Clinical value of patient-specific three-dimensional printing of congenital heart disease: Quantitative and qualitative assessments

Lau, Ivan; Liu, Dongting; Xu, Lei; Fan, Zhanming; Sun, Zhonghua

doi:10.1371/journal.pone.0194333

Cited by 70 publications

(67 citation statements)

References 38 publications

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“…Analyses of printed 3D heart replicas bring the real 3D tactile experience with the possibility of detailed examination from all possible perspectives (5,9,10). This kind of information is helpful for surgical decision-making, as even minor anatomical details can indicate the optimal surgical approach in each individual patient with a complex congenital heart defect.…”

Section: Discussionmentioning

confidence: 99%

First printed 3D heart model based on cardiac magnetic resonance imaging data in Slovakia

Olejník¹,

Juskanič²,

Patrovic³

et al. 2019

BLL

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OBJECTIVES: To present our experience with initial fabrication of 3D printed model of heart from cardiac magnetic resonance (CMR) imaging data. METHODS: A 20-year-old patient with a congenital heart defect after a surgical correction underwent CMR imaging. A novel whole-heart CMR imaging sequence, not requiring gadolinium contrast material application, was performed. Image data from this CMR sequence were used for 3D heart model printing. RESULTS: A lifelike 3D printed copy of the heart with a congenital defect with superior visualization of cardiovascular anatomical details was successfully fabricated. CONCLUSION: 3D printing of the heart copies from novel whole heart CMR imaging data is feasible and harmless to patients. These models can be used for operative planning of complex congenital heart defects (Fig. 4, Ref. 14).

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Section: Discussionmentioning

confidence: 99%

First printed 3D heart model based on cardiac magnetic resonance imaging data in Slovakia

Olejník¹,

Juskanič²,

Patrovic³

et al. 2019

BLL

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“…Despite these advantages, the medical application of 3D printing in the domain of complex CHD is still under research and requires further validation. Several centres have adopted this technology and published case reports and series to share their experience in using 3D-printed heart models (5)(6)(7)(8)(9)(10)(11)(12)(22)(23)(24)27,33,36). The general consensus is that the cost of 3D printing remains one of the main hurdles impeding the wider application of this technology in medicine (9,19,35,37).…”

Section: Technical Notementioning

confidence: 99%

Quantitative and qualitative comparison of low- and high-cost 3D-printed heart models

Lau¹,

Wong²,

Yeong³

et al. 2019

Quant. Imaging Med. Surg

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Current visualization techniques of complex congenital heart disease (CHD) are unable to provide comprehensive visualization of the anomalous cardiac anatomy as the medical datasets can essentially only be viewed from a flat, two-dimensional (2D) screen. Three-dimensional (3D) printing has therefore been used to replicate patient-specific hearts in 3D views based on medical imaging datasets. This technique has been shown to have a positive impact on the preoperative planning of corrective surgery, patient-doctor communication, and the learning experience of medical students. However, 3D printing is often costly, and this impedes the routine application of this technology in clinical practice. This technical note aims to investigate whether reducing 3D printing costs can have any impact on the clinical value of the 3D-printed heart models. Low-cost and a high-cost 3D-printed models based on a selected case of CHD were generated with materials of differing cost. Quantitative assessment of dimensional accuracy of the cardiac anatomy and pathology was compared between the 3D-printed models and the original cardiac computed tomography (CT) images with excellent correlation (r=0.99). Qualitative evaluation of model usefulness showed no difference between the two models in medical applications.

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“…A high degree of accuracy of 3D printed models is of paramount importance to assist physicians in developing personalized medicine for patient's treatment options, thus minimizing risks and complications associated with surgical procedures and improving patient outcomes (11). Applications of 3D printed models are mainly dominated by orthopedics and maxillofacial surgery with increasing roles in cardiovascular disease (12)(13)(14)(15)(16)(17)(18)(19), however, its use in hepatobiliary disease is limited.…”

Section: Introductionmentioning

confidence: 99%

Patient-specific 3D printed model of biliary ducts with congenital cyst

Allan¹,

Kealley²,

Squelch³

et al. 2019

Quant. Imaging Med. Surg

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Background: 3D printing has shown great promise in medical applications, with increasing reports in liver diseases. However, research on 3D printing in biliary disease is limited with lack of studies on validation of model accuracy. In this study, we presented our experience of creating a realistic 3D printed model of biliary ducts with congenital cyst. Measurements of anatomical landmarks were compared at different stages of model generation to determine dimensional accuracy. Methods: Contrast-enhanced computed tomography (CT) images of a patient diagnosed with congenital cyst in the common bile duct with dilated hepatic ducts were used to create the 3D printed model. The 3D printed model was scanned on a 64-slice CT scanner using the similar abdominal CT protocol. Measurements of anatomical structures including common hepatic duct (CHD), right hepatic duct (RHD), left hepatic duct (LHD) and the cyst at left to right and anterior to posterior dimensions were performed and compared between original CT images, the standard tessellation language (STL) image and CT images of the 3D model. Results: The 3D printing model was successfully generated with replication of biliary ducts and cyst. Significant differences in measurements of these landmarks were found between the STL and the original CT images, and the CT images of the 3D printed model and the original CT images (P<0.05). Measurements of the RHD and LHD diameters from the original CT images were significantly larger than those from the CT images of 3D model or STL file (P<0.05), while measurements of the CHD diameters were significantly smaller than those of the other two datasets (P<0.05). No significant differences were reached in measurements of the CHD, RHD, LHD and the biliary cyst between CT images of the 3D printed model and STL file (P=0.08-0.98). Conclusions: This study shows our experience in producing a realistic 3D printed model of biliary ducts and biliary cyst. The model was found to replicate anatomical structures and cyst with high accuracy between the STL file and the CT images of the 3D model. Large discrepancy in dimensional measurements was noted between the original CT and STL file images, and the original CT and CT images of the 3D model, highlighting the necessity of further research with inclusion of more cases of biliary disease to validate accuracy of 3D printed biliary models.

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Clinical value of patient-specific three-dimensional printing of congenital heart disease: Quantitative and qualitative assessments

Cited by 70 publications

References 38 publications

First printed 3D heart model based on cardiac magnetic resonance imaging data in Slovakia

First printed 3D heart model based on cardiac magnetic resonance imaging data in Slovakia

Quantitative and qualitative comparison of low- and high-cost 3D-printed heart models

Patient-specific 3D printed model of biliary ducts with congenital cyst

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