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Fanizzi C, Carone G, Rocca A, Ayadi R, Petrenko V, Casali C, Rani M, Giachino M, Falsitta LV, Gambatesa E, Galbiati TF, Orena EF, Tramacere I, Riker NI, Mocca A, Schaller K, Meling TR, DiMeco F, Perin A. Simulation to become a better neurosurgeon. An international prospective controlled trial: The Passion study. BRAIN & SPINE 2024; 4:102829. [PMID: 38812880 PMCID: PMC11134543 DOI: 10.1016/j.bas.2024.102829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/31/2024]
Abstract
Introduction Surgical training traditionally adheres to the apprenticeship paradigm, potentially exposing trainees to an increased risk of complications stemming from their limited experience. To mitigate this risk, augmented and virtual reality have been considered, though their effectiveness is difficult to assess. Research question The PASSION study seeks to investigate the improvement of manual dexterity following intensive training with neurosurgical simulators and to discern how surgeons' psychometric characteristics may influence their learning process and surgical performance. Material and methods Seventy-two residents were randomized into the simulation group (SG) and control group (CG). The course spanned five days, commencing with assessment of technical skills in basic procedures within a wet-lab setting on day 1. Over the subsequent core days, the SG engaged in simulated procedures, while the CG carried out routine activities in an OR. On day 5, all residents' technical competencies were evaluated. Psychometric measures of all participants were subjected to analysis. Results The SG demonstrated superior performance (p < 0.0001) in the brain tumour removal compared to the CG. Positive learning curves were evident in the SG across the three days of simulator-based training for all tumour removal tasks (all p-values <0.05). No significant differences were noted in other tasks, and no meaningful correlations were observed between performance and any psychometric parameters. Discussion and conclusion A brief and intensive training regimen utilizing 3D virtual reality simulators enhances residents' microsurgical proficiency in brain tumour removal models. Simulators emerge as a viable tool to expedite the learning curve of in-training neurosurgeons.
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Affiliation(s)
- Claudia Fanizzi
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Giovanni Carone
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Alessandra Rocca
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Roberta Ayadi
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Veronika Petrenko
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Cecilia Casali
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Martina Rani
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan,
Italy
| | - Marta Giachino
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan,
Italy
| | - Lydia Viviana Falsitta
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Enrico Gambatesa
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Tommaso Francesco Galbiati
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Eleonora Francesca Orena
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
| | - Irene Tramacere
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
| | - Nicole Irene Riker
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
| | - Alessandro Mocca
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan,
Italy
| | - Karl Schaller
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva
University Hospitals & Faculty of Medicine, Geneva, Switzerland
- Department of Clinical Neurosciences, Division of Neurosurgery, Geneva
University Hospitals & Faculty of Medicine, and SFITS, Geneva,
Switzerland
| | - Torstein Ragnar Meling
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
- Department of Neurosurgery, The National Hospital of Denmark,
Rigshospitalet, Copenhagen, Denmark
| | - Francesco DiMeco
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
- Department of Pathophysiology and Transplantation, University of Milano,
Milano, Italy
- Department of Neurological Surgery, Johns Hopkins Medical School,
Baltimore, MD, USA
| | - Alessandro Perin
- Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico
“C. Besta”, Milano, Italy
- Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico
Nazionale "C. Besta", Milano, Italy
- Department of Life Sciences, University of Trieste, Trieste,
Italy
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2
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Agarwal P, Arora G, Panwar A, Mathur V, Srinivasan V, Pandita D, Vasanthan KS. Diverse Applications of Three-Dimensional Printing in Biomedical Engineering: A Review. 3D PRINTING AND ADDITIVE MANUFACTURING 2023; 10:1140-1163. [PMID: 37886418 PMCID: PMC10599440 DOI: 10.1089/3dp.2022.0281] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
A three-dimensional (3D) printing is a robotically controlled state-of-the-art technology that is promising for all branches of engineering with a meritorious emphasis to biomedical engineering. The purpose of 3D printing (3DP) is to create exact superstructures without any framework in a brief period with high reproducibility to create intricate and complex patient-tailored structures for organ regeneration, drug delivery, imaging processes, designing personalized dose-specific tablets, developing 3D models of organs to plan surgery and to understand the pathology of disease, manufacturing cost-effective surgical tools, and fabricating implants and organ substitute devices for prolonging the lives of patients, etc. The formulation of bioinks and programmed G codes help to obtain precise 3D structures, which determines the stability and functioning of the 3D-printed structures. Three-dimensional printing for medical applications is ambitious and challenging but made possible with the culmination of research expertise from various fields. Exploring and expanding 3DP for biomedical and clinical applications can be life-saving solutions. The 3D printers are cost-effective and eco-friendly, as they do not release any toxic pollutants or waste materials that pollute the environment. The sampling requirements and processing parameters are amenable, which further eases the production. This review highlights the role of 3D printers in the health care sector, focusing on their roles in tablet development, imaging techniques, disease model development, and tissue regeneration.
