Methods of 3D printing models of pituitary tumors

Abstract

Background Pituitary adenomas can give rise to a variety of clinical disorders and surgery is often the primary treatment option. However, preoperative magnetic resonance imaging (MRI) does not always reliably identify the site of an adenoma. In this setting molecular (functional) imaging (e.g. 11C-methionine PET/CT) may help with tumor localisation, although interpretation of these 2D images can be challenging. 3D printing of anatomicalal models for other indications has been shown to aid surgical planning and improve patient understanding of the planned procedure. Here, we explore the potential utility of four types of 3D printing using PET/CT and co-registered MRI for visualising pituitary adenomas. Methods A 3D patient-specific model based on a challenging clinical case was created by segmenting the pituitary gland, pituitary adenoma, carotid arteries and bone using contemporary PET/CT and MR images. The 3D anatomical models were printed using VP, MEX, MJ and PBF 3D printing methods. Different anatomicalal structures were printed in color with the exception of the PBF anatomical model where a single color was used. The anatomical models were compared against the computer model to assess printing accuracy. Three groups of clinicians (endocrinologists, neurosurgeons and ENT surgeons) assessed the anatomical models for their potential clinical utility. Results All of the printing techniques produced anatomical models which were spatially accurate, with the commercial printing techniques (MJ and PBF) and the consumer printing techniques (VP and MEX) demonstrating comparable findings (all techniques had mean spatial differences from the computer model of < 0.6 mm). The MJ, VP and MEX printing techniques yielded multicolored anatomical models, which the clinicians unanimously agreed would be preferable to use when talking to a patient; in contrast, 50%, 40% and 0% of endocrinologists, neurosurgeons and ENT surgeons respectively would consider using the PBF model. Conclusion 3D anatomical models of pituitary tumors were successfully created from PET/CT and MRI using four different 3D printing techniques. However, the expert reviewers unanimously preferred the multicolor prints. Importantly, the consumer printers performed comparably to the commercial MJ printing technique, opening the possibility that these methods can be adopted into routine clinical practice with only a modest investment.

3D Printing in Medicine; Application in Intracranial Tumours in Southern Nigeria

“…recommendations for pituitary tumours range from no immediate treatment, to medical or surgical treatment. Surgical treatment, however, is the mainstay of treatment [7]. Surgical approaches like the minimally invasive transsphenoidal approach which is regarded as safe, versatile, and effective in about 95% of pituitary tumours [9].…”

“…Applications of 3D printing from cross-sectional images like MRI and CT have shown great importance in several surgical practices such as surgical planning, implant preplanning, and enhance patient understanding of the condition and surgical process [14]. Guidelines and applications for use of 3D printing have been developed in clinical practice, including, maxillofacial, orthopaedics, cardiac and hepatobiliary, and other conditions where it may have a potential role in informing management.…”

“…Other alternative imaging strategies to aid visualization are Positron Emission Tomography (PET) with Computed Tomography (PET/CT) or MRI (PET/MR) which permit correlation of function and anatomy. Incidental pituitary tumours, however, are discovered on CT which further prompts the use of MRI in evaluation [7,8].…”

3D-printed mouthpiece adapter for sampling exhaled breath in medical applications

“…The rapid growth of 3D printing applications in the medical field is expected to revolutionise healthcare [3] and has been suggested to be of particular benefit in times of health crises when 3D printed materials can offer on-demand alternatives to medical parts and equipment that may be in short supply [4][5][6][7]. Prevalent biomedical applications include customised prosthetics [8,9], implants [10], tissue and organ fabrication [11,12], or anatomical models for medical training purposes [13][14][15], amongst others. Since their first reported use in medicine in the early 2000s [16,17], 3D printers have evolved to become a reliable engineering tool in this field, providing the freedom to produce bespoke medical products and fittings with enhanced and cost-effective productivity [18].…”

Correction to Acknowledgement

“…Following publication of the articles [ 1 , 2 ], it is noticed the below sentence needs to be added to the Acknowledgement section of the two articles:…”