Assessment of Optimization of Computed Tomography Angiography Protocols for Follow-Up Type B Aortic Dissection Patients by Using a 3D-Printed Model

Abstract

Aim: This study aimed to investigate the optimal computed tomography angiography (CTA) scanning protocols in patients with aortic dissection following thoracic endovascular aortic repair. Materials & methods: A patient-specific aortic dissection model was CT scanned at different tube voltages (80, 100 and 120 kVp) and pitch values (1.2, 1.5, 2.0 and 2.5). Six radiologists and ten radiological technologists were invited to assess images in terms of both image quality and diagnostic value. Results & conclusion: The protocol of 80 kVp with 2.0 pitch resulted in highest subjective scores with lowest dose value compared with other protocols. This study concludes that low tube voltage with high pitch (CTA) using 3D-printed model produces adequate image quality while reducing radiation dose.

Patient-Specific 3D-Printed Low-Cost Models in Medical Education and Clinical Practice

“…EVAR is a less invasive procedure commonly used for the treatment of AAA and aortic dissection with lower risks of complications or mortality than open surgery [ 62 , 63 ]. The 3D-printed aorta models (five AAA models) served as a useful tool not only for the simulation and planning of EVAR in complex aneurysm cases, but also for the development of optimal CT scanning protocols, since routine CT angiography follow-up is commonly performed in patients following EVAR treatment [ 32 , 64 ]. Figure 12 shows 3D-printed AAA models with the use of different materials with the aim of simulating EVAR procedures.…”

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.…”

“…CT scans were conducted to investigate the optimal aortic CT angiography (CTA) protocols in the follow-up of patients with aortic dissection following EVAR treatment. Low kilovoltage peak (80 kVp) and high pitch (2.0) can be suggested as the optimal CT protocol with a reduction of more than 20% radiation dose without affecting image quality as assessed quantitatively and qualitatively ( Figure 14 ) [ 25 , 88 ]. Since aorta CTA is the preferred imaging modality for both diagnosis of aortic aneurysm/dissection and follow-up of EVAR patients due to consecutive CT scans at regular periods, low-dose CT protocol is of paramount importance to minimize radiation dose.…”

“…Third, the use of appropriate printing materials plays an important role, especially in the simulation of cardiac or interventional procedures, such as the operators need to experience a similar feeling when performing the simulation on 3D printed models so that clinicians and students can gain confidence and skills that are required to operate on real patients. This is already achievable with the current printing materials [ 25 , 63 , 70 , 88 ].…”

Three-Dimensional Bioprinting in Cardiovascular Disease: Current Status and Future Directions

“…Nearly 50% of the current applications of 3D printing lie in the pre-surgical planning of cardiovascular procedures, with results from single and multi-centre studies showing changes in surgical decision-making when 3D printed models are employed [ 7 , 14 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Three-dimensionally printed models are also used to simulate interventional cardiology or radiology procedures, such as endovascular aneurysm repair, increasing confidence through training and practice [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ].…”