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Affiliation(s)
- Prachi Agarwal
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Gargi Arora
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research, Delhi Pharmaceutical Science and Research University, Government of NCT of Delhi, New Delhi, India
| | - Amit Panwar
- Institute of Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong, New Territories, Hong Kong
| | - Vidhi Mathur
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Deepti Pandita
- Department of Pharmaceutics, Delhi Institute of Pharmaceutical Sciences and Research, Delhi Pharmaceutical Science and Research University, Government of NCT of Delhi, New Delhi, India
- Centre for Advanced Formulation and Technology (CAFT), Delhi Pharmaceutical Sciences and Research University, PushpVihar, Government of NCT of Delhi, New Delhi, India
| | - Kirthanashri S. Vasanthan
- Manipal Centre for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Laurent D, Lucke-Wold B, Pierre K, Bardhi O, Yue S, Brennan M, Fox WC, Chalouhi N, Koch MJ, Hoh B, Dow JS, Murad GJA, Polifka A. Focused selection of open cerebrovascular cases for residents interested in cerebrovascular neurosurgery. NEUROCIRUGIA (ENGLISH EDITION) 2023; 34:53-59. [PMID: 36754760 PMCID: PMC9994638 DOI: 10.1016/j.neucie.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/23/2021] [Indexed: 02/08/2023]
Abstract
INTRODUCTION National and international trends continue to show greater emphasis on endovascular techniques for the treatment of cerebrovascular disease. The cerebrovascular neurosurgeon however must be adequately equipped to treat these patients via both open and endovascular techniques. METHODS The decline in open cerebrovascular cases for aneurysm clipping has forced many trainees to pursue open cerebrovascular fellowships to increase case volume. An alternative strategy has been employed at our institution, which is early identification of subspecialty focus with resident driven self-selection of open cerebrovascular cases. RESULTS This has allowed recent graduates to obtain enfolded endovascular training and a significant number of open cerebrovascular cases in order to obtain competence and exposure. DISCUSSION We advocate for further self-selection paradigms supplemented with simulation training in order to obviate the need for extended post-residency fellowships.
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Affiliation(s)
- Dimitri Laurent
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, United States.
| | - Kevin Pierre
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Olgert Bardhi
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Sijia Yue
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Meghan Brennan
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - W Christopher Fox
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Nohra Chalouhi
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Matthew J Koch
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Brian Hoh
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Jamie S Dow
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Gregory J A Murad
- Department of Neurosurgery, University of Florida, Gainesville, United States
| | - Adam Polifka
- Department of Neurosurgery, University of Florida, Gainesville, United States
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Wang S, Huang Q, Yuan J, Zhang H, Yang N, Pang Z. Application of 3D Printing in Individualized Treatment of Intracranial Aneurysms. Ann Indian Acad Neurol 2023; 26:81-84. [PMID: 37034038 PMCID: PMC10081545 DOI: 10.4103/aian.aian_133_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 01/19/2023] Open
Affiliation(s)
- Sen Wang
- Department of Neurosurgery, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
| | - Qing Huang
- Department of Neurosurgery, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
| | - Jing Yuan
- Department of Radiotherapy, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
| | - HongBing Zhang
- Department of Neurosurgery, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
| | - Nan Yang
- Capital Medical University, Beijing, China
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Mantilla DE, Ferrara R, Ortiz AF, Vera DD, Nicoud F, Costalat V. Validation of three-dimensional printed models of intracranial aneurysms. Interv Neuroradiol 2022:15910199221143254. [PMID: 36503318 DOI: 10.1177/15910199221143254] [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: 02/17/2024] Open
Abstract
INTRODUCTION Three-dimensional (3D) printing has evolved for medical applications as it can produce customized 3D models of devices and implants that can improve patient care. In this study, we aimed to validate the geometrical accuracy of the 3D models of intracranial aneurysms printed using Stereolithography 3D printing technology. MATERIALS AND METHODS To compare the unruptured intracranial aneurysm mesh between the five patients and 3D printed models, we opened the DICOM files in the Sim&Size® simulation software, selected the region of interest, and performed the threshold check. We juxtaposed the 3D reconstructions and manually rotated the images to get the same orientation when needed and measured deviations at different nodes of the patient and 3D printed model meshes. RESULTS In the first patient, 80% of the nodes were separated by <0.56 mm and 0.17 mm. In the second patient, the deviations were below 0.17 mm for 80% of the meshes' nodes. In the next three patients, the deviations were below 0.21, 0.23, and 0.11 mm for 80% of the meshes' nodes. Finally, the overall deviation was below 0.21 mm for 80% of the mesh nodes of the five aneurysms. CONCLUSIONS 3D printed models of intracranial aneurysms are accurate, having surfaces that resemble that of patients' angiographies with an 80% cumulative deviation below 0.21 mm.
