Radiopaque Three-dimensional Printing: A Method to Create Realistic CT Phantoms

Jahnke, Paul; Limberg, Felix R P; Gerbl, Andreas; Pardo, Gracia Lana Ardila; Braun, Victor Paul Bela; Hamm, Bernd; Scheel, Michael

doi:10.1148/radiol.2016152710

Cited by 52 publications

(80 citation statements)

References 9 publications

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“…Jahnke et al used a standard ink-jet dot matrix printer filled with a potassium iodide solution to print radiopaque phantoms, derived from CT data, in several layers of printer paper which were then stacked to form 1 cm thick, three-dimensional phantoms. 15 This phantom type mimics lung, bone and soft tissue in aggregate only (e.g., in Hounsfield Unit (HU) values), as iodine has a K-edge (33.2 keV) in the diagnostic x ray energy range.…”

Section: Introductionmentioning

confidence: 99%

Three‐dimensional printing CT‐derived objects with controllable radiopacity

Hamedani

Melvin

Vaheesan

et al. 2018

J Applied Clin Med Phys

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PurposeThe goal of this work was to develop phantoms for the optimization of pre‐operative computed tomography (CT) scans of the prostate artery, which are used for embolization planning.MethodsAcrylonitrile butadiene styrene (ABS) pellets were doped with barium sulfate and extruded into filaments suitable for 3D printing on a fused deposition modeling (FDM) printer. Cylinder phantoms were created to evaluate radiopacity as a function of doping percentage. Small‐diameter tree phantoms were created to assess their composition and dimensional accuracy. A half‐pelvis phantom was created using clinical CT images, to assess the printer's control over cortical bone thickness and cancellous bone attenuation. CT‐derived prostate artery phantoms were created to simulate complex, contrast‐filled arteries.ResultsA linear relationship (R = 0.998) was observed between barium sulfate added (0%–10% by weight), and radiopacity (−31 to 1454 Hounsfield Units [HU]). Micro‐CT scans showed even distribution of the particles, with air pockets comprising 0.36% by volume. The small vessels were found to be oversized by a consistent amount of 0.08 mm. Micro‐CT scans revealed that the phantoms' interiors were completely filled in. The maximum HU values of cortical bone in the phantom were lower than that of the filament, a result of CT image reconstruction. Creation of cancellous bone regions with lower HU values, using the printer's infill parameter, was successful. Direct volume renderings of the pelvis and prostate artery were similar to the clinical CT, with the exception that the surfaces of the phantom objects were not as smooth.ConclusionsIt is possible to reliably create FDM 3D printer filaments with predictable radiopacity in a wide range of attenuation values, which can be used to print dimensionally accurate radiopaque objects derived from CT data. Phantoms of this type can be quickly and inexpensively developed to assess and optimize CT protocols for specific clinical applications.

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Section: Introductionmentioning

confidence: 99%

Three‐dimensional printing CT‐derived objects with controllable radiopacity

Hamedani

Melvin

Vaheesan

et al. 2018

J Applied Clin Med Phys

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Section: Discussionmentioning

confidence: 99%

“…It would be possible to print other tissue types with varying attenuation characteristics by printing with varying gray levels. This is the approach that has been previously used in fabricating paper phantoms for CT. 26,27 Another issue is with the parchment paper. Because the parchment paper is not perfectly uniform, a stack of parchment paper will yield an image with a slightly mottled appearance.…”

Section: Discussionmentioning

confidence: 99%

A four‐alternative forced choice (4AFC) methodology for evaluating microcalcification detection in clinical full‐field digital mammography (FFDM) and digital breast tomosynthesis (DBT) systems using an inkjet‐printed anthropomorphic phantom

