONCLUSIONS Three-dimensional volume is highly correlated with actual liver explant volume and may vary across different allografts for living donation. The addition of 3D-printed liver models during the transplant evaluation and organ procurement process is a feasible and safe adjunct to the perioperative decision-making process.
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Affiliation(s)
- Jorge Sanchez-Garcia
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Fidel Lopez-Verdugo
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Rami Shorti
- Emerging Technologies, Intermountain Health, Murray, UT
| | - Jake Krong
- Transplant Research Department, Intermountain Medical Center, Murray, UT
| | - Zachary J Kastenberg
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Division of Pediatric Surgery, University of Utah School of Medicine, Salt Lake City, UT
| | - Shannon Walters
- Department of Radiology, Stanford University School of Medicine, Stanford, CA
| | - Andrew Gagnon
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Philippe Paci
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Ivan Zendejas
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Diane Alonso
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Shiro Fujita
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Alan G Contreras
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Jean Botha
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Abdominal Transplant Service, Intermountain Medical Center, Murray, UT
| | - Carlos O Esquivel
- Division of Abdominal Transplantation, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, CA
| | - Manuel I Rodriguez-Davalos
- Liver Center, Intermountain Primary Children's Hospital, Salt Lake City, UT
- Division of Transplant Surgery, University of Utah School of Medicine, Salt Lake City, UT
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Kasturi M, Mathur V, Gadre M, Srinivasan V, Vasanthan KS. Three Dimensional Bioprinting for Hepatic Tissue Engineering: From In Vitro Models to Clinical Applications. Tissue Eng Regen Med 2024; 21:21-52. [PMID: 37882981 PMCID: PMC10764711 DOI: 10.1007/s13770-023-00576-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 10/27/2023] Open
Abstract
Fabrication of functional organs is the holy grail of tissue engineering and the possibilities of repairing a partial or complete liver to treat chronic liver disorders are discussed in this review. Liver is the largest gland in the human body and plays a responsible role in majority of metabolic function and processes. Chronic liver disease is one of the leading causes of death globally and the current treatment strategy of organ transplantation holds its own demerits. Hence there is a need to develop an in vitro liver model that mimics the native microenvironment. The developed model should be a reliable to understand the pathogenesis, screen drugs and assist to repair and replace the damaged liver. The three-dimensional bioprinting is a promising technology that recreates in vivo alike in vitro model for transplantation, which is the goal of tissue engineers. The technology has great potential due to its precise control and its ability to homogeneously distribute cells on all layers in a complex structure. This review gives an overview of liver tissue engineering with a special focus on 3D bioprinting and bioinks for liver disease modelling and drug screening.
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Affiliation(s)
- Meghana Kasturi
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vidhi Mathur
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Mrunmayi Gadre
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Varadharajan Srinivasan
- Department of Civil Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Kirthanashri S Vasanthan
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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Arnold J, Vijayakumar N, Levy P. Advanced imaging and modeling in neonatal simulation. Semin Perinatol 2023; 47:151825. [PMID: 37940437 DOI: 10.1016/j.semperi.2023.151825] [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] [Indexed: 11/10/2023]
Abstract
Advances in modeling and imaging have resulted in realistic tools that can be applied to education and training, and even direct patient care. These include point-of-care ultrasound (POCUS), 3-dimensional and digital anatomic modeling, and extended reality. These technologies have been used for the preparation of complex patient care through simulation-based clinical rehearsals, direct patient care such as the creation of patient devices and implants, and for simulation-based education and training for health professionals, patients and families. In this section, we discuss these emerging technologies and describe how they can be utilized to improve patient care.
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Oh N, Kim JH, Rhu J, Jeong WK, Choi GS, Kim JM, Joh JW. Automated 3D liver segmentation from hepatobiliary phase MRI for enhanced preoperative planning. Sci Rep 2023; 13:17605. [PMID: 37848662 PMCID: PMC10582008 DOI: 10.1038/s41598-023-44736-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/11/2023] [Indexed: 10/19/2023] Open
Abstract
Recent advancements in deep learning have facilitated significant progress in medical image analysis. However, there is lack of studies specifically addressing the needs of surgeons in terms of practicality and precision for surgical planning. Accurate understanding of anatomical structures, such as the liver and its intrahepatic structures, is crucial for preoperative planning from a surgeon's standpoint. This study proposes a deep learning model for automatic segmentation of liver parenchyma, vascular and biliary structures, and tumor mass in hepatobiliary phase liver MRI to improve preoperative planning and enhance patient outcomes. A total of 120 adult patients who underwent liver resection due to hepatic mass and had preoperative gadoxetic acid-enhanced MRI were included in the study. A 3D residual U-Net model was developed for automatic segmentation of liver parenchyma, tumor mass, hepatic vein (HV), portal vein (PV), and bile duct (BD). The model's performance was assessed using Dice similarity coefficient (DSC) by comparing the results with manually delineated structures. The model achieved high accuracy in segmenting liver parenchyma (DSC 0.92 ± 0.03), tumor mass (DSC 0.77 ± 0.21), hepatic vein (DSC 0.70 ± 0.05), portal vein (DSC 0.61 ± 0.03), and bile duct (DSC 0.58 ± 0.15). The study demonstrated the potential of the 3D residual U-Net model to provide a comprehensive understanding of liver anatomy and tumors for preoperative planning, potentially leading to improved surgical outcomes and increased patient safety.
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Affiliation(s)
- Namkee Oh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jae-Hun Kim
- Department of Radiology and Center for Imaging Sciences, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jinsoo Rhu
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Woo Kyoung Jeong
- Department of Radiology and Center for Imaging Sciences, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Gyu-Seong Choi
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jong Man Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jae-Won Joh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
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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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Shahbaz M, Miao H, Farhaj Z, Gong X, Weikai S, Dong W, Jun N, Shuwei L, Yu D. Mixed reality navigation training system for liver surgery based on a high-definition human cross-sectional anatomy data set. Cancer Med 2023; 12:7992-8004. [PMID: 36607128 PMCID: PMC10134360 DOI: 10.1002/cam4.5583] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/24/2022] [Accepted: 12/17/2022] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES This study aims to use the three-dimensional (3D) mixed-reality model of liver, entailing complex intrahepatic systems and to deeply study the anatomical structures and to promote the training, diagnosis and treatment of liver diseases. METHODS Vascular perfusion human specimens were used for thin-layer frozen milling to obtain liver cross-sections. The 104-megapixel-high-definition cross sectional data set was established and registered to achieve structure identification and manual segmentation. The digital model was reconstructed and data was used to print a 3D hepatic model. The model was combined with HoloLens mixed reality technology to reflect the complex relationships of intrahepatic systems. We simulated 3D patient specific anatomy for identification and preoperative planning, conducted a questionnaire survey, and evaluated the results. RESULTS The 3D digital model and 1:1 transparent and colored model of liver established truly reflected intrahepatic vessels and their complex relationships. The reconstructed model imported into HoloLens could be accurately matched with the 3D model. Only 7.7% participants could identify accessory hepatic veins. The depth and spatial-relationship of intrahepatic structures were better understandable for 92%. The 100%, 84.6%, 69% and 84% believed the 3D models were useful in planning, safer surgical paths, reducing intraoperative complications and training of young surgeons respectively. CONCLUSIONS A detailed 3D model can be reconstructed using the higher quality cross-sectional anatomical data set. When combined with 3D printing and HoloLens technology, a novel hybrid-reality navigation-training system for liver surgery is created. Mixed Reality training is a worthy alternative to provide 3D information to clinicians and its possible application in surgery. This conclusion was obtained based on a questionnaire and evaluation. Surgeons with extensive experience in surgical operations perceived in the questionnaire that this technology might be useful in liver surgery, would help in precise preoperative planning, accurate intraoperative identification, and reduction of hepatic injury.