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Affiliation(s)
- Daniel E Mantilla
- Interventional Radiology Department, Fundación oftalmológica de Santander Clínica Ardila Lülle, Floridablanca, Colombia
- Interventional Radiology Department, 27968Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
- Faculté de Sciencies, Université de Montpellier, Montpellier, France
| | | | - Andrés F Ortiz
- Interventional Radiology Department, Fundación oftalmológica de Santander Clínica Ardila Lülle, Floridablanca, Colombia
- Interventional Radiology Department, 27968Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | - Daniela D Vera
- Physician. Radiology Department, Fundación oftalmológica de Santander, Clínica Ardila Lülle, Floridablanca, Colombia
| | - Franck Nicoud
- Institut Montpelliérain Alexander, Grothendieck, CNRS, Univ. Montpellier, Montpellier, France
| | - Vincent Costalat
- Neuroradiology, Hôpital Güi-de-Chauliac, CHU de Montpellier, Montpellier, France
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Muacevic A, Adler JR, Laleva L, Nakov V, Spiriev T. Three-Dimensional Printing in Neurosurgery: A Review of Current Indications and Applications and a Basic Methodology for Creating a Three-Dimensional Printed Model for the Neurosurgical Practice. Cureus 2022; 14:e33153. [PMID: 36733788 PMCID: PMC9887931 DOI: 10.7759/cureus.33153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/01/2023] Open
Abstract
Introduction Three-dimensional (3D) printing is an affordable aid that is useful in neurosurgery. It allows for better visualization and tactile appreciation of the individual anatomy and regions of interest and therefore potentially lowers the risk of complications. There are various applications of this technology in the field of neurosurgery. Materials and methods In this paper, we present a basic methodology for the creation of a 3D printed model using only open-source software for medical image editing, model generation, pre-printing preparation, and analysis of the literature concerning the practical use of this methodology. Results The literature review on the current applications of 3D printed models in neurosurgery shows that they are mostly used for preoperative planning, surgical training, and simulation, closely followed by their use in patient-specific implants and instrumentation and medical education. MaterialiseTM Mimics is the most frequently used commercial software for a 3D modeling for preoperative planning and surgical simulation, while the most popular open-source software for the same applications is 3D Slicer. In this paper, we present the algorithm that we employ for 3D printing using HorosTM, Blender, and Cura software packages which are all free and open-source. Conclusion Three-dimensional printing is becoming widely available and of significance to neurosurgical practice. Currently, there are various applications of this technology that are less demanding in terms of technical knowledge and required fluency in medical imaging software. These predispositions open the field for further research on the possible use of 3D printing in neurosurgery.
