Understanding Spatially Complex Segmental and Branch Anatomy Using 3D Printing

Javan, Ramin; Herrin, Douglas; Tangestanipoor, Ardalan

doi:10.1016/j.acra.2016.04.010

Cited by 79 publications

(45 citation statements)

References 27 publications

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“…For 3D printed heart and liver models, the time spent on image processing and segmentation could be up to 12 and 15 hours respectively, according to the systematic review and other reports (9,10). The whole process of creating a 3D printed liver model could be up to 100 hours, and this does not take into account post-printing work, which could take up to 4-5 days as reported in some studies (37)(38)(39). Image postprocessing and segmentation of renal CT or MRI data for 3D printing is relatively easier when compared to those for heart or liver 3D printing since the contrast-enhanced renal parenchyma, renal vessels and renal tumours can be easily segmented through automatic or semi-automatic approach.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of clinical value of three-dimensional printing in renal disease

Sun

Liu

2018

Quant. Imaging Med. Surg.

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The aim of this systematic review is to analyse current literature related to the clinical value of three-dimensional (3D) printed models in renal disease. A literature search of PubMed and Scopus databases was performed to identify studies reporting the clinical application and usefulness of 3D printed models in renal disease. Fifteen studies were found to meet the selection criteria and were included in the analysis. Eight of them provided quantitative assessments with five studies focusing on dimensional accuracy of 3D printed models in replicating renal anatomy and tumour, and on measuring tumour volume between 3D printed models and original source images and surgical specimens, with mean difference less than 10%. The other three studies reported that the use of 3D printed models significantly enhanced medical students and specialists' ability to identify anatomical structures when compared to two-dimensional (2D) images alone; and significantly shortened intraoperative ultrasound duration compared to without use of 3D printed models. Seven studies provided qualitative assessments of the usefulness of 3D printed kidney models with findings showing that 3D printed models improved patient's understanding of renal anatomy and pathology; improved medical trainees' understanding of renal malignant tumours when compared to viewing medical images alone; and assisted surgical planning and simulation of renal surgical procedures with significant reductions of intraoperative complications. The cost and time associated with 3D printed kidney model production was reported in 10 studies, with costs ranging from USD$100 to USD$1,000, and duration of 3D printing production up to 31 h. The entire process of 3D printing could take up to a few days. This review shows that 3D printed kidney models are accurate in delineating renal anatomical structures and renal tumours with high accuracy. Patient-specific 3D printed models serve as a useful tool in preoperative planning and simulation of surgical procedures for treatment of renal tumours. Further studies with inclusion of more cases and with a focus on reducing the cost and 3D model production time deserve to be investigated.

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Section: Discussionmentioning

confidence: 99%

A systematic review of clinical value of three-dimensional printing in renal disease

Sun

Liu

2018

Quant. Imaging Med. Surg.

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“…Javan et al demonstrated that a variety of 3D print models were ideal for coronary visualization (Figure 5). (29) 3D printing of coronary structures can enable visualization of stenotic regions, which may serve as a bench top tool to prepare and/or practice interventional procedures within a pulsatile flow loop environment. The coronary artery tree can be clearly defined by gated-CT methods and when 3D printed in the diastolic phase, these models can be coupled to a flow loop to replicate epicardial coronary perfusion.…”

Section: Cardiovascular Applicationsmentioning

confidence: 99%

Cardiac 3D Printing and its Future Directions

Vukicevic

Mosadegh

Min

et al. 2017

JACC: Cardiovascular Imaging

436

284

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3D printing is at the crossroads of printer and materials engineering; non-invasive diagnostic imaging; computer aided design (CAD); and structural heart intervention. Cardiovascular applications of this technology development include the use of patient-specific 3D models for medical teaching, exploration of valve and vessel function, surgical and catheter-based procedural planning, and early work in designing and refining the latest innovations in percutaneous structural devices. In this review we discuss the methods and materials being used for 3D printing today. We discuss the basic principles of clinical image segmentation including co-registration of multiple imaging datasets to create an anatomic model of interest. With applications in congenital heart disease, coronary artery disease, and in surgical and catheter-based structural disease – 3D printing is a new tool that is challenging how we image, plan, and carry out cardiovascular interventions.