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Affiliation(s)
- Muhammad Shahbaz
- Department of Radiology, Qilu Hospital of Shandong UniversityJinanShandongChina
- Research Center for Sectional and Imaging AnatomyDigital Human Institute, School of Basic Medical Science, Shandong UniversityJinanShandongChina
- Department of General SurgeryQilu Hospital of Shandong UniversityJinanShandongChina
| | - Huachun Miao
- Department of Anatomy, Wannan Medical CollegeWuhuAnhuiChina
| | - Zeeshan Farhaj
- Department of Cardiovascular Surgery, Shandong Qianfoshan Hospital, Cheeloo College of MedicineShandong UniversityJinanShandongChina
| | - Xin Gong
- Department of Anatomy, Wannan Medical CollegeWuhuAnhuiChina
| | - Sun Weikai
- Department of Radiology, Qilu Hospital of Shandong UniversityJinanShandongChina
| | - Wenqing Dong
- Department of Anatomy, Wannan Medical CollegeWuhuAnhuiChina
| | - Niu Jun
- Department of General SurgeryQilu Hospital of Shandong UniversityJinanShandongChina
| | - Liu Shuwei
- Research Center for Sectional and Imaging AnatomyDigital Human Institute, School of Basic Medical Science, Shandong UniversityJinanShandongChina
| | - Dexin Yu
- Department of Radiology, Qilu Hospital of Shandong UniversityJinanShandongChina
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Zhang J, Liu W, Zhang Q, Zhao C, Li J, Li X, Li G, Chen J, Peng D, Wang Y, Yang C. Total thyroidectomy for giant nodular goiter guided by pre-operative 3D computed tomography reconstruction and 3D printing: A case report. Medicine (Baltimore) 2022; 101:e32456. [PMID: 36596049 PMCID: PMC9803474 DOI: 10.1097/md.0000000000032456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Nodular goiter is a common clinical problem, and thyroidectomy is preferred in patients with obstructive symptoms. Thyroidectomy is a complex procedure with some common complications. Three-dimensional (3D) computed tomography (CT) reconstruction and 3D printing provide visualized 3D anatomical structure, posing an enormously valuable potential in precise surgery with optimal efficacy and minimum complications. Here, we aimed to perform a precise thyroidectomy guided by this technology. METHODS The patient was an 80-year-old woman with 10 years of goiter, 1 year of labored dyspnea, and a history of thyroid surgery 62 years ago. In addition to ultrasonography examination, CT images were obtained to construct the 3D model to identify the 3D relationship between the lesion and adjacent structures, and a 3D model of the trachea was created and printed using a 3D printer. RESULTS The 3D model clearly presented the diffuse enlargement of the two lobes and isthmus and the compression of the goiter. Under the 3D guidance, the operative resection specimen of the right lobe and isthmus was 12 ´ 7 ´ 5 cm, whereas the left lobe specimen was 12 ´ 9 ´ 6 cm. Nodular goiter and lymphocytic thyroiditis were confirmed by postoperative histopathology. There were no complications after total thyroidectomy except for non-permanent hypocalcemia and hypoparathyroidism. CONCLUSION Our results proved that total thyroidectomy for giant goiter is challenging, and 3D image-guided thyroidectomy facilitates precise and safe resection with fewer complications. 3D CT reconstruction and 3D printing can provide anatomical details and may be considered in thyroidectomy planning for patients with giant goiter.
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Affiliation(s)
- Jun Zhang
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
- * Correspondence: Jun Zhang, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Shenzhen 518067, China (e-mail: )
| | - Wanli Liu
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Qi Zhang
- Department of Plastic and Cosmetic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chongru Zhao
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Jie Li
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Xing Li
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Gezi Li
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Jiali Chen
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Dawei Peng
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Yifei Wang
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Chang Yang
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
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Dai S, Wang Q, Jiang Z, Liu C, Teng X, Yan S, Xia D, Tuo Z, Bi L. Application of three-dimensional printing technology in renal diseases. Front Med (Lausanne) 2022; 9:1088592. [PMID: 36530907 PMCID: PMC9755183 DOI: 10.3389/fmed.2022.1088592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/21/2022] [Indexed: 10/15/2023] Open
Abstract
Three-dimensional (3D) printing technology involves the application of digital models to create 3D objects. It is used in construction and manufacturing and has gradually spread to medical applications, such as implants, drug development, medical devices, prosthetic limbs, and in vitro models. The application of 3D printing has great prospects for development in orthopedics, maxillofacial plastic surgery, cardiovascular conditions, liver disease, and other fields. With in-depth research on 3D printing technology and the continuous update of printing materials, this technology also shows broad development prospects in renal medicine. In this paper, the author mainly summarizes the basic theory of 3D printing technology, its research progress, application status, and development prospect in renal diseases.
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Affiliation(s)
- Shuxin Dai
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Qi Wang
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhiwei Jiang
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chang Liu
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xiangyu Teng
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Songbai Yan
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Dian Xia
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhouting Tuo
- Department of Urology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Liangkuan Bi
- Peking University Shenzhen Hospital, Shenzhen, China
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11
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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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Three-dimensional modeling in complex liver surgery and liver transplantation. Hepatobiliary Pancreat Dis Int 2022; 21:318-324. [PMID: 35701284 DOI: 10.1016/j.hbpd.2022.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 05/24/2022] [Indexed: 02/05/2023]
Abstract
Liver resection and transplantation are the most effective therapies for many hepatobiliary tumors and diseases. However, these surgical procedures are challenging due to the anatomic complexity and many anatomical variations of the vascular and biliary structures. Three-dimensional (3D) printing models can clearly locate and describe blood vessels, bile ducts and tumors, calculate both liver and residual liver volumes, and finally predict the functional status of the liver after resection surgery. The 3D printing models may be particularly helpful in the preoperative evaluation and surgical planning of especially complex liver resection and transplantation, allowing to possibly increase resectability rates and reduce postoperative complications. With the continuous developments of imaging techniques, such models are expected to become widely applied in clinical practice.
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Christou CD, Tsoulfas G. Role of three-dimensional printing and artificial intelligence in the management of hepatocellular carcinoma: Challenges and opportunities. World J Gastrointest Oncol 2022; 14:765-793. [PMID: 35582107 PMCID: PMC9048537 DOI: 10.4251/wjgo.v14.i4.765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/24/2021] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) constitutes the fifth most frequent malignancy worldwide and the third most frequent cause of cancer-related deaths. Currently, treatment selection is based on the stage of the disease. Emerging fields such as three-dimensional (3D) printing, 3D bioprinting, artificial intelligence (AI), and machine learning (ML) could lead to evidence-based, individualized management of HCC. In this review, we comprehensively report the current applications of 3D printing, 3D bioprinting, and AI/ML-based models in HCC management; we outline the significant challenges to the broad use of these novel technologies in the clinical setting with the goal of identifying means to overcome them, and finally, we discuss the opportunities that arise from these applications. Notably, regarding 3D printing and bioprinting-related challenges, we elaborate on cost and cost-effectiveness, cell sourcing, cell viability, safety, accessibility, regulation, and legal and ethical concerns. Similarly, regarding AI/ML-related challenges, we elaborate on intellectual property, liability, intrinsic biases, data protection, cybersecurity, ethical challenges, and transparency. Our findings show that AI and 3D printing applications in HCC management and healthcare, in general, are steadily expanding; thus, these technologies will be integrated into the clinical setting sooner or later. Therefore, we believe that physicians need to become familiar with these technologies and prepare to engage with them constructively.
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Affiliation(s)
- Chrysanthos D Christou
- Department of Transplantation Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54622, Greece
| | - Georgios Tsoulfas
- Department of Transplantation Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54622, Greece
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Bhuskute H, Shende P, Prabhakar B. 3D Printed Personalized Medicine for Cancer: Applications for Betterment of Diagnosis, Prognosis and Treatment. AAPS PharmSciTech 2021; 23:8. [PMID: 34853934 DOI: 10.1208/s12249-021-02153-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022] Open
Abstract
Cancer treatment is challenging due to the tumour heterogeneity that makes personalized medicine a suitable technique for providing better cancer treatment. Personalized medicine analyses patient-related factors like genetic make-up and lifestyle and designs treatments that offer the benefits of reduced side effects and efficient drug delivery. Personalized medicine aims to provide a holistic way for prevention, diagnosis and treatment. The customization desired in personalized medicine is produced accurately by 3D printing which is an established technique known for its precision. Different 3D printing techniques exhibit their capability in producing cancer-specific medications for breast, liver, thyroid and kidney tumours. Three-dimensional printing displays major influence on cancer modelling and studies using cancer models in treatment and diagnosis. Three-dimensional printed personalized tumour models like physical 3D models, bioprinted models and tumour-on-chip models demonstrate better in vitro and in vivo correlation in drug screening, cancer metastasis and prognosis studies. Three-dimensional printing helps in cancer modelling; moreover, it has also changed the facet of cancer treatment. Improved treatment via custom-made 3D printed devices, implants and dosage forms ensures the delivery of anticancer agents efficiently. This review covers recent applications of 3D printed personalized medicine in various cancer types and comments on the possible future directions like application of 4D printing and regularization of 3D printed personalized medicine in healthcare.
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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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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, GPO Box U1987, Perth, Australia
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Semenkov AV, Subbot VS. [Systematic review of current trends in preoperative planning of surgery for liver tumors]. Khirurgiia (Mosk) 2021:84-97. [PMID: 34363450 DOI: 10.17116/hirurgia202108184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of the study was a systematic review of current trends in preoperative planning of surgery for liver tumors. These data will be valuable to determine the advantages and disadvantages of 3D modeling, augmented reality technology and 3D printing in preoperative planning of surgery for focal liver lesions.
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Affiliation(s)
- A V Semenkov
- Sklifosovsky Institute for Emergency Care, Moscow, Russia.,Sechenov First Moscow State Medical University, Moscow, Russia
| | - V S Subbot
- Sklifosovsky Institute for Emergency Care, Moscow, Russia.,Sechenov First Moscow State Medical University, Moscow, Russia
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Haleem A, Javaid M, Suman R, Singh RP. 3D Printing Applications for Radiology: An Overview. Indian J Radiol Imaging 2021; 31:10-17. [PMID: 34316106 PMCID: PMC8299499 DOI: 10.1055/s-0041-1729129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Three-dimensional (3D) printing technologies are part of additive manufacturing processes and are used to manufacture a 3D physical model from a digital computer-aided design model as per the required shape and size. These technologies are now used for advanced radiology applications by providing all information through 3D physical model. It provides innovation in radiology for clinical applications, treatment planning, procedural simulation, medical and patient education. Radiological advancements have been made in diagnosis and communication through medical digital imaging techniques like computed tomography, magnetic resonance imaging. These images are converted into Digital Imaging and Communications in Medicine in Standard Triangulate Language file format, easily printable in 3D printing technologies. This 3D model provides in-depth information about pathologic and anatomic states. It is useful to create new opportunities related to patient care. This article discusses the potential of 3D printing technology in radiology. The steps involved in 3D printing for radiology are discussed diagrammatically, and finally identified 12 significant applications of 3D printing technology for radiology with a brief description. A radiologist can incorporate this technology to fulfil different challenges such as training, planning, guidelines, and better communications.
