CT Conversion Workflow for Intraoperative Usage of Bony Models: From DICOM Data to 3D Printed Models

Abstract

This paper presents the application of a low-cost 3D printing technology in pre-operative planning and intra-operative decision-making. Starting from Computed Tomography (CT) scans, we were able to reconstruct a 3D model of the area of interest with a very simple and rapid workflow, using open-source software and an entry level 3D printer. The use of High Temperature Poly-Lactic Acid (HTPLA) by ProtoPasta allowed fabricating sterilizable models, which could be used within the surgical field. We believe that our method is an appealing alternative to high-end commercial products, being superior for cost and speed of production. It could be advantageous especially for small and less affluent hospitals that could produce customized sterilizable tools with little investment and high versatility.

An investigation into the effect of changing the computed tomography slice reconstruction interval on the spatial replication accuracy of three‐dimensional printed anatomical models constructed by fused deposition modelling

“…The use of three‐dimensional (3D) printing in medicine is expanding rapidly. Scan data can be printed by 3D printers to create replicas of anatomy that can be held, manipulated, studied and utilised in surgical planning, medical training and patient education . Previously, clinical training and education of health practitioners has relied on the use of human cadavers .…”

“…However, the use of models provides realistic and low‐cost alternatives, particularly where financial limitations or cultural considerations impede use . Now, clinicians can produce 3D models from patient scan data to improve the diagnosis, visualisation and management of pathology, whilst surgeons may plan and rehearse difficult surgical approaches prior to performing intraoperative surgery . Clinicians can create guides that follow a patient's unique anatomy or fabricate lattice structures on medical implants to promote osseointegration and reduce risk of rejection .…”

“…CT scanners are the gold standard for imaging bony anatomy due to superior hard tissue contrast and spatial resolution . CT allows the segmentation of anatomy by utilising the Hounsfield values of the voxels in the scan data set .…”

“…Segmentation can isolate bone from soft tissue to produce 3D replicas of bony structures or separate contrast‐filled vascular structures from neighbouring anatomy to model aneurisms . Segmentation may be automatic (dependent on Hounsfield values of voxels), manual (operator‐defined spatial selection) or semi‐automatic (combination of both) …”

“…Scan data can be printed by 3D printers to create replicas of anatomy that can be held, manipulated, studied and utilised in surgical planning, medical training and patient education. [1][2][3][4][5] Previously, clinical training and education of health practitioners has relied on the use of human cadavers. 6 Difficulties reported from this approach include the lack of patientspecific pathological representation and inconsistencies within unique human anatomy.…”