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“…Individuals creating the 3D liver model for pre-operative applications should attain a sound understanding of the software involved, as well as the anatomy and pathology of interest (20,29). Involvement of the reporting radiologist and surgeon (or surgeons) in 3D liver model production should also be considered to ensure accuracy of segmentation and identification of appropriate critical structures required for surgical planning (10,20).…”

Section: D Model Productionmentioning

confidence: 99%

“…Physical 3D modelling has been identified to support efficient and effective perception of positional and structural information through the direct visualization of anatomy and pathology (2,3,9,13,14,16,22,25). This ultimately surpasses the need for mental 3D reconstruction involved when attempting to understand 2D images (29), which may be considered particularly valuable in the case of HCC due to the relative complexity of hepatic anatomy and pathological characteristics associated with certain HCC lesions (1,5).…”

Section: Clinical Value In Radiologymentioning

confidence: 99%

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Patient-specific three-dimensional printing for pre-surgical planning in hepatocellular carcinoma treatment

Perica

Sun

2017

Quant. Imaging Med. Surg.

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Background: Recently, three-dimensional (3D) printing has shown great interest in medicine, and 3D printed models may be rendered as part of the pre-surgical planning process in order to better understand the complexities of an individual's anatomy. The aim of this study is to investigate the feasibility of utilising 3D printed liver models as clinical tools in pre-operative planning for resectable hepatocellular carcinoma (HCC) lesions.Methods: High-resolution contrast-enhanced computed tomography (CT) images were acquired and utilized to generate a patient-specific 3D printed liver model. Hepatic structures were segmented and edited to produce a printable model delineating intrahepatic anatomy and a resectable HCC lesion. Quantitative assessment of 3D model accuracy compared measurements of critical anatomical landmarks acquired from the original CT images, standard tessellation language (STL) files, and the 3D printed liver model.Comparative analysis of surveys completed by two radiologists investigated the clinical value of 3D printed liver models in radiology. The application of utilizing 3D printed liver models as tools in surgical planning for resectable HCC lesions was evaluated through kappa analysis of questionnaires completed by two abdominal surgeons.Results: A scaled down multi-material 3D liver model delineating patient-specific hepatic anatomy and pathology was produced, requiring a total production time of 25.25 hours and costing a total of AUD $1,250.A discrepancy was found in the total mean of measurements at each stage of production, with a total mean of 18.28±9.31 mm for measurements acquired from the original CT data, 15.63±8.06 mm for the STL files, and 14.47±7.71 mm for the 3D printed liver model. The 3D liver model did not enhance the radiologists' perception of patient-specific anatomy or pathology. Kappa analysis of the surgeon's responses to survey questions yielded a percentage agreement of 80%, and a κ value of 0.38 (P=0.24) indicating fair agreement.Conclusions: Study outcomes indicate that there is minimal value in utilizing the 3D printed models in diagnostic radiology. The potential usefulness of utilizing patient-specific 3D printed liver models as tools in surgical planning and intraoperative guidance for HCC treatment is verified. However, the feasibility of this application is currently challenged by identified limitations in 3D model production, including the cost and time required for model production, and inaccuracies potentially introduced at each stage of model fabrication. IntroductionLiver lesion resection is often a complex task requiring sound comprehension of patient specific anatomical and pathological characteristics to ensure optimal surgical outcomes (1-6). Diagnostic imaging plays a major role in the diagnosis and characterisation of liver lesions, with imaging appearance and radiological reporting outcomes being utilized to direct patient-specific treatment planning (7,8). However, confidence in the comprehension of anatomical, pathological and structural com...

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Understanding Spatially Complex Segmental and Branch Anatomy Using 3D Printing

Cited by 79 publications

References 27 publications

A systematic review of clinical value of three-dimensional printing in renal disease

A systematic review of clinical value of three-dimensional printing in renal disease

Cardiac 3D Printing and its Future Directions

Patient-specific three-dimensional printing for pre-surgical planning in hepatocellular carcinoma treatment

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