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Affiliation(s)
- Abid Haleem
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia, New Delhi, India
| | - Rajiv Suman
- Department of Industrial and Production Engineering, G.B. Pant University of Agriculture and Technology, Pantnagar, Uttarakhand, India
| | - Ravi Pratap Singh
- Department of Industrial and Production Engineering, Dr. B. R. Ambedkar National Institute of Technology, Jalandhar, Punjab, India
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Markovitz MA, Lu S, Viswanadhan NA. Role of 3D Printing and Modeling to Aid in Neuroradiology Education for Medical Trainees. Fed Pract 2021; 38:256-260. [PMID: 34733071 PMCID: PMC8560046 DOI: 10.12788/fp.0134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Applications of 3-dimensional (3D) printing in medical imaging and health care are expanding. Currently, primary uses involve presurgical planning and patient and medical trainee education. Neuroradiology is a complex subdiscipline of radiology that requires further training beyond radiology residency. This review seeks to explore the clinical value of 3D printing and modeling specifically in enhancing neuroradiology education for radiology physician residents and medical trainees. METHODS A brief review summarizing the key steps from radiologic image to 3D printed model is provided, including storage of computed tomography and magnetic resonance imaging data as digital imaging and communications in medicine files; conversion to standard tessellation language (STL) format; manipulation of STL files in interactive medical image control system software (Materialise) to create 3D models; and 3D printing using various resins via a Formlabs 2 printer. RESULTS For the purposes of demonstration and proof of concept, neuroanatomy models deemed crucial in early radiology education were created via open-source hardware designs under free or open licenses. 3D-printed objects included a sphenoid bone, cerebellum, skull base, middle ear labyrinth and ossicles, mandible, circle of Willis, carotid aneurysm, and lumbar spine using a combination of clear, white, and elastic resins. CONCLUSIONS Based on this single-institution experience, 3D-printed complex neuroanatomical structures seem feasible and may enhance resident education and patient safety. These same steps and principles may be applied to other subspecialties of radiology. Artificial intelligence also has the potential to advance the 3D process.
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Affiliation(s)
- Michael A Markovitz
- and are Radiology Resident Physicians at the University of South Florida in Tampa. is Assistant Chief of Radiology at James A. Haley Veterans' Hospital in Tampa
| | - Sen Lu
- and are Radiology Resident Physicians at the University of South Florida in Tampa. is Assistant Chief of Radiology at James A. Haley Veterans' Hospital in Tampa
| | - Narayan A Viswanadhan
- and are Radiology Resident Physicians at the University of South Florida in Tampa. is Assistant Chief of Radiology at James A. Haley Veterans' Hospital in Tampa
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Frizziero L, Santi GM, Leon-Cardenas C, Donnici G, Liverani A, Papaleo P, Napolitano F, Pagliari C, Di Gennaro GL, Stallone S, Stilli S, Trisolino G, Zarantonello P. In-House, Fast FDM Prototyping of a Custom Cutting Guide for a Lower-Risk Pediatric Femoral Osteotomy. Bioengineering (Basel) 2021; 8:bioengineering8060071. [PMID: 34073324 PMCID: PMC8230284 DOI: 10.3390/bioengineering8060071] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/11/2021] [Accepted: 05/20/2021] [Indexed: 12/01/2022] Open
Abstract
Three-dimensional printed custom cutting guides (CCGs) are becoming more and more investigated in medical literature, as a patient-specific approach is often desired and very much needed in today’s surgical practice. Three-dimensional printing applications and computer-aided surgical simulations (CASS) allow for meticulous preoperatory planning and substantial reductions of operating time and risk of human error. However, several limitations seem to slow the large-scale adoption of 3D printed CCGs. CAD designing and 3D printing skills are inevitably needed to develop workflow and address the study; therefore, hospitals are pushed to include third-party collaboration, from highly specialized medical centers to industrial engineering companies, thus increasing the time and cost of labor. The aim of this study was to move towards the feasibility of an in-house, low-cost CCG 3D printing methodology for pediatric orthopedic (PO) surgery. The prototype of a femoral cutting guide was developed for its application at the IOR—Rizzoli Orthopedic Institute of Bologna. The element was printed with an entry-level 3D printer with a high-temperature PLA fiber, whose thermomechanical properties can withstand common steam heat sterilization without bending or losing the original geometry. This methodology allowed for extensive preoperatory planning that would likewise reduce the overall surgery time, whilst reducing the risks related to the intervention.
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Affiliation(s)
- Leonardo Frizziero
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
- Correspondence:
| | - Gian Maria Santi
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Christian Leon-Cardenas
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Giampiero Donnici
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Alfredo Liverani
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Paola Papaleo
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Francesca Napolitano
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Curzio Pagliari
- Department of Industrial Engineering, Alma Mater Studiorum University of Bologna, 40136 Bologna, Italy; (G.M.S.); (C.L.-C.); (G.D.); (A.L.); (P.P.); (F.N.); (C.P.)
| | - Giovanni Luigi Di Gennaro
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
| | - Stefano Stallone
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
| | - Stefano Stilli
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
| | - Giovanni Trisolino
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
| | - Paola Zarantonello
- IRCCS—Istituto Ortopedico Rizzoli (Rizzoli Orthopaedic Institute), Paediatric Orthopaedics and Traumatology, 40136 Bologna, Italy; (G.L.D.G.); (S.S.); (S.S.); (G.T.); (P.Z.)
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Effectiveness Assessment of CAD Simulation in Complex Orthopedic Surgery Practices. Symmetry (Basel) 2021. [DOI: 10.3390/sym13050850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This experimental study defines the usage of a computer-aided surgical simulation process that is effective, safe, user-friendly, and low-cost, that achieves a detailed and realistic representation of the anatomical region of interest. The chosen tools for this purpose are state-of-the-art Computer Aided Design (CAD) software for mechanical design, and are the fundamental application dedicated to parametric modeling. These tools support different work environments, each one is for a specific type of modeling, and they allow the simulation of surgery. The result will be a faithful representation of the anatomical part both before and after the surgical procedure, screening all the intermediate phases. The doctor will assess different lines of action according to the results, then he will communicate them to the engineer who, consequently, will correct the antisymmetric issue and regenerate the model. Exact measurements of the mutual positions of the various components, skeletal and synthetic, can be achieved; all the osteosynthesis tools, necessary for the surgeon, can be included in the project according to different types of fracture to perfectly match the morphology of the bone to be treated. The method has been tested on seven clinical cases of different complexity and nature and the results of the simulations have been found to be of great effectiveness in the phase of diagnosis and of preoperative planning for the doctors and surgeons; therefore, allowing a lower risk medical operation with a better outcome. This work delivers experimental results in line with theoretical research findings in detail; moreover, full experimental and/or methodical details are provided, so that outcomes could be obtained.
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Applicability of 3D-printed models in hepatobiliary surgey: results from "LIV3DPRINT" multicenter study. HPB (Oxford) 2021; 23:675-684. [PMID: 33071150 DOI: 10.1016/j.hpb.2020.09.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 05/26/2020] [Accepted: 09/25/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hepatobiliary resections are challenging due to the complex liver anatomy. Three-dimensional printing (3DP) has gained popularity due to its ability to produce anatomical models based on the characteristics of each patient. METHODS A multicenter study was conducted on complex hepatobiliary tumours. The endpoint was to validate 3DP model accuracy from original image sources for application in the teaching, patient-communication, and planning of hepatobiliary surgery. RESULTS Thirty-five patients from eight centers were included. Process testing between 3DP and CT/MRI presented a considerable degree of similarity in vascular calibers (0.22 ± 1.8 mm), and distances between the tumour and vessel (0.31 ± 0.24 mm). The Dice Similarity Coefficient was 0.92, with a variation of 2%. Bland-Altman plots also demonstrated an agreement between 3DP and the surgical specimen with the distance of the resection margin (1.15 ± 1.52 mm). Professionals considered 3DP at a positive rate of 0.89 (95%CI; 0.73-0.95). According to student's distribution a higher success rate was reached with 3DP (median:0.9, IQR: 0.8-1) compared with CT/MRI or 3D digital imaging (P = 0.01). CONCLUSION 3DP hepatic models present a good correlation compared with CT/MRI and surgical pathology and they are useful for education, understanding, and surgical planning, but does not necessarily affect the surgical outcome.
