CT image segmentation methods for bone used in medical additive manufacturing

Eijnatten, Maureen van; Dijk, R. van; Dobbe, Johannes G. G.; Streekstra, Geert J.; Koivisto, Juha; Wolff, Jan

doi:10.1016/j.medengphy.2017.10.008

Cited by 156 publications

(138 citation statements)

References 60 publications

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“…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 .…”

Section: Introductionmentioning

confidence: 99%

“…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 . Models can be used to educate patients and their families about an upcoming surgery or to communicate the surgical steps to a clinical team .…”

Section: Introductionmentioning

confidence: 99%

“…Reported benefits of the implementation of medical model use in surgery include an operating room time reduction of 10–20% in a range of clinical scenarios . However, inaccurate anatomical representation is a reported flaw in these surgical applications, which can lead to suboptimal treatment planning . For example, George et al reported examples of model defects including occluded foramina, blurred sutures or vascular models that eliminate arteries visible in CT angiograms.…”

Section: Introductionmentioning

confidence: 99%

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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

Searle

Starkey

2020

J of Medical Radiation Sci

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Introduction Three‐dimensional (3D) printed models can be constructed utilising computed tomography (CT) data. This project aimed to determine the effect of changing the slice reconstruction interval (SRI) on the spatial replication accuracy of 3D‐printed anatomical models constructed by fused deposition modelling (FDM). Methods Three bovine vertebrae and an imaging phantom were imaged using a CT scanner. The Queensland State Government’s Animal Care and Protection Act 2001 did not apply as no animals were harmed to carry out scientific activity. The data were reconstructed into SRIs of 0.1, 0.3, 0.5 and 1 mm and processed by software before 3D printing. Specimens and printed models were measured with calipers to calculate mean absolute error prior to statistical analysis. Results Mean absolute error from the original models for the 0.1, 0.3, 0.5 and 1 mm 3D‐printed models was 0.592 ± 0.396 mm, 0.598 ± 0.479 mm, 0.712 ± 0.498 mm and 0.933 ± 0.457 mm, respectively. Paired t‐tests (P < 0.05) indicated a statistically significant difference between all original specimens and corresponding 3D‐printed models except the 0.1 mm vertebrae 2 (P = 0.061), 0.3 mm phantom 1 (P = 0.209) and 0.3 mm vertebrae 2 (P = 0.097). Conclusion This study demonstrated that changing the SRI influences the spatial replication accuracy of 3D‐printed models constructed by FDM. Matching the SRI to the primary spatial resolution limiting factor of acquisition slice width or printer capabilities optimises replication accuracy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Searle

Starkey

2020

J of Medical Radiation Sci

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“…Seit das Verfahren der additiven Fertigung Einzug in die Medizin gehalten hat, eröffnen patientenspezifische Implantate, die aus 3D-gedruckten Formen hergestellt werden, neue Perspektiven für das Atemwegsmanagement [11,12,13]. Die FDA hat die Bedeutung dieses Verfahrens bereits anerkannt und kürzlich Leitlinien zum 3D-Druck von Medizinprodukten herausgegeben [14].…”

Section: Introductionunclassified

3D-gedruckte patientenspezifische Silikon-Stents: Nachbeobachtung nach 1 Jahr bei 2 Patienten

2019

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Die Behandlung komplexer gutartiger Atemwegserkrankungen stellt eine große Herausforderung für die interventionelle Pneumologie dar. Stents in den Atemwegen können aus verschiedenen Gründen Komplikationen hervorrufen, unter anderem bei mangelhafter Passung des Stents. Wir berichten hier über das 1-Jahres-Outcome von 2 Patienten mit Atemwegserkrankung im Rahmen einer Granulomatose mit Polyangiitis (Morbus Wegener) mit Beteiligung des linken Hauptbronchus und der sekundären Carina. Bei beiden Patienten hatten systemische Therapien und bronchoskopische Standardverfahren versagt und handelsübliche Atemwegs-Stents zu Komplikationen geführt. Wir beschreiben unsere klinische Erfahrung mit einem erstmals beim Menschen angewandten Ansatz zur Überwindung dieser Probleme: Mittels Computertomographie- (CT-)Bildgebung und 3D-Drucktechnologie stellten wir einen patientenspezifischen Atemwegs-Stent aus Silikon her und implantierten diesen bei den Patienten mit Atemwegserkrankung. Den Bauplan oder das Rezept für den patientenspezifischen Stent erstellten wir anhand von Thorax-CT-Aufnahmen der Patienten in einem proprietären Softwarepaket, das ursprünglich für die orthopädische OP-Planung entwickelt worden war. Die Silikon-Stents wurden angefertigt und implantiert. Die Nachbeobachtung über >1 Jahr nach der Implantation des patientenspezifischen Stents wurde mit den 6 Monaten vor der Implantation verglichen; Kriterien waren die Anzahl klinisch erforderlicher Stent-Wechsel, die Behandlungsdauer und die allgemeine klinische Verbesserung unter standardmäßiger Versorung nach einem Atemwegs-Stenting. Der Vergleich ergab längere Stent-Liegezeit, kürzere Behandlungsdauer sowie Besserung der Symptome laut Patientenauskunft und dadurch geringeren Bedarf an Stent-Wechseln und -Modifikationen. Die Herstellung patientenspezifischer Silikon-Stents mittels 3D-Druck ist mithin durchführbar, und der erste klinische Nachweis der Praxistauglichkeit (Proof of Concept) belegt eine dauerhafte Verbesserung über den einjährigen Nachbeobachtungszeitraum.

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“…With the introduction of additive manufacturing in the medical field, patient-specific implants made from 3D-printed molds are an innovative prospect for airway management [11][12][13]. The FDA has acknowledged the rise of 3D printing and recently released guidelines on the 3D printing of medical devices [14].…”

Section: Introductionmentioning

confidence: 99%

Application of 3D Printing for Patient-Specific Silicone Stents: 1-Year Follow-Up on 2 Patients

2018

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Managing complex benign airway disease is a major challenge in interventional pulmonology. Airway stent placement can result in complications due to a variety of factors, including poor fit of the stent in the airway. We report the 1-year outcome of 2 patients with airway disease caused by granulomatosis with polyangiitis (Wegener’s) affecting the left main bronchus and secondary carina. These patients had not responded to systemic therapy or standard bronchoscopic techniques and had complications with commercially available airway stents. We describe a first-in-human, clinical experience to address these issues. Using computed tomography (CT) imaging and 3D printing technology, we generated and implanted patient-specific silicone airway stents to address airway disease. 3D patient-specific stent prescription was created using a CT scan of the patient’s chest and a proprietary software package originally developed for orthopedic surgical planning. Silicone stents were manufactured and implanted. Observation for > 1 year after implantation compared to the 6 months prior to patient-specific stent implant were compared for the number, clinically required stent changes, procedure time, and general clinical improvement per usual standard of care after airway stenting. Patients showed improved durability, a shorter procedure time, and improvement of patient-reported symptoms leading to a reduced need for stent changes and modifications. The use of 3D printing technology to make patient-specific silicone stents is feasible with early clinical proof of concept noting a durable improvement over 1 year of follow-up.

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CT image segmentation methods for bone used in medical additive manufacturing

Cited by 156 publications

References 60 publications

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

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

3D-gedruckte patientenspezifische Silikon-Stents: Nachbeobachtung nach 1 Jahr bei 2 Patienten

Application of 3D Printing for Patient-Specific Silicone Stents: 1-Year Follow-Up on 2 Patients

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