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Algin O, Keles A, Oto C. Cerebrovascular modelling for the management of aneurysm embolization using an intrasaccular flow diverter made by 3D printing. Pol J Radiol 2022; 87:e557-e562. [PMID: 36420125 PMCID: PMC9673973 DOI: 10.5114/pjr.2022.120520] [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: 12/06/2021] [Accepted: 04/04/2022] [Indexed: 09/18/2023] Open
Abstract
PURPOSE Using 3-dimensional (3D) printers, the creation of patient-specific models is possible before and after a therapeutic intervention. There are many articles about replicas for training and simulation of aneurysm clipping. However, no paper has focused on 3D replicas obtained from 3-tesla 3D time of flight (3D-TOF) MR angiography for intrasaccular flow diverter (WEB device) embolization of the cerebral aneurysms. In this paper, we aimed to investigate the feasibility of 3D printing models obtained from 3-tesla 3D-TOF data in the management and training of WEB-assisted embolization procedures. CASE PRESENTATION We presented a longitudinal case report with several 3D-TOF MRA prints over time. Three-tesla 3D-TOF data were converted into STL and G-code files using an open-source (3D-Slicer) program. We built patient-specific realistic 3D models of a patient with a middle cerebral artery trifurcation aneurysm, which were able to demonstrate the entire WEB device treatment procedure in the pre-intervention and post-intervention periods. The aneurysmatic segment was well displayed on the STL files and the 3D replicas. They allowed visualization of the aneurysmatic segment and changes within a 6-year follow-up period. We successfully showed the possibility of fast, cheap, and easy production of replicas for demonstration of the aneurysm, the parent vessels, and post-intervention changes in a simple way using an affordable 3D printer. CONCLUSIONS 3D printing is useful for training the endovascular team and the patients, understanding the aneurysm/parent vessels, and choosing the optimal embolization technique/device. 3D printing will potentially lead to greater interventionalist confidence, decreased radiation dose, and improvements in patient safety.
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Affiliation(s)
- Oktay Algin
- Yildirim Beyazit University, Ankara, Turkey
- National MR Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Ayse Keles
- Yildirim Beyazit University, Ankara, Turkey
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You Y, Niu Y, Sun F, Huang S, Ding P, Wang X, Zhang X, Zhang J. Three-dimensional printing and 3D slicer powerful tools in understanding and treating neurosurgical diseases. Front Surg 2022; 9:1030081. [PMCID: PMC9614074 DOI: 10.3389/fsurg.2022.1030081] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Abstract
With the development of the 3D printing industry, clinicians can research 3D printing in preoperative planning, individualized implantable materials manufacturing, and biomedical tissue modeling. Although the increased applications of 3D printing in many surgical disciplines, numerous doctors do not have the specialized range of abilities to utilize this exciting and valuable innovation. Additionally, as the applications of 3D printing technology have increased within the medical field, so have the number of printable materials and 3D printers. Therefore, clinicians need to stay up-to-date on this emerging technology for benefit. However, 3D printing technology relies heavily on 3D design. 3D Slicer can transform medical images into digital models to prepare for 3D printing. Due to most doctors lacking the technical skills to use 3D design and modeling software, we introduced the 3D Slicer to solve this problem. Our goal is to review the history of 3D printing and medical applications in this review. In addition, we summarized 3D Slicer technologies in neurosurgery. We hope this article will enable many clinicians to leverage the power of 3D printing and 3D Slicer.
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Affiliation(s)
- Yijie You
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Yunlian Niu
- Department of Neurology, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Fengbing Sun
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Sheng Huang
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Peiyuan Ding
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China
| | - Xuhui Wang
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China,Department of Neurosurgery, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, The Cranial Nerve Disease Center of Shanghai JiaoTong University, Shanghai, China
| | - Xin Zhang
- Educational Administrative Department, Shanghai Chongming Health School, Shanghai, China,Correspondence: Xin Zhang Jian Zhang
| | - Jian Zhang
- Department of Neurosurgery, Xinhua Hospital Chongming Branch, Shanghai, China,Correspondence: Xin Zhang Jian Zhang
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Park CK. 3D-Printed Disease Models for Neurosurgical Planning, Simulation, and Training. J Korean Neurosurg Soc 2022; 65:489-498. [PMID: 35762226 PMCID: PMC9271812 DOI: 10.3340/jkns.2021.0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/17/2021] [Indexed: 11/27/2022] Open
Abstract
Spatial insight into intracranial pathology and structure is important for neurosurgeons to perform safe and successful surgeries. Three-dimensional (3D) printing technology in the medical field has made it possible to produce intuitive models that can help with spatial perception. Recent advances in 3D-printed disease models have removed barriers to entering the clinical field and medical market, such as precision and texture reality, speed of production, and cost. The 3D-printed disease model is now ready to be actively applied to daily clinical practice in neurosurgical planning, simulation, and training. In this review, the development of 3D-printed neurosurgical disease models and their application are summarized and discussed.