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Ivashchenko OV, Kuhlmann KFD, van Veen R, Pouw B, Kok NFM, Hoetjes NJ, Smit JN, Klompenhouwer EG, Nijkamp J, Ruers TJM. CBCT-based navigation system for open liver surgery: Accurate guidance toward mobile and deformable targets with a semi-rigid organ approximation and electromagnetic tracking of the liver. Med Phys 2021; 48:2145-2159. [PMID: 33666243 PMCID: PMC8251891 DOI: 10.1002/mp.14825] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose The surgical navigation system that provides guidance throughout the surgery can facilitate safer and more radical liver resections, but such a system should also be able to handle organ motion. This work investigates the accuracy of intraoperative surgical guidance during open liver resection, with a semi‐rigid organ approximation and electromagnetic tracking of the target area. Methods The suggested navigation technique incorporates a preoperative 3D liver model based on diagnostic 4D MRI scan, intraoperative contrast‐enhanced CBCT imaging and electromagnetic (EM) tracking of the liver surface, as well as surgical instruments, by means of six degrees‐of‐freedom micro‐EM sensors. Results The system was evaluated during surgeries with 35 patients and resulted in an accurate and intuitive real‐time visualization of liver anatomy and tumor's location, confirmed by intraoperative checks on visible anatomical landmarks. Based on accuracy measurements verified by intraoperative CBCT, the system’s average accuracy was 4.0 ± 3.0 mm, while the total surgical delay due to navigation stayed below 20 min. Conclusions The electromagnetic navigation system for open liver surgery developed in this work allows for accurate localization of liver lesions and critical anatomical structures surrounding the resection area, even when the liver was manipulated. However, further clinically integrating the method requires shortening the guidance‐related surgical delay, which can be achieved by shifting to faster intraoperative imaging like ultrasound. Our approach is adaptable to navigation on other mobile and deformable organs, and therefore may benefit various clinical applications.
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Affiliation(s)
- Oleksandra V Ivashchenko
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Koert F D Kuhlmann
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Ruben van Veen
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Bas Pouw
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Niels F M Kok
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Nikie J Hoetjes
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Jasper N Smit
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Elisabeth G Klompenhouwer
- Department of Radiology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Jasper Nijkamp
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Theodoor J M Ruers
- Department of Surgical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Faculty of Science and Technology (TNW), University of Twente, Drienerlolaan 5, 7522 NB, Enschede, The Netherlands
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Qu Y, Li X, Yan Z, Zhao L, Zhang L, Liu C, Xie S, Li K, Metaxas D, Wu W, Hao Y, Dai K, Zhang S, Tao X, Ai S. Surgical planning of pelvic tumor using multi-view CNN with relation-context representation learning. Med Image Anal 2021; 69:101954. [PMID: 33550006 DOI: 10.1016/j.media.2020.101954] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/21/2020] [Accepted: 12/28/2020] [Indexed: 12/20/2022]
Abstract
Limb salvage surgery of malignant pelvic tumors is the most challenging procedure in musculoskeletal oncology due to the complex anatomy of the pelvic bones and soft tissues. It is crucial to accurately resect the pelvic tumors with appropriate margins in this procedure. However, there is still a lack of efficient and repetitive image planning methods for tumor identification and segmentation in many hospitals. In this paper, we present a novel deep learning-based method to accurately segment pelvic bone tumors in MRI. Our method uses a multi-view fusion network to extract pseudo-3D information from two scans in different directions and improves the feature representation by learning a relational context. In this way, it can fully utilize spatial information in thick MRI scans and reduce over-fitting when learning from a small dataset. Our proposed method was evaluated on two independent datasets collected from 90 and 15 patients, respectively. The segmentation accuracy of our method was superior to several comparing methods and comparable to the expert annotation, while the average time consumed decreased about 100 times from 1820.3 seconds to 19.2 seconds. In addition, we incorporate our method into an efficient workflow to improve the surgical planning process. Our workflow took only 15 minutes to complete surgical planning in a phantom study, which is a dramatic acceleration compared with the 2-day time span in a traditional workflow.
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Affiliation(s)
- Yang Qu
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Xiaomin Li
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Zhennan Yan
- SenseBrain Technology, Princeton, NJ 08540, USA
| | - Liang Zhao
- SenseTime Research, Shanghai 200233, China
| | - Lichi Zhang
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030 China
| | - Chang Liu
- SenseTime Research, Shanghai 200233, China
| | | | - Kang Li
- Department of Orthopaedics, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
| | - Dimitris Metaxas
- Department of Computer Science, Rutgers University, Piscataway, NJ 08854, USA
| | - Wen Wu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Yongqiang Hao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Kerong Dai
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200240, China
| | - Shaoting Zhang
- SenseTime Research, Shanghai 200233, China; Qing Yuan Research Institute, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
| | - Songtao Ai
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.
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Chaudhary B, Anand U, Kumari V, Agrawal P, Kumar P, Priyadarshi R. Feasibility and adaptation of three-dimensional model for surgical planning and training: A pilot study. NATIONAL JOURNAL OF CLINICAL ANATOMY 2021. [DOI: 10.4103/2277-4025.329493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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26
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Huang J, Shi H, Chen Q, Hu J, Zhang Y, Song H, Zhou Q. Three-Dimensional Printed Model Fabrication and Effectiveness Evaluation in Fetuses With Congenital Heart Disease or With a Normal Heart. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:15-28. [PMID: 32562576 DOI: 10.1002/jum.15366] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/02/2020] [Accepted: 05/14/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate the technical feasibility and accuracy of applying 3-dimensional (3D) printing of normal and abnormal fetal hearts based on spatiotemporal image correlation (STIC) volume-rendered data. METHODS Spatiotemporal image correlation volume images of 15 healthy fetuses and 15 fetuses with cardiac abnormalities were collected, and Mimics software (Materialise NV, Leuven, Belgium) was used to postprocess the volume data to obtain a 3D digital model of fetal heart and large blood vessel morphologic characteristics and to output the file to a 3D printer for printing the 3D model of the fetal heart and large blood vessels. The effect accuracy of the 3D printed model was qualitatively evaluated by showing the 3D anatomic structure of the model combined with echocardiographic or autopsy results, and the dimensional accuracy of the 3D printed model was quantitatively evaluated by comparing the measured data of the model and echocardiography. RESULTS In all 30 fetuses, STIC volume data of the fetal heart were successfully reprocessed and printed out, which could visually display the morphologic characteristics of the fetal heart chamber and passage of the great vessels under normal and abnormal pathologic conditions. No significant differences in all of the heart size parameters were found between the 3D digital model, 3D printed model, and routine echocardiographic images (all P > .05). Moreover, the size parameters were concordant well between the methods, and all of the data points fell within the limits of agreement. CONCLUSIONS It is feasible to 3D print the fetal heart using STIC volumetric images as the data source, and the 3D printed model can fully and accurately display abnormal anatomic structures of the heart.
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Affiliation(s)
- Jia Huang
- Ultrasonography Center of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hua Shi
- Ultrasonography Center of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qian Chen
- Ultrasonography Center of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiaqi Hu
- Ultrasonography Center of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuguo Zhang
- Ultrasonography Center of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongning Song
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China
| | - Qing Zhou
- Department of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, China
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27
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Maina RM, Barahona MJ, Geibel P, Lysyy T, Finotti M, Isaji T, Wengerter B, Mentone S, Dardik A, Geibel JP. Hydrogel-based 3D bioprints repair rat small intestine injuries and integrate into native intestinal tissue. J Tissue Eng Regen Med 2020; 15:129-138. [PMID: 33197151 DOI: 10.1002/term.3157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 10/18/2020] [Accepted: 11/02/2020] [Indexed: 12/14/2022]
Abstract
3D Printing has become a mainstay of industry, with several applications in the medical field. One area that could benefit from 3D printing is intestinal failure due to injury or genetic malformations. We bioprinted cylindrical tubes from rat vascular cells that were sized to form biopatches. 2 mm enterotomies were made in the small intestine of male Sprague-Dawley rats, and sealed with biopatches. These intestinal segments were connected to an ex vivo perfusion device that provided independent extraluminal and intraluminal perfusion. The fluorescence signal of fluorescein isothiocyanate (FITC)-inulin in the intraluminal perfusate, a non-absorbable fluorescent marker of intestinal integrity, was measured every 15 min over 90 min, and used to assess the integrity of the segments under both continuous perfusion and alternate-flow perfusion. Enterotomies were made an inch away from the ileocecal junction in male Wistar rats and sealed with biopatches. The animals were monitored daily and euthanized at post-operative days 7, 14, 21, and 30. Blinded histopathological analysis was conducted to compare the patch segments to native intestine. Biopatch-sealed intestinal segments withstood both continuous and pulsatile flow rates without leakage of FITC-inulin above the control baseline. 21 of 26 animals survived with normal activity, weight gain, and stool output. Histopathology of the explanted segments showed progressive villi and crypt formation over the enterotomies, with complete restoration of the epithelium by 30 days. This study presents a novel application of 3D bioprinting to develop a universal repair patch that can seal lesions in vivo, and fully integrate into the native intestine.
