Three-Dimensional Printing for Procedure Rehearsal/Simulation/Planning in Interventional Radiology

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With the advances in affordable three-dimensional (3D) printing technology, 3D reconstruction and patient-specific 3D printed models are establishing a crucial role in the field of medicine for both educational purposes and procedural planning. 3D printed models provide physicians with increased 3D perception and tactile feedback, and enable a team-based approach to operational planning. However, performing an effective 3D reconstruction requires an in-depth understanding of the software features to accurately segment and reconstruct the human anatomy of interest from preacquired image data from multiple modalities such as computer tomography, 3D angiography and magnetic resonance imaging, and the different 3D printers/materials available in the market today. Increased understanding of this technology may benefit radiologists by developing techniques and tricks specific to interventional radiology and establishing a criterion to determine when to use these. Thus, the purpose of this manuscript is to provide physicians with an update on currently available 3D reconstruction software as well as printers and materials. Our initial experience using this technology is introduced based on a specific case of developing a 3D printed aorta for a patient with severe stenosis of the abdominal aorta.

Section snippets

Indications for Seeking a 3D Printed Model

Deciding when a three-dimensional (3D) printed model is beneficial in the clinical setting based on patient outcomes is still being actively investigated. It has been postulated that 3D printed models in the field of vascular surgery and vascular interventional radiology can provide patient education, improve the confidence of physicians for procedures and be useful for procedural planning.1, 2, 3, 4, 5, 6 A previous study on the applications of 3D printing in pediatric cerebrovascular

Procedural Steps for Developing a 3D Printed Model

The general procedure needed to develop a 3D printed model could be simplified into 4 major steps: imaging, segmentation, postprocessing, and printing. Within each of these steps, there are several combinations of segmentation algorithms and postprocessing editing tools that can allow for a 3D printed model to be developed. However, selecting the appropriate methods at each level may expedite the process, and most importantly, provide more accurate results. In this manuscript, we will discuss

Overcoming Technical Challenges

One of the most challenging aspects of creating a 3D reconstruction for vasculature is performing the segmentation process. As discussed previously, having an imaging study with a high degree of contrast differentiation greatly enhances the simplicity and accuracy of the segmentation process. In addition to using a CT with IV contrast, smaller slice thickness allows for higher resolution for the 3D reconstruction, and consequently, a more accurate 3D printed model. These adjustments also allow

Acknowledgment

The authors would like to thank the Florida International University's Miami Beach Urban Studios for their support in printing the 3D models.

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