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Affiliation(s)
- Chul-Kee Park
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Wang Y, Cui H, Esworthy T, Mei D, Wang Y, Zhang LG. Emerging 4D Printing Strategies for Next-Generation Tissue Regeneration and Medical Devices. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2109198. [PMID: 34951494 DOI: 10.1002/adma.202109198] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/17/2021] [Indexed: 06/14/2023]
Abstract
The rapid development of 3D printing has led to considerable progress in the field of biomedical engineering. Notably, 4D printing provides a potential strategy to achieve a time-dependent physical change within tissue scaffolds or replicate the dynamic biological behaviors of native tissues for smart tissue regeneration and the fabrication of medical devices. The fabricated stimulus-responsive structures can offer dynamic, reprogrammable deformation or actuation to mimic complex physical, biochemical, and mechanical processes of native tissues. Although there is notable progress made in the development of the 4D printing approach for various biomedical applications, its more broad-scale adoption for clinical use and tissue engineering purposes is complicated by a notable limitation of printable smart materials and the simplistic nature of achievable responses possible with current sources of stimulation. In this review, the recent progress made in the field of 4D printing by discussing the various printing mechanisms that are achieved with great emphasis on smart ink mechanisms of 4D actuation, construct structural design, and printing technologies, is highlighted. Recent 4D printing studies which focus on the applications of tissue/organ regeneration and medical devices are then summarized. Finally, the current challenges and future perspectives of 4D printing are also discussed.
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Affiliation(s)
- Yue Wang
- State Key Laboratory of Fluid Power and Mechatronics Systems, Zhejiang University, Hangzhou, 310027, China
- Key Laboratory of Advanced Manufacturing Technology of Zhejiang Province, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Haitao Cui
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC, 20052, USA
| | - Timothy Esworthy
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC, 20052, USA
| | - Deqing Mei
- State Key Laboratory of Fluid Power and Mechatronics Systems, Zhejiang University, Hangzhou, 310027, China
- Key Laboratory of Advanced Manufacturing Technology of Zhejiang Province, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Yancheng Wang
- State Key Laboratory of Fluid Power and Mechatronics Systems, Zhejiang University, Hangzhou, 310027, China
- Key Laboratory of Advanced Manufacturing Technology of Zhejiang Province, School of Mechanical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Lijie Grace Zhang
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC, 20052, USA
- Department of Electrical and Computer Engineering, The George Washington University, Washington, DC, 20052, USA
- Department of Biomedical Engineering, The George Washington University, Washington, DC, 20052, USA
- Department of Medicine, The George Washington University, Washington, DC, 20052, USA
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Atypical formation of pericallosal artery A4 segment altering the corpus callosum – Anatomical case report. TRANSLATIONAL RESEARCH IN ANATOMY 2022. [DOI: 10.1016/j.tria.2022.100197] [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] Open
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12
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Focused selection of open cerebrovascular cases for residents interested in cerebrovascular neurosurgery. Neurocirugia (Astur) 2022. [DOI: 10.1016/j.neucir.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Caregiver Preferences for Three-Dimensional Printed or Augmented Reality Craniosynostosis Skull Models: A Cross-Sectional Survey. J Craniofac Surg 2021; 33:151-155. [PMID: 34967521 DOI: 10.1097/scs.0000000000008134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Recent advances in three-dimensional (3D) printing and augmented reality (AR) have expanded anatomical modeling possibilities for caregiver craniosynostosis education. The purpose of this study is to characterize caregiver preferences regarding these visual models and determine the impact of these models on caregiver understanding of craniosynostosis. METHODS The authors constructed 3D-printed and AR craniosynostosis models, which were randomly presented in a cross-sectional survey. Caregivers rated each model's utility in learning about craniosynostosis, learning about skull anatomy, viewing an abnormal head shape, easing anxiety, and increasing trust in the surgeon in comparison to a two-dimensional (2D) diagram. Furthermore, caregivers were asked to identify the fused suture on each model and indicate their preference for generic versus patient-specific models. RESULTS A total of 412 craniosynostosis caregivers completed the survey (mean age 33 years, 56% Caucasian, 51% male). Caregivers preferred interactive, patient-specific 3D-printed or AR models over 2D diagrams (mean score difference 3D-printed to 2D: 0.16, P < 0.05; mean score difference AR to 2D: 0.17, P < 0.01) for learning about craniosynostosis, with no significant difference in preference between 3D-printed and AR models. Caregiver detection accuracy of the fused suture on the sagittal model was 19% higher with the 3D-printed model than with the AR model (P < 0.05) and 17% higher with the 3D-printed model than with the 2D diagram (P < 0.05). CONCLUSIONS Our findings indicate that craniosynostosis caregivers prefer 3D-printed or AR models over 2D diagrams in learning about craniosynostosis. Future craniosynostosis skull models with increased user interactivity and patient-specific components can better suit caregiver preferences.