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Affiliation(s)
- Renee M Maina
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Maria J Barahona
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Peter Geibel
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Taras Lysyy
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michele Finotti
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.,Transplantation & Hepatobiliary Surgery, University of Padova, Padova, Italy
| | - Toshihiko Isaji
- Division of Vascular Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Brian Wengerter
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - SueAnn Mentone
- Department of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Alan Dardik
- Division of Vascular Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - John P Geibel
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, Connecticut, USA
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29
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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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30
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Pereira da Silva N, Abreu I, Serôdio M, Ferreira L, Alexandrino H, Donato P. Advanced hepatic vasculobiliary imaging segmentation and 3D reconstruction as an aid in the surgical management of high biliary stenosis. BMC Med Imaging 2020; 20:120. [PMID: 33092546 PMCID: PMC7584102 DOI: 10.1186/s12880-020-00520-0] [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: 06/30/2020] [Accepted: 10/13/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) models are increasingly used to help surgeons, guiding them through the complex hepatic vasculobiliary anatomy. The biliary tract is a relatively untapped territory with only a few case reports described in medical literature. Our aim is to present an innovative 3D reconstruction methodology for biliary imaging and surgical planning, applied to a case of iatrogenic biliary stricture, with fusion of segmented CT and MRI images. CASE PRESENTATION A selected case of Bismuth type III iatrogenic biliary stenosis for 3D planning. CT and MR studies were acquired with dedicated protocols for segmentation. Two radiologists performed segmentation and 3D model post-processing, fusing both imaging techniques to faithfully render the anatomical structures. Measurements of anatomical landmarks were taken in both the CT/MRI and the 3D model to assure its accuracy and differences in measurement were calculated. The 3D model replicates anatomical structures and pathology with high accuracy, with only 2.2% variation between STL, CT and MRI measurements. The model was discussed with the surgical team and used in the surgical planning, improving confidence in this delicate procedure, due to the detailed prior knowledge of the patient's anatomy. CONCLUSION Three-dimensional reconstructions are a rapidly growing area of research with a significant impact in the personalized and precision medicine. The construction of 3D models that combine vascular and biliary anatomy, using different imaging techniques, respectively CT and MRI, will predictably contribute to a more rigorous planning of complex liver surgeries.
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Affiliation(s)
- Nuno Pereira da Silva
- Medical Imaging Department, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal.
| | - Inês Abreu
- Medical Imaging Department, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal
| | - Marco Serôdio
- Department of Surgery, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal
| | - Luís Ferreira
- Department of Surgery, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal
| | - Henrique Alexandrino
- Department of Surgery, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal.,University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Rua Larga, 3004-504, Coimbra, Portugal.,University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Rua Larga, 3004-504, Coimbra, Portugal
| | - Paulo Donato
- Medical Imaging Department, Coimbra University Hospital Center, Praceta Prof. Mota Pinto, 3000-075, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504, Coimbra, Portugal
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Etherton D, Tee L, Tillett C, Wong YH, Yeong CH, Sun Z. 3D visualization and 3D printing in abnormal gastrointestinal system manifestations of situs ambiguus. Quant Imaging Med Surg 2020; 10:1877-1883. [PMID: 32879864 DOI: 10.21037/qims-20-661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Dior Etherton
- Discipline of Physics and Astronomy, School of Engineering, Computing and Mathematical Sciences, Curtin University, Perth, Western Australia, Australia.,Discipline of Computing, School of Engineering, Computing and Mathematical Sciences, Curtin University, Perth, Western Australia, Australia
| | - Lisa Tee
- School of Pharmacy and Biomedical Sciences, Curtin University, Perth, Western Australia, Australia
| | - Carley Tillett
- Curtin Hub for Immersive Visualisation and eResearch (HIVE), Curtin University, Perth, Western Australia, Australia
| | - Yin Hong Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, Australia
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32
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Ni ZK, Lin D, Wang ZQ, Jin HM, Li XW, Li Y, Huang H. Precision Liver Resection: Three-Dimensional Reconstruction Combined with Fluorescence Laparoscopic Imaging. Surg Innov 2020; 28:71-78. [PMID: 32873180 DOI: 10.1177/1553350620954581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Liver surgery has entered the era of precision surgery. Therefore, how to optimize the resection of lesions and reduce the unnecessary time of liver ischemia and hypoxia have become the focus. A total of 11 patients who underwent fluorescence laparoscopic liver mass resection and preoperative three-dimensional (3D) reconstruction between August 2018 and July 2020 were evaluated. Liver cirrhosis occurred in 3 patients. The mean intraoperative blood loss was 166.8 ± 105.7 mL. The average length of the operation time was 152.0 ± 45.3 minutes. The average intraoperative hilar occlusion time was 9.3 minutes (except for hilar cholangiocarcinoma). The liver function of all patients, except patients with hilar bile duct carcinoma, returned to the preoperative level at 72 hours, and no serious complications occurred. 3D reconstruction combined with fluorescence laparoscopic imaging is safe and effective for precision liver resection.
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Affiliation(s)
- Zhong-Kai Ni
- Department of General Surgery, 194033Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, P.R. China
| | - Da Lin
- Department of General Surgery, Guang Xing Hospital Affiliated with Zhejiang University of Traditional Chinese Medicine, P.R. China
| | - Zi-Qiang Wang
- Department of General Surgery, Guang Xing Hospital Affiliated with Zhejiang University of Traditional Chinese Medicine, P.R. China
| | - Hai-Min Jin
- Department of General Surgery, 194033Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, P.R. China
| | - Xiao-Wen Li
- Department of General Surgery, 194033Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, P.R. China
| | - Ye Li
- Department of General Surgery, 194033Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, P.R. China
| | - Hai Huang
- Department of General Surgery, 194033Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, P.R. China
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33
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Larghi Laureiro Z, Novelli S, Lai Q, Mennini G, D'andrea V, Gaudenzi P, Marinozzi F, Engelmann C, Mookarje R, Raptis D, Rossi M, Jalan R. There Is a Great Future in Plastics: Personalized Approach to the Management of Hilar Cholangiocarcinoma Using a 3-D-Printed Liver Model. Dig Dis Sci 2020; 65:2210-2215. [PMID: 32440740 DOI: 10.1007/s10620-020-06326-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
In recent years, three-dimensional (3-D) printing technology has become a standard tool that is used in several medical applications such as education, surgical training simulation and planning, and doctor-patient communication. Although liver surgery is ideally complemented by the use of preoperative 3-D-printed models, only a few publications have addressed this topic. We report the case of a 29-year-old Caucasian woman admitted for a Klatskin tumor infiltrating the right portal vein requiring surgery that required complex vascular reconstruction. A life-sized liver model with colorful plastic vessels and realistic looking tumor was created with the aim of planning an optimal surgical approach. According to the 3-D model, we performed a right hepatic trisectionectomy, also removing enbloc the tract of portal vein encased by the tumor and the neoplastic thrombus, followed by a complex vascular reconstruction between the main portal vein and the left portal branch. After 22 months of follow-up, the patient was alive and continuing chemotherapy. The use of the 3-D models in liver surgery helps clarify several useful preoperative issues. The accuracy of the model regarding anatomical findings was high. In the case of complex vascular reconstruction strategies, rational use of 3-D printing technology should be implemented.
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Affiliation(s)
- Zoe Larghi Laureiro
- Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Simone Novelli
- Department of Mechanical and Aerospace Engineering, La Sapienza University of Rome, Rome, Italy.,Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
| | - Quirino Lai
- Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Gianluca Mennini
- Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Vito D'andrea
- Department of Surgical Sciences, La Sapienza University of Rome, Rome, Italy
| | - Paolo Gaudenzi
- Department of Mechanical and Aerospace Engineering, La Sapienza University of Rome, Rome, Italy
| | - Franco Marinozzi
- Department of Mechanical and Aerospace Engineering, La Sapienza University of Rome, Rome, Italy
| | - Cornelius Engelmann
- Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
| | - Raj Mookarje
- Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
| | - Dimitri Raptis
- Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
| | - Massimo Rossi
- Department of General Surgery and Organ Transplantation, La Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Rajiv Jalan
- Institute for Liver and Digestive Health, University College London, Royal Free Campus, Rowland Hill Street, London, UK
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Computer-Aided Surgical Simulation for Correcting Complex Limb Deformities in Children. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10155181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This work aims to present an in-house low-cost computer-aided simulation (CASS) process that was recently implemented in the preoperative planning of complex osteotomies for limb deformities in children. Five patients admitted to the Unit of Paediatric Orthopaedics and Traumatology from April 2018 to December 2019, for correcting congenital or post-traumatic limb deformities were included in the study. Three-dimensional (3D) digital models were generated from Computed Tomography (CT) scans, using free open-source software, and the surgery was planned and simulated starting from the 3D digital model. 3D printed sterilizable models were fabricated using a low-cost 3D printer, and animations of the operation were generated with the aim to accurately explain the operation to parents. All procedures were successfully planned using our CASS method and the 3D printed models were used during the operation, improving the understanding of the severely abnormal bony anatomy. The surgery was precisely reproduced according to CASS and the deformities were successfully corrected in four cases, while in one case, the intraoperative intentional undersizing of the bone osteotomy produced an incomplete correction of a congenital forearm deformity. Our study describes the application of a safe, effective, user-friendly, and low-cost CASS process in paediatric orthopaedics (PO) surgery. We are convinced that our study will stimulate the widespread adoption of this technological innovation in routine clinical practice for the treatment of rare congenital and post-traumatic limb deformities during childhood.
