3D-Printed Coronary Plaques to Simulate High Calcification in the Coronary Arteries for Investigation of Blooming Artifacts

Abstract

The diagnostic value of coronary computed tomography angiography (CCTA) is significantly affected by high calcification in the coronary arteries owing to blooming artifacts limiting its accuracy in assessing the calcified plaques. This study aimed to simulate highly calcified plaques in 3D-printed coronary models. A combination of silicone + 32.8% calcium carbonate was found to produce 800 HU, representing extensive calcification. Six patient-specific coronary artery models were printed using the photosensitive polyurethane resin and a total of 22 calcified plaques with diameters ranging from 1 to 4 mm were inserted into different segments of these 3D-printed coronary models. The coronary models were scanned on a 192-slice CT scanner with 70 kV, pitch of 1.4, and slice thickness of 1 mm. Plaque attenuation was measured between 1100 and 1400 HU. Both maximum-intensity projection (MIP) and volume rendering (VR) images (wide and narrow window widths) were generated for measuring the diameters of these calcified plaques. An overestimation of plaque diameters was noticed on both MIP and VR images, with measurements on the MIP images close to those of the actual plaque sizes (<10% deviation), and a large measurement discrepancy observed on the VR images (up to 50% overestimation). This study proves the feasibility of simulating extensive calcification in coronary arteries using a 3D printing technique to develop calcified plaques and generate 3D-printed coronary models.

Artificial Intelligence for Radiation Dose Optimization in Pediatric Radiology: A Systematic Review

“…Hence, “as low as reasonably achievable” (ALARA) has become the fundamental principle of radiology practice [ 17 , 24 , 25 ]. International Commission on Radiological Protection (ICRP) has introduced the diagnostic reference levels (DRLs) initiative for radiological departments to identify examinations with radiation doses exceeding their corresponding DRLs and trigger the radiation dose-optimization process [ 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. As the radiation used in radiological examinations is the source of signal, a reduction of the radiation amount results in a decrease of signal strength and an increase of image noise.…”

3D Printed Models in Cardiovascular Disease: An Exciting Future to Deliver Personalized Medicine

“…Several studies have explored the feasibility of developing 3D printed heart and vascular models for CT dose optimization [ 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 ]. Abdullah et al developed an organ-specific cardiac insert phantom for the investigation of cardiac CT scanning protocols.…”

“…We have developed personalized coronary artery models and aorta models using CT images for optimizing CT protocols and visualization of coronary calcified plaques and stenting [ 83 , 84 , 85 , 86 ]. Calcified plaques were created using a mixture of silicone, ethiodized oil and carbonate to simulate calcification in the coronary arteries.…”

“…Calcified plaques were created using a mixture of silicone, ethiodized oil and carbonate to simulate calcification in the coronary arteries. The combination of silicone and 32.8% calcium carbonate was found to produce CT attenuation of 800 HU, representing extensive calcification ( Figure 12 ); thus, it is suitable for studying CT protocols for assessing calcified coronary plaques ( Figure 13 ) [ 83 ].…”

“… The 3D-printed coronary artery models with simulated calcified plaques were inserted into the coronary artery branches. Reprinted with permission under the open access from Sun et al [ 83 ]. …”