Three-dimensional (3D) printing is an emerging technology aiding diagnostics, education, and interventional, and surgical planning in congenital heart disease (CHD). Three-dimensional printing has been derived from computed tomography, cardiac magnetic resonance, and 3D echocardiography. However, individually the imaging modalities may not provide adequate visualization of complex CHD. The integration of the strengths of two or more imaging modalities has the potential to enhance visualization of cardiac pathomorphology. We describe the feasibility of hybrid 3D printing from two imaging modalities in a patient with congenitally corrected transposition of the great arteries (L-TGA). Hybrid 3D printing may be useful as an additional tool for cardiologists and cardiothoracic surgeons in planning interventions in children and adults with CHD.

Hand-held three dimensional models of the human anatomy and pathology, tailored-made protheses, and custom-designed implants can be derived from imaging modalities, most commonly Computed Tomography (CT). However, standard DICOM format images cannot be 3D printed; instead, additional image post-processing is required to transform the anatomy of interest into Standard Tessellation Language (STL) format is needed. This conversion, and the subsequent 3D printing of the STL file, requires a series of steps. Initial post-processing involves the segmentation-demarcation of the desired for 3D printing parts and creating of an initial STL file. Then, Computer Aided Design (CAD) software is used, particularly for wrapping, smoothing and trimming. Devices and implants that can also be 3D printed, can be designed using this software environment. The purpose of this article is to provide a tutorial on 3D Printing with the test case of complex congenital heart disease (CHD). While the infant was born with double outlet right ventricle (DORV), this hands-on guide to be featured at the 2015 annual meeting of the Radiological Society of North America Hands-on Course in 3D Printing focused on the additional finding of a ventricular septal defect (VSD). The process of segmenting the heart chambers and the great vessels will be followed by optimization of the model using CAD software. A virtual patch that accurately matches the patient’s VSD will be designed and both models will be prepared for 3D printing.

Three-dimensional printing technology has significant clinical implications for the management of congenital heart disease. Computed tomography and magnetic resonance imaging have been established as imaging tools for the creation of physical three-dimensional models. The potential use of non-invasive bedside imaging techniques such as three-dimensional echocardiography to derive three-dimensional printed models can revolutionize the planning of interventions for complex congenital malformations. The feasibility of deriving three-dimensional printing from ultrasound provides an additional cost-effective and patient-centered option for interventional cardiologists and surgeons for the management and care of congenital heart disease patients.

Advanced visualization of medical image data in the form of three-dimensional (3D) printing continues to expand in clinical settings and many hospitals have started to adapt 3D technologies to aid in patient care. It is imperative that radiologists and other medical professionals understand the multi-step process of converting medical imaging data to digital files. To educate health care professionals about the steps required to prepare DICOM data for 3D printing anatomical models, hands-on courses have been delivered at the Radiological Society of North America (RSNA) annual meeting since 2014. In this paper, a supplement to the RSNA 2018 hands-on 3D printing course, we review methods to create cranio-maxillofacial (CMF), orthopedic, and renal cancer models which can be 3D printed or visualized in augmented reality (AR) or virtual reality (VR).

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