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Guarino S, Marchese E, Ponticelli GS, Scerrati A, Tagliaferri V, Trovalusci F. Additive Manufacturing for Neurosurgery: Digital Light Processing of Individualized Patient-Specific Cerebral Aneurysms. MATERIALS 2021; 14:ma14206057. [PMID: 34683649 PMCID: PMC8539393 DOI: 10.3390/ma14206057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/25/2021] [Accepted: 10/07/2021] [Indexed: 12/27/2022]
Abstract
This study aims at demonstrating the feasibility of reproducing individualized patient-specific three-dimensional models of cerebral aneurysms by using the direct light processing (DLP) 3D printing technique in a low-time and inexpensive way. Such models were used to help neurosurgeons understand the anatomy of the aneurysms together with the surrounding vessels and their relationships, providing, therefore, a tangible supporting tool with which to train and plan surgical operations. The starting 3D models were obtained by processing the computed tomography angiographies and the digital subtraction angiographies of three patients. Then, a 3D DLP printer was used to print the models, and, if acceptable, on the basis of the neurosurgeon’s opinion, they were used for the planning of the neurosurgery operation and patient information. All the models were printed within three hours, providing a comprehensive representation of the cerebral aneurysms and the surrounding structures and improving the understanding of their anatomy and simplifying the planning of the surgical operation.
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Affiliation(s)
- Stefano Guarino
- Department of Engineering, University of Rome “Niccolò Cusano”, Via Don Carlo Gnocchi 3, 00166 Rome, Italy; (S.G.); (G.S.P.)
| | - Enrico Marchese
- Department of Neurosurgery, Catholic University of Rome, L.go A. Gemelli 8, 00100 Rome, Italy;
| | - Gennaro Salvatore Ponticelli
- Department of Engineering, University of Rome “Niccolò Cusano”, Via Don Carlo Gnocchi 3, 00166 Rome, Italy; (S.G.); (G.S.P.)
| | - Alba Scerrati
- Department of Transalational Medicine, University of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
- Correspondence:
| | - Vincenzo Tagliaferri
- Department of Enterprise Engineering, University of Rome Tor Vergata, Via del Politecnico 1, 00133 Rome, Italy; (V.T.); (F.T.)
| | - Federica Trovalusci
- Department of Enterprise Engineering, University of Rome Tor Vergata, Via del Politecnico 1, 00133 Rome, Italy; (V.T.); (F.T.)
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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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Marciuc EA, Dobrovat BI, Popescu RM, Dobrin N, Chiriac A, Marciuc D, Eva L, Haba D. 3D Printed Models-A Useful Tool in Endovascular Treatment of Intracranial Aneurysms. Brain Sci 2021; 11:brainsci11050598. [PMID: 34066604 PMCID: PMC8148564 DOI: 10.3390/brainsci11050598] [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: 04/14/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 11/17/2022] Open
Abstract
Many developments were made in the area of endovascular treatment of intracranial aneurysms, but this procedure also requires a good assessment of vascular anatomy prior to intervention. Seventy-six cases with brain aneurysms were selected and 1:1 scale 3D printed models were created. We asked three interventional neurosurgeons with different degrees of experience (ten years, four years, and a fourth-year resident) to review the cases using CTA (computed tomography angiogram) with MPR (multiplanar reconstructions) and VRT (volume rendering technique) and make a decision: coil embolization or stent-assisted coil embolization. After we provided them with the 3D printed models, they were asked to review their treatment plan. Statistical analysis was performed and the endovascular approach changed in 11.84% of cases for ten-year experienced neurosurgeons, 13.15% for four years experienced neurosurgeon, and 21.05% for residents. The interobserver agreement was very good between the ten years experienced interventionist and four years experienced interventionist when they analyzed the data set that included the 3D printed model. The agreement was higher between all physicians after they examined the printed model. 3D patient-specific printed models may be useful in choosing between two different endovascular techniques and also help the residents to better understand the vascular anatomy and the overall procedure.