et al. 2019

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Purpose The advent of three‐dimensional breast imaging systems such as digital breast tomosynthesis (DBT) has great promise for improving the detection and diagnosis of breast cancer. With these new technologies comes an essential need for testing methods to assess the resultant image quality. Although randomized clinical trials are the gold standard for assessing image quality, phantom‐based studies can provide a simpler and less burdensome approach. In this work, a complete framework is presented for task‐based evaluation of microcalcification (MCs) detection performance for DBT imaging systems. Methods The framework consists of three parts. The first part is a realistic anthropomorphic physical breast phantom created through inkjet printing, with parchment paper and iodine‐doped ink. The second is a method for inserting realistic MCs fabricated from calcium hydroxyapatite. The reproducibility and stability of the phantom materials were investigated through multiple samples of parchment and ink over 6 months. The final part is an analysis using a four‐alternative forced choice (4AFC) reader study. To demonstrate the framework, a task‐based 4AFC study was conducted using a clinical system to compare performance from DBT, synthetic mammography (SM), and full‐field digital mammography (FFDM). Nine human observers read images containing MC clusters imaged with all three modalities and tried to correctly locate the MCs. The proportion correct (PC) was measured as the number of correctly detected clusters out of all trials. Results Overall, readers scored the highest with FFDM, (PC = 0.95 ± 0.03) then DBT (0.85 ± 0.04), and finally SM (0.44 ± 0.06). For the parchment and ink samples, the linear attenuation properties were very stable over 6 months. In addition, little difference was found between the various parchment and ink samples, indicating good reproducibility. Conclusions This framework presents a promising methodology for evaluating diagnostic task performance of clinical breast DBT systems.

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“…Radiopaque inkjet printing and paper-based 3D printing were used to create phantoms from the template image files [8,9]. In preparation for the inkjet printing step, the template images were processed using a gray-scale correction procedure as previously described [8].…”

Section: Phantom Constructionmentioning

confidence: 99%

“…However, no previous work attempted to create lowcontrast lesions in phantoms that mimic patient anatomy. The present work therefore used radiopaque 3D printing, a method that was previously shown to provide flexibility and anatomic detail in producing patient-mimicking phantoms [8,9]. With this method, phantoms representing a patient's neck and containing different low-contrast lesions were created.…”

Section: Introductionmentioning

confidence: 99%

3D printing of anatomically realistic phantoms with detection tasks to assess the diagnostic performance of CT images

et al. 2020

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Objectives Detectability experiments performed to assess the diagnostic performance of computed tomography (CT) images should represent the clinical situation realistically. The purpose was to develop anatomically realistic phantoms with low-contrast lesions for detectability experiments. Methods Low-contrast lesions were digitally inserted into a neck CT image of a patient. The original and the manipulated CT images were used to create five phantoms: four phantoms with lesions of 10, 20, 30, and 40 HU contrast and one phantom without any lesion. Radiopaque 3D printing with potassium-iodide-doped ink (600 mg/mL) was used. The phantoms were scanned with different CT settings. Lesion contrast was analyzed using HU measurement. A 2-alternative forced choice experiment was performed with seven radiologists to study the impact of lesion contrast on detection accuracy and reader confidence (1 = lowest, 5 = highest). Results The phantoms reproduced patient size, shape, and anatomy. Mean ± SD contrast values of the low-contrast lesions were 9.7 ± 1.2, 18.2 ± 2, 30.2 ± 2.7, and 37.7 ± 3.1 HU for the 10, 20, 30, and 40 HU contrast lesions, respectively. Mean ± SD detection accuracy and confidence values were not significantly different for 10 and 20 HU lesion contrast (82.1 ± 6.3% vs. 83.9 ± 9.4%, p = 0.863 and 1.7 ± 0.4 vs. 1.8 ± 0.5, p = 0.159). They increased to 95 ± 5.7% and 2.6 ± 0.7 for 30 HU lesion contrast and 99.5 ± 0.9% and 3.8 ± 0.7 for 40 HU lesion contrast (p < 0.005). Conclusions A CT image was manipulated to produce anatomically realistic phantoms for low-contrast detectability experiments. The phantoms and our initial experiments provide a groundwork for the assessment of CT image quality in a clinical context. Key Points • Phantoms generated from manipulated CT images provide patient anatomy and can be used for detection tasks to evaluate the diagnostic performance of CT images. • Radiologists are unconfident and unreliable in detecting hypodense lesions of 20 HU contrast and less in an anatomical neck background. • Detectability experiments with anatomically realistic phantoms can assess CT image quality in a clinical context.

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Radiopaque Three-dimensional Printing: A Method to Create Realistic CT Phantoms

Cited by 52 publications

References 9 publications

Three‐dimensional printing CT‐derived objects with controllable radiopacity

Three‐dimensional printing CT‐derived objects with controllable radiopacity

A four‐alternative forced choice (4AFC) methodology for evaluating microcalcification detection in clinical full‐field digital mammography (FFDM) and digital breast tomosynthesis (DBT) systems using an inkjet‐printed anthropomorphic phantom

3D printing of anatomically realistic phantoms with detection tasks to assess the diagnostic performance of CT images

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