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Fang C, An J, Bruno A, Cai X, Fan J, Fujimoto J, Golfieri R, Hao X, Jiang H, Jiao LR, Kulkarni AV, Lang H, Lesmana CRA, Li Q, Liu L, Liu Y, Lau W, Lu Q, Man K, Maruyama H, Mosconi C, Örmeci N, Pavlides M, Rezende G, Sohn JH, Treeprasertsuk S, Vilgrain V, Wen H, Wen S, Quan X, Ximenes R, Yang Y, Zhang B, Zhang W, Zhang P, Zhang S, Qi X. Consensus recommendations of three-dimensional visualization for diagnosis and management of liver diseases. Hepatol Int 2020; 14:437-453. [PMID: 32638296 PMCID: PMC7366600 DOI: 10.1007/s12072-020-10052-y] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 05/04/2020] [Indexed: 12/14/2022]
Abstract
Three-dimensional (3D) visualization involves feature extraction and 3D reconstruction of CT images using a computer processing technology. It is a tool for displaying, describing, and interpreting 3D anatomy and morphological features of organs, thus providing intuitive, stereoscopic, and accurate methods for clinical decision-making. It has played an increasingly significant role in the diagnosis and management of liver diseases. Over the last decade, it has been proven safe and effective to use 3D simulation software for pre-hepatectomy assessment, virtual hepatectomy, and measurement of liver volumes in blood flow areas of the portal vein; meanwhile, the use of 3D models in combination with hydrodynamic analysis has become a novel non-invasive method for diagnosis and detection of portal hypertension. We herein describe the progress of research on 3D visualization, its workflow, current situation, challenges, opportunities, and its capacity to improve clinical decision-making, emphasizing its utility for patients with liver diseases. Current advances in modern imaging technologies have promised a further increase in diagnostic efficacy of liver diseases. For example, complex internal anatomy of the liver and detailed morphological features of liver lesions can be reflected from CT-based 3D models. A meta-analysis reported that the application of 3D visualization technology in the diagnosis and management of primary hepatocellular carcinoma has significant or extremely significant differences over the control group in terms of intraoperative blood loss, postoperative complications, recovery of postoperative liver function, operation time, hospitalization time, and tumor recurrence on short-term follow-up. However, the acquisition of high-quality CT images and the use of these images for 3D visualization processing lack a unified standard, quality control system, and homogeneity, which might hinder the evaluation of application efficacy in different clinical centers, causing enormous inconvenience to clinical practice and scientific research. Therefore, rigorous operating guidelines and quality control systems need to be established for 3D visualization of liver to develop it to become a mature technology. Herein, we provide recommendations for the research on diagnosis and management of 3D visualization in liver diseases to meet this urgent need in this research field.
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Affiliation(s)
- Chihua Fang
- The First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510282, China.
| | - Jihyun An
- Department of Gastroenterology, Hanyang University College of Medicine and Hanyang University Guri Hospital, Guri, 11923, South Korea
| | - Antonio Bruno
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Xiujun Cai
- Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jia Fan
- Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Fudan University, Shanghai, 200032, China.,Key Laboratory of Medical Epigenetics and Metabolism, Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Jiro Fujimoto
- Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Rita Golfieri
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Xishan Hao
- Department of Gastrointestinal Cancer Biology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Hongchi Jiang
- Department of Liver Surgery, The First Affiliated Hospital Harbin Medical University, Harbin, 150001, Heilongjiang, China
| | - Long R Jiao
- HPB Surgical Unit, Department of Surgery and Cancer, Imperial College, London, W12 0HS, UK
| | - Anand V Kulkarni
- Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Hauke Lang
- Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg-University, Langenbeckst. 1, 55131, Mainz, Germany
| | - Cosmas Rinaldi A Lesmana
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, 10430, Indonesia
| | - Qiang Li
- National Clinical Research Center for Cancer and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, China
| | - Lianxin Liu
- Department of Hepatobillirary Surgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Yingbin Liu
- Department of General Surgery, Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wanyee Lau
- Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Qiping Lu
- Department of General Surgery, Central theater General Hospital of the Chinese people's Liberation Army, Wuhan, 430070, Hubei, China
| | - Kwan Man
- Department of Surgery, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Hitoshi Maruyama
- Department of Gastroenterology, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Cristina Mosconi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, S. Orsola-Malpighi Hospital, Via Giuseppe Massarenti 9, 40138, Bologna, Italy
| | - Necati Örmeci
- Department of Gastroenterology, Ankara University Medical School, Ibn'i Sina Hospital, Sihhiye, 06100, Ankara, Turkey
| | - Michael Pavlides
- Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Guilherme Rezende
- Internal Medicine Department, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Joo Hyun Sohn
- Department of Gastroenterology, Hanyang University College of Medicine and Hanyang University Guri Hospital, Guri, 11923, South Korea
| | - Sombat Treeprasertsuk
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, 10700, Thailand
| | - Valérie Vilgrain
- Department of Radiology, Assistance-Publique Hôpitaux de Paris, APHP, HUPNVS, Hôpital Beaujon, 100 bd du Général Leclerc, 92110, Clichy, France
| | - Hao Wen
- Department of Hydatid & Hepatobiliary Surgery, Digestive and Vascular Surgery Centre, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Sai Wen
- The First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510282, China
| | - Xianyao Quan
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Rafael Ximenes
- Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Yinmo Yang
- Department of General Surgery, Peking University First Hospital, Beijing, China
| | - Bixiang Zhang
- Department of Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weiqi Zhang
- The First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510282, China
| | - Peng Zhang
- The First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University, Guangdong Provincial Clinical and Engineering Center of Digital Medicine, Guangzhou, 510282, China
| | - Shaoxiang Zhang
- Institute of Digital Medicine, School of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Xiaolong Qi
- CHESS Center, Institute of Portal Hypertension, The First Hospital of Lanzhou University, Lanzhou, China.
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Bati AH, Guler E, Ozer MA, Govsa F, Erozkan K, Vatansever S, Ersin MS, Elmas ZN, Harman M. Surgical planning with patient-specific three-dimensional printed pancreaticobiliary disease models - Cross-sectional study. Int J Surg 2020; 80:175-183. [PMID: 32622058 DOI: 10.1016/j.ijsu.2020.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Three-dimensional (3D) printing has been increasingly used in medical applications with the creation of accurate patient-specific 3D printed models in medical imaging data. This study has been planned based on the fact that research on 3D printing in pancreaticobiliary disease is limited due to lack of studies on validation of model accuracy. METHODS This is an innovative study where general surgery residents are presented 5 distinct hepatopancreatobiliary disease scenarios to generate a perception and required to compare their perception level of these cases with magnetic resonance cholangiopancreatography (MRCP), 3D images and 1:1 solid models that the pathology, diverse diagnosis and presurgery diagnosis stages can be observed. This study is single-centered. RESULTS The dilated pancreaticobiliary intervention based on scenarios for general surgery residency was more original since there was no prior study that includes both model building and the evaluation of the perception created by the model. Five scenarios provided qualitative assessment with results showing the usefulness of 3D models when used as clinical tools in preoperative planning, simulation of interventional procedures, surgical education, and training. The perception level in the 3D model, MRCP (Z: 3.854, p: 0.000) and the 3D image (Z: 2.865, p: 0.004) was higher; likewise, the 3D-STL image was higher compared to the MRCP image (Z: 3.779, p: 0.000). All subspecialists agree that 3D models provided better understanding of dilated pancreaticobiliary pathoanatomy and improved surgical planning. CONCLUSIONS A thoroughly outlined genuine patient situation layout aimed for general surgery training can be installed and monitored with the support of 3D printing technology of this study. This can be utilized to develop the comprehension of pathoanatomical variations of complex pancreaticobiliary illness and to adopt a surgical approach.
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Affiliation(s)
| | | | - Mehmet Asim Ozer
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Turkey
| | - Figen Govsa
- Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Turkey.
| | - Kamil Erozkan
- Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Safa Vatansever
- Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Muhtar Sinan Ersin
- Department of General Surgery, Faculty of Medicine, Ege University, Izmir, Turkey
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Ballard DH, Wake N, Witowski J, Rybicki FJ, Sheikh A. Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: abdominal, hepatobiliary, and gastrointestinal conditions. 3D Print Med 2020; 6:13. [PMID: 32514795 PMCID: PMC7278118 DOI: 10.1186/s41205-020-00065-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/23/2020] [Indexed: 02/06/2023] Open
Abstract
Background Medical 3D printing has demonstrated value in anatomic models for abdominal, hepatobiliary, and gastrointestinal conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for abdominal, hepatobiliary, and gastrointestinal 3D printing indications. Methods A literature search was conducted to identify all relevant articles using 3D printing technology associated with a number of abdominal pathologic processes. Each included study was graded according to published guidelines. Results Evidence-based appropriateness guidelines are provided for the following areas: intra-hepatic masses, hilar cholangiocarcinoma, biliary stenosis, biliary stones, gallbladder pathology, pancreatic cancer, pancreatitis, splenic disease, gastric pathology, small bowel pathology, colorectal cancer, perianal fistula, visceral trauma, hernia, abdominal sarcoma, abdominal wall masses, and intra-abdominal fluid collections. Conclusion This document provides initial appropriate use criteria for medical 3D printing in abdominal, hepatobiliary, and gastrointestinal conditions.