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Affiliation(s)
- Emilia Adriana Marciuc
- Department of Radiology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (E.A.M.); (R.M.P.); (D.H.)
| | - Bogdan Ionut Dobrovat
- Department of Radiology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (E.A.M.); (R.M.P.); (D.H.)
- Correspondence: ; Tel.: +40-752-173-839
| | - Roxana Mihaela Popescu
- Department of Radiology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (E.A.M.); (R.M.P.); (D.H.)
| | - Nicolaie Dobrin
- Department of Neurosurgery, Emergency Hospital “Prof. Dr. N. Oblu”, 700309 Iasi, Romania; (N.D.); (A.C.); (L.E.)
| | - Alexandru Chiriac
- Department of Neurosurgery, Emergency Hospital “Prof. Dr. N. Oblu”, 700309 Iasi, Romania; (N.D.); (A.C.); (L.E.)
| | - Daniel Marciuc
- Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania;
| | - Lucian Eva
- Department of Neurosurgery, Emergency Hospital “Prof. Dr. N. Oblu”, 700309 Iasi, Romania; (N.D.); (A.C.); (L.E.)
| | - Danisia Haba
- Department of Radiology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (E.A.M.); (R.M.P.); (D.H.)
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Battistoni G, Cassi D, Magnifico M, Pedrazzi G, Di Blasio M, Vaienti B, Di Blasio A. Does Head Orientation Influence 3D Facial Imaging? A Study on Accuracy and Precision of Stereophotogrammetric Acquisition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084276. [PMID: 33920674 PMCID: PMC8073202 DOI: 10.3390/ijerph18084276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 11/18/2022]
Abstract
This study investigates the reliability and precision of anthropometric measurements collected from 3D images and acquired under different conditions of head rotation. Various sources of error were examined, and the equivalence between craniofacial data generated from alternative head positions was assessed. 3D captures of a mannequin head were obtained with a stereophotogrammetric system (Face Shape 3D MaxiLine). Image acquisition was performed with no rotations and with various pitch, roll, and yaw angulations. On 3D images, 14 linear distances were measured. Various indices were used to quantify error magnitude, among them the acquisition error, the mean and the maximum intra- and inter-operator measurement error, repeatability and reproducibility error, the standard deviation, and the standard error of errors. Two one-sided tests (TOST) were performed to assess the equivalence between measurements recorded in different head angulations. The maximum intra-operator error was very low (0.336 mm), closely followed by the acquisition error (0.496 mm). The maximum inter-operator error was 0.532 mm, and the highest degree of error was found in reproducibility (0.890 mm). Anthropometric measurements from alternative acquisition conditions resulted in significantly equivalent TOST, with the exception of Zygion (l)–Tragion (l) and Cheek (l)–Tragion (l) distances measured with pitch angulation compared to no rotation position. Face Shape 3D Maxiline has sufficient accuracy for orthodontic and surgical use. Precision was not altered by head orientation, making the acquisition simpler and not constrained to a critical precision as in 2D photographs.
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Affiliation(s)
- Giuditta Battistoni
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
- Correspondence: ; Tel.: +39-3403042386
| | - Diana Cassi
- Department of Surgical, Medical, Dental and Morphological Science with Interest in Transplant Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Marisabel Magnifico
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
| | - Giuseppe Pedrazzi
- Department of Medicine and Surgery, Unit of Neuroscience, Interdepartmental Centre of Robust Statistics (Ro.S.A.), University of Parma, 43126 Parma, Italy;
| | - Marco Di Blasio
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
| | - Benedetta Vaienti
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
| | - Alberto Di Blasio
- Section of Orthodontics, Dental School, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (M.M.); (M.D.B.); (B.V.); (A.D.B.)
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