Role of three-dimensional printing and artificial intelligence in the management of hepatocellular carcinoma: Challenges and opportunities

Abstract

Hepatocellular carcinoma (HCC) constitutes the fifth most frequent malignancy worldwide and the third most frequent cause of cancer-related deaths. Currently, treatment selection is based on the stage of the disease. Emerging fields such as three-dimensional (3D) printing, 3D bioprinting, artificial intelligence (AI), and machine learning (ML) could lead to evidence-based, individualized management of HCC. In this review, we comprehensively report the current applications of 3D printing, 3D bioprinting, and AI/ML-based models in HCC management; we outline the significant challenges to the broad use of these novel technologies in the clinical setting with the goal of identifying means to overcome them, and finally, we discuss the opportunities that arise from these applications. Notably, regarding 3D printing and bioprinting-related challenges, we elaborate on cost and cost-effectiveness, cell sourcing, cell viability, safety, accessibility, regulation, and legal and ethical concerns. Similarly, regarding AI/ML-related challenges, we elaborate on intellectual property, liability, intrinsic biases, data protection, cybersecurity, ethical challenges, and transparency. Our findings show that AI and 3D printing applications in HCC management and healthcare, in general, are steadily expanding; thus, these technologies will be integrated into the clinical setting sooner or later. Therefore, we believe that physicians need to become familiar with these technologies and prepare to engage with them constructively.

Recent Advancements in 3-D Printing in Medical Applications

“…printing is open-source and accessible to everyone, making it difficult to regulate the use of intellectual property and patents. It could lead to the creation of counterfeit medical devices, which may not be safe or effective [74]. 4.6.4.…”

Introductory Chapter: Liver Transplantation – The path to a bright future!

“…c. The role of technology: technology moves at a lightning speed in our days, as evidenced by the leaps and bounds of artificial intelligence (AI), the increasing use of 3D printing in medicine and surgery, and the introduction of augmented and virtual reality from the lab to the bedside [9]. The technological imperative makes it crucial that future physicians in transplantation not only acknowledge its existence but also actively make an effort to understand it and make the best use of this huge potential.…”

Application of 3D Bioprinting in Liver Diseases

“…The prognosis of patients at advanced stages is worse. Early-stage patients are eligible for surgical resection, transplantation, and ablative techniques, though they may suffer recurrence and metastasis owing to malignant tissue remaining in situ [ 9 , 10 ]. Patients at advanced stages could be treated with trans-arterial chemoembolization (TACE) and oral dosing with sorafenib.…”