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Affiliation(s)
- David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, St. Louis, MO, 63110, USA.
| | - Nicole Wake
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jan Witowski
- 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21, 31-501, Krakow, Poland
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Adnan Sheikh
- Department of Radiology and The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
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Sun Z. Use of Three-dimensional Printing in the Development of Optimal Cardiac CT Scanning Protocols. Curr Med Imaging 2020; 16:967-977. [PMID: 32107994 DOI: 10.2174/1573405616666200124124140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/22/2019] [Accepted: 11/27/2019] [Indexed: 01/01/2023]
Abstract
Three-dimensional (3D) printing is increasingly used in medical applications with most of the studies focusing on its applications in medical education and training, pre-surgical planning and simulation, and doctor-patient communication. An emerging area of utilising 3D printed models lies in the development of cardiac computed tomography (CT) protocols for visualisation and detection of cardiovascular disease. Specifically, 3D printed heart and cardiovascular models have shown potential value in the evaluation of coronary plaques and coronary stents, aortic diseases and detection of pulmonary embolism. This review article provides an overview of the clinical value of 3D printed models in these areas with regard to the development of optimal CT scanning protocols for both diagnostic evaluation of cardiovascular disease and reduction of radiation dose. The expected outcomes are to encourage further research towards this direction.
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Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, 6845, Australia
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Color Enhancement Strategies for 3D Printing of X-ray Computed Tomography Bone Data for Advanced Anatomy Teaching Models. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10051571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Three-dimensional (3D) printed anatomical models are valuable visual aids that are widely used in clinical and academic settings to teach complex anatomy. Procedures for converting human biomedical image datasets, like X-ray computed tomography (CT), to prinTable 3D files were explored, allowing easy reproduction of highly accurate models; however, these largely remain monochrome. While multi-color 3D printing is available in two accessible modalities (binder-jetting and poly-jet/multi-jet systems), studies embracing the viability of these technologies in the production of anatomical teaching models are relatively sparse, especially for sub-structures within a segmentation of homogeneous tissue density. Here, we outline a strategy to manually highlight anatomical subregions of a given structure and multi-color 3D print the resultant models in a cost-effective manner. Readily available high-resolution 3D reconstructed models are accessible to the public in online libraries. From these databases, four representative files (of a femur, lumbar vertebra, scapula, and innominate bone) were selected and digitally color enhanced with one of two strategies (painting or splitting) guided by Feneis and Dauber’s Pocket Atlas of Human Anatomy. Resulting models were created via 3D printing with binder-jet and/or poly-jet machines with important features, such as muscle origin and insertion points, highlighted using multiple colors. The resulting multi-color, physical models are promising teaching tools that will enhance the anatomical learning experience.
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An C, Li X, Zhang M, Yang J, Cheng Z, Yu X, Han Z, Liu F, Dong L, Yu J, Liang P. 3D visualization ablation planning system assisted microwave ablation for hepatocellular carcinoma (Diameter >3): a precise clinical application. BMC Cancer 2020; 20:44. [PMID: 31959147 PMCID: PMC6972027 DOI: 10.1186/s12885-020-6519-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 01/06/2020] [Indexed: 02/06/2023] Open
Abstract
Background The aim of this retrospective study was to compare the feasibility and efficiency of ultrasound-guided percutaneous microwave ablation (US-PMWA) assisted by three-dimensional visualization ablation planning system (3DVAPS) and conventional 2D planning for hepatocellular carcinoma (HCC) (diameter > 3 cm). Methods One hundred thirty patients with 223 HCC nodules (5.0 ± 1.5 cm in diameter, [3.0–10.0 cm]) who met the eligibility criteria divided into 3D and 2D planning group were reviewed from April 2015 to August 2018. Ablation parameters and oncological outcomes were compared, including overall survival (OS), recurrence-free survival (RFS), and local tumor progression (LTP). Multivariate analysis was performed on clinicopathological variables to identify the risk factors for OS and LTP. Results The median follow-up period was 21 months (range 3–44). Insertion number (5.4 ± 1.2 VS. 4.5 ± 0.9, P = 0.034), ablation time (1249.2 ± 654.2 s VS. 1082.4 ± 584.7 s, P = 0.048), ablation energy (57,000 ± 11,892 J VS. 42,600 ± 10,271 J, P = 0.038) and success rate of first ablation (95.0% VS. 85.7%, P = 0.033) were higher in the 3D planning group compared with those in 2D planning group. There was no statistical difference in OS, and RFS between the two groups (P = 0.995, P = 0.845). LTP rate of 3D planning group was less than that of 2D planning group (16.5% VS 41.2%, P = 0.003). Multivariate analysis showed tumor maximal diameters (P < 0.001), tumor number (P = 0.003) and preoperative TACE (P < 0.001) were predictors for OS and sessions (P = 0.024), a-fetoprotein level (P = 0.004), and preoperative planning (P = 0.002) were predictors for LTP, respectively. Conclusions 3DVAPS improves precision of US guided ablation resulting in lower LTP and higher 5 mm-AM for patients with HCC lesions larger than 3 cm in diameter.
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Affiliation(s)
- Chao An
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Xin Li
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Min Zhang
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China.,Department of Ultrasound, General Hospital of Xinjiang Military Region, Urumqi, China
| | - Jian Yang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Electronics, Beijing Institute of Technology, Beijing, 100081, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Xiaoling Yu
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Zhiyu Han
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Fangyi Liu
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Linan Dong
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Jie Yu
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China.
| | - Ping Liang
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, People's Republic of China.
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Li X, Chen Y, Liu J, Xu L, Li Y, Liu D, Sun Z, Wen Z. Cardiac magnetic resonance imaging of primary cardiac tumors. Quant Imaging Med Surg 2020; 10:294-313. [PMID: 31956550 DOI: 10.21037/qims.2019.11.13] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cardiac magnetic resonance (CMR) offers superior advantages in cardiac imaging due to supplying a greater field of view, excellent soft-tissue imaging, and multiplanar imaging capabilities. CMR imaging can evaluate the characteristics of cardiac tumors by visualizing the relationship between the tumor and surrounding tissues, and plays a vital role in assisting the formulation of the surgical plan, the assessment of tumor progression, and the monitoring of postoperative tumor recurrence and metastasis. In this review, we present the clinical manifestations and imaging features of different cardiac tumors. The superior performance of CMR in preoperative diagnosis, surgical treatment, and postoperative follow-up of patients with heart tumors are also highlighted.
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Affiliation(s)
- Xiaodan Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yan Chen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Jiayi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Yu Li
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Dongting Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Australia
| | - Zhaoying Wen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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Personalized 3D-Printed Transparent Liver Model Using the Hepatobiliary Phase MRI: Usefulness in the Lesion-by-Lesion Imaging-Pathologic Matching of Focal Liver Lesions-Preliminary Results. Invest Radiol 2019; 54:138-145. [PMID: 30379728 DOI: 10.1097/rli.0000000000000521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of this study was to investigate the usefulness of a personalized, 3-dimensional (3D)-printed, transparent liver model with focal liver lesions (FLLs) for lesion-by-lesion imaging-pathologic matching. MATERIALS AND METHODS This preliminary, prospective study was approved by our institutional review board, and written informed consent was obtained. Twenty patients (male-to-female ratio, 13:7; mean age, 56 years) with multiple FLLs, including at least one presumed malignant, or an indeterminate lesion 10 mm or less on the preoperative gadoxetic acid-enhanced magnetic resonance imaging (MRI), were included. After digital segmentation of hepatobiliary phase MRI, a transparent, 3D-printed liver model with colored anatomical structures and FLLs was produced. During the gross examination of the liver specimen, the per-lesion detection rates were compared between those without (routine protocol) and those with the aid of the 3D-printed liver model. RESULTS Among 98 MRI-detected FLLs (11.5 ± 12.5 mm), the per-lesion detection rate on gross examination using the 3D-printed liver model was 99.0% (97/98), which was significantly higher than that obtained on routine examination (82.7% [81/98]; P < 0.001). In the subgroup analysis, according to the tumor size, 23.9% (16/67) of FLLs 10 mm or less were additionally detected using the liver model, whereas none were additionally detected in greater than 10 mm. The additionally detected 16 FLLs in 12 patients included histologic diagnoses of viable metastases, pathologic complete response of metastases, hepatocellular carcinomas, focal nodular hyperplasia-like nodules, and hemangiomas. CONCLUSIONS A personalized, 3D-printed liver model with FLLs may improve the lesion-by-lesion imaging-pathologic matching for small FLLs, thus leading to accurate pathologic tumor staging and obtaining a reliable reference for imaging-detected FLLs.
