Purpose To develop a method to create anthropomorphic phantoms of individual patients with high precision of anatomic details and radiation attenuation properties. Materials and Methods Inkjet cartridges were filled with potassium iodide solutions (600 mg/mL) and prints were realized on plain paper (80 g/m). Stacks of 100 prints resulted in three-dimensional phantoms of 1 cm thickness. In a first step, reproduction of patient anatomy was tested by printing computed tomographic (CT) images of a real patient abdomen scan. In a second step, gray scales, iodine deposition, and Hounsfield units were investigated by printing geometric phantoms with gray scales ranging from 0% (white) to 100% (black). On the basis of these results, a gray-scale-correction procedure was developed to achieve realistic Hounsfield units in the patient phantom. In a third step, reproduction of the real patient's Hounsfield units was verified by printing the initial patient CT scan again after application of the gray-scale-correction procedure. Data were analyzed by using Pearson correlation, linear regression, and nonlinear regression. Results The first abdomen phantom showed a detailed reproduction of the patient anatomy and demonstrated feasibility of the concept. However, individual-organ Hounsfield units deviated from the real patient CT scan. Analysis of the geometric phantoms revealed an exponential correlation between template gray scales and printer deposition. Application of a correction procedure to the template gray scales allowed for a linear correlation (r = 0.9946; 95% confidence interval: 0.9916, 0.9966). After the same correction procedure was applied to the abdomen phantom, linear correlation of phantom and patient Hounsfield units was confirmed (r = 0.9925; 95% confidence interval: 0.9635, 0.9985). Conclusion The method presented in this work can realize realistic and customizable phantoms for diagnostic and therapeutic radiology, including the reproduction of individual patients. RSNA, 2016.

The purpose of our study is to develop and evaluate a method for radiopaque 3-D printing (R3P) of soft tissue computed tomography (CT) phantoms with office laser printers. Five laser printers from different vendors are tested for toner CT attenuation. A liver phantom is created by printing CT images of a patient liver on office paper. One thousand eight hundred sixty paper sheets are printed with three repeated prints per page, resulting in a stack of 18.6 cm. The phantom is examined with 12 tube current settings. Images are reconstructed using filtered back projection (FBP) and iterative reconstruction [adaptive iterative dose reduction 3D (AIDR 3D)]. Seven radiologists rated image quality of all acquisitions. Toner attenuation of all investigated printers increased linearly with the print template grayscale. The liver phantom reproduced anatomic detail and attenuation values of the patient (mean AE SD HU difference 12.68 AE 7.74). Image quality scores increased with dose but did not vary significantly above a threshold dose for AIDR 3D. Overall, AIDR 3D reconstructed images are rated superior to FBP reconstructions (p < 0.001). In conclusion, R3P with standard office laser printers can generate soft tissue CT phantoms without hardware manipulations but with limited flexibility regarding attenuation properties of the printed toner material.