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Perica ER, Sun Z. A Systematic Review of Three-Dimensional Printing in Liver Disease. J Digit Imaging 2019; 31:692-701. [PMID: 29633052 DOI: 10.1007/s10278-018-0067-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The purpose of this review is to analyse current literature related to the clinical applications of 3D printed models in liver disease. A search of the literature was conducted to source studies from databases with the aim of determining the applications and feasibility of 3D printed models in liver disease. 3D printed model accuracy and costs associated with 3D printing, the ability to replicate anatomical structures and delineate important characteristics of hepatic tumours, and the potential for 3D printed liver models to guide surgical planning are analysed. Nineteen studies met the selection criteria for inclusion in the analysis. Seventeen of them were case reports and two were original studies. Quantitative assessment measuring the accuracy of 3D printed liver models was analysed in five studies with mean difference between 3D printed models and original source images ranging from 0.2 to 20%. Fifteen studies provided qualitative assessment with results showing the usefulness of 3D printed models when used as clinical tools in preoperative planning, simulation of surgical or interventional procedures, medical education, and training. The cost and time associated with 3D printed liver model production was reported in 11 studies, with costs ranging from US$13 to US$2000, duration of production up to 100 h. This systematic review shows that 3D printed liver models demonstrate hepatic anatomy and tumours with high accuracy. The models can assist with preoperative planning and may be used in the simulation of surgical procedures for the treatment of malignant hepatic tumours.
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Affiliation(s)
- Elizabeth Rose Perica
- Department of Medical Radiation Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia
| | - Zhonghua Sun
- Department of Medical Radiation Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
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Guy AA, Justin AW, Aguilar-Garza DM, Markaki AE. 3D Printable Vascular Networks Generated by Accelerated Constrained Constructive Optimization for Tissue Engineering. IEEE Trans Biomed Eng 2019; 67:1650-1663. [PMID: 31545704 DOI: 10.1109/tbme.2019.2942313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
One of the greatest challenges in fabricating artificial tissues and organs is the incorporation of vascular networks to support the biological requirements of the embedded cells, encouraging tissue formation and maturation. With the advent of 3D printing technology, significant progress has been made with respect to generating vascularized artificial tissues. Current algorithms to generate arterial/venous trees are computationally expensive and offer limited freedom to optimize the resulting structures. Furthermore, there is no method for algorithmic generation of vascular networks that can recapitulate the complexity of the native vasculature for more than two trees, and export directly to a 3D printing format. Here, we report such a method, using an accelerated constructive constrained optimization approach, by decomposing the process into construction, optimization, and collision resolution stages. The new approach reduces computation time to minutes at problem sizes where previous implementations have reported days. With the optimality criterion of maximizing the volume of useful tissue which could be grown around such a network, an approach of alternating stages of construction and batch optimization of all node positions is introduced and shown to yield consistently more optimal networks. The approach does not place a limit on the number of interpenetrating networks that can be constructed in a given space; indeed we demonstrate a biomimetic, liver-like tissue model. Methods to account for the limitations of 3D printing are provided, notably the minimum feature size and infill at sharp angles, through padding and angle reduction, respectively.
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Medical 3D Printing. Is This Just The Beginning? Heart Lung Circ 2019; 28:1457-1458. [PMID: 31495503 DOI: 10.1016/j.hlc.2019.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Bangeas P, Tsioukas V, Papadopoulos VN, Tsoulfas G. Role of innovative 3D printing models in the management of hepatobiliary malignancies. World J Hepatol 2019; 11:574-585. [PMID: 31388399 PMCID: PMC6669192 DOI: 10.4254/wjh.v11.i7.574] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/12/2019] [Accepted: 06/27/2019] [Indexed: 02/06/2023] Open
Abstract
Three-dimensional (3D) printing has recently emerged as a new technique in various liver-related surgical fields. There are currently only a few systematic reviews that summarize the evidence of its impact. In order to construct a systematic literature review of the applications and effects of 3D printing in liver surgery, we searched the PubMed, Embase and ScienceDirect databases for relevant titles, according to the PRISMA statement guidelines. We retrieved 162 titles, of which 32 met the inclusion criteria and are reported. The leading application of 3D printing in liver surgery is for preoperative planning. 3D printing techniques seem to be beneficial for preoperative planning and educational tools, despite their cost and time requirements, but this conclusion must be confirmed by additional randomized controlled trials.
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Affiliation(s)
- Peter Bangeas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Vassilios Tsioukas
- Department of School of Rural and Surveying Engineering, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | | | - Georgios Tsoulfas
- Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
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The Role of 3D Printing in Medical Applications: A State of the Art. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:5340616. [PMID: 31019667 PMCID: PMC6451800 DOI: 10.1155/2019/5340616] [Citation(s) in RCA: 206] [Impact Index Per Article: 41.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 02/26/2019] [Indexed: 02/07/2023]
Abstract
Three-dimensional (3D) printing refers to a number of manufacturing technologies that generate a physical model from digital information. Medical 3D printing was once an ambitious pipe dream. However, time and investment made it real. Nowadays, the 3D printing technology represents a big opportunity to help pharmaceutical and medical companies to create more specific drugs, enabling a rapid production of medical implants, and changing the way that doctors and surgeons plan procedures. Patient-specific 3D-printed anatomical models are becoming increasingly useful tools in today's practice of precision medicine and for personalized treatments. In the future, 3D-printed implantable organs will probably be available, reducing the waiting lists and increasing the number of lives saved. Additive manufacturing for healthcare is still very much a work in progress, but it is already applied in many different ways in medical field that, already reeling under immense pressure with regards to optimal performance and reduced costs, will stand to gain unprecedented benefits from this good-as-gold technology. The goal of this analysis is to demonstrate by a deep research of the 3D-printing applications in medical field the usefulness and drawbacks and how powerful technology it is.
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Li J, Qian K, Wu H, Zeng Y. Effective preoperative abdominal incision planning on a patient with a history of repeated abdominal operations using a three-dimensional reconstruction technique: a case report. J Int Med Res 2019; 47:1359-1364. [PMID: 30773967 PMCID: PMC6421371 DOI: 10.1177/0300060519828510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This case report describes the use of a three-dimensional reconstruction
technique to plan the abdominal incision in order to avoid incision-related
complications in a 53-year-old female patient who had had a cystic mass in the
liver for 16 years and had undergone four previous surgeries. The patient
presented with a recurrent cyst. The surgical team used three-dimensional
reconstruction to model the liver mass, the area of abdominal wall weakness due
to previous surgeries, bowel adhesions, skeletal structure and whole abdominal
contour. The models were superimposed upon each other to reveal the relationship
between the various features so that the optimum incision point could be
selected so as to avoid the area of abdominal wall weakness, bowel adhesions and
vital organs. The actual surgical incision was made based on the
three-dimensional reconstruction models and the surgeon was able to avoid the
area of abdominal wall weakness and bowel adhesions as planned. No incisional
hernia and wound infection were observed postoperatively and the incision healed
well. The three-dimensional reconstruction technique for preoperative surgical
incision planning on patients with a history of multiple abdominal surgeries can
minimize incision-related complications and achieve good therapeutic
results.
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Affiliation(s)
- Jiaxin Li
- 1 Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Kun Qian
- 2 Faculty of Life Sciences & Medicine, King's College, London, UK
| | - Hong Wu
- 1 Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yong Zeng
- 1 Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Sun Z. Insights into 3D printing in medical applications. Quant Imaging Med Surg 2019; 9:1-5. [PMID: 30788241 PMCID: PMC6351810 DOI: 10.21037/qims.2019.01.03] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 01/10/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, Australia
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Lau I, Wong YH, Yeong CH, Abdul Aziz YF, Md Sari NA, Hashim SA, Sun Z. Quantitative and qualitative comparison of low- and high-cost 3D-printed heart models. Quant Imaging Med Surg 2019; 9:107-114. [PMID: 30788252 DOI: 10.21037/qims.2019.01.02] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Current visualization techniques of complex congenital heart disease (CHD) are unable to provide comprehensive visualization of the anomalous cardiac anatomy as the medical datasets can essentially only be viewed from a flat, two-dimensional (2D) screen. Three-dimensional (3D) printing has therefore been used to replicate patient-specific hearts in 3D views based on medical imaging datasets. This technique has been shown to have a positive impact on the preoperative planning of corrective surgery, patient-doctor communication, and the learning experience of medical students. However, 3D printing is often costly, and this impedes the routine application of this technology in clinical practice. This technical note aims to investigate whether reducing 3D printing costs can have any impact on the clinical value of the 3D-printed heart models. Low-cost and a high-cost 3D-printed models based on a selected case of CHD were generated with materials of differing cost. Quantitative assessment of dimensional accuracy of the cardiac anatomy and pathology was compared between the 3D-printed models and the original cardiac computed tomography (CT) images with excellent correlation (r=0.99). Qualitative evaluation of model usefulness showed no difference between the two models in medical applications.
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Affiliation(s)
- Ivan Lau
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, Australia
| | - Yin How Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Yang Faridah Abdul Aziz
- Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, Malaysia.,University of Malaya Research Imaging Centre (UMRIC) University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Ashikin Md Sari
- Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, Malaysia.,University of Malaya Research Imaging Centre (UMRIC) University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Amry Hashim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Zhonghua Sun
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, Perth, Western Australia, Australia
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