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Our study explores the integration of three-dimensional (3D) virtual reality (VR) and 3D printing in neurosurgical preoperative planning. Traditionally, surgeons relied on two-dimensional (2D) imaging for complex neuroanatomy analyses, requiring significant mental visualization. Fortunately, nowadays advanced technology enables the creation of detailed 3D models from patient scans, utilizing different software. Afterwards, these models can be experienced through VR systems, offering comprehensive preoperative rehearsal opportunities. Additionally, 3D models can be 3D printed for hands-on training, therefore enhancing surgical preparedness. This technological integration transforms the paradigm of neurosurgical planning, ensuring safer procedures. [ABSTRACT FROM AUTHOR]

Background: Medical three dimensional (3D) printing is performed for neurosurgical and otolaryngologic conditions, but without evidence-based guidance on clinical appropriateness. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness recommendations for neurologic 3D printing conditions. Methods: A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with neurologic and otolaryngologic conditions. Each study was vetted by the authors and strength of evidence was assessed according to published guidelines. Results: Evidence-based recommendations for when 3D printing is appropriate are provided for diseases of the calvaria and skull base, brain tumors and cerebrovascular disease. Recommendations are provided in accordance with strength of evidence of publications corresponding to each neurologic condition combined with expert opinion from members of the 3D printing SIG. Conclusions: This consensus guidance document, created by the members of the 3D printing SIG, provides a reference for clinical standards of 3D printing for neurologic conditions. [ABSTRACT FROM AUTHOR]

Objectives Informed consent is fundamental to good practice. We hypothesized that a personalized three-dimensional (3D)-printed model of skull base pathology would enhance informed consent and reduce patient anxiety. Design Digital images and communication in medicine (DICOM) files were 3D printed. After a standard pre-surgery consent clinic, patients completed part one of a two-part structured questionnaire. They then interacted with their personalized 3D printed model and completed part two. This explored their perceived involvement in decision-making, anxiety, concerns and also their understanding of lesion location and surgical risks. Descriptive statistics were used to report responses and text classification tools were used to analyze free text responses. Setting and Participants In total,14 patients undergoing elective skull base surgery (with pathologies including skull base meningioma, craniopharyngioma, pituitary adenoma, Rathke cleft cyst, and olfactory neuroblastoma) were prospectively identified at a single unit. Results After 3D model exposure, there was a net trend toward reduced patient-reported anxiety and enhanced patient-perceived involvement in treatment. Thirteen of 14 patients (93%) felt better about their operation and 13/14 patients (93%) thought all patients should have access to personalized 3D models. After exposure, there was a net trend toward improved patient-reported understanding of surgical risks, lesion location, and extent of feeling informed. Thirteen of 14 patients (93%) felt the model helped them understand the surgical anatomy better. Analysis of free text responses to the model found mixed sentiment: 47% positive, 35% neutral, and 18% negative. Conclusion In the context of skull base neurosurgery, personalized 3D-printed models of skull base pathology can inform the surgical consent process, impacting the levels of patient understanding and anxiety. [ABSTRACT FROM AUTHOR]

Introduction: Pediatric cerebrovascular lesions are very rare and include aneurysms, arteriovenous malformations (AVM), and vein of Galen malformations (VOGM). Objective: To describe and disseminate a validated, reproducible set of 3D models for optimization of neurosurgical training with respect to pediatric cerebrovascular diseases Methods: All pediatric cerebrovascular lesions treated at our institution with adequate imaging studies during the study period 2015–2020 were reviewed by the study team. Three major diagnostic groups were identified: aneurysm, AVM, and VOGM. For each group, a case deemed highly illustrative of the core diagnostic and therapeutic principles was selected by the lead and senior investigators for printing (CSG/JM). Files for model reproduction and free distribution were prepared for inclusion as Supplemental Materials. Results: Representative cases included a 7-month-old female with a giant left MCA aneurysm; a 3-day-old male with a large, complex, high-flow, choroidal-type VOGM, supplied from bilateral thalamic, choroidal, and pericallosal perforators, with drainage into a large prosencephalic vein; and a 7-year-old male with a left frontal AVM with one feeding arterial vessel from the anterior cerebral artery and one single draining vein into the superior sagittal sinus Conclusion: Pediatric cerebrovascular lesions are representative of rare but important neurosurgical diseases that require creative approaches for training optimization. As these lesions are quite rare, 3D-printed models and open source educational materials may provide a meaningful avenue for impactful clinical teaching with respect to a wide swath of uncommon or unusual neurosurgical diseases. [ABSTRACT FROM AUTHOR]

A 10‐year‐old, male, neutered, domestic shorthair cat with generalised tonic‐clonic seizures was suspected of parietal meningioma. After segmentation from computed tomography images, real‐scale three‐dimensional prints of the skull and tumour were made using stereolithography. Intraoperative use of this model enabled identification of the craniectomy margins and exposed suitable tumour edges. Debulking was straightforward with no serious complications such as severe haemorrhage or untreatable cerebral oedema. Recovery was uneventful, and the cat showed normal neurological status postoperatively. Based on histopathological findings, a meningioma was confirmed. This is the first report of a three‐dimensional printed resin anatomic model of the skull with an intracranial tumour in companion animals. Such three‐dimensional prints are easily designed, inexpensive and accurate tools to study anatomic features of the patient and improve surgical procedures. The simple three‐dimensional printed replica presented here is a starting point for more detailed prints and extended applications such as craniectomy and cranioplasty procedures in veterinary neurosurgery. [ABSTRACT FROM AUTHOR]

In recent years, there has been a growing interest in the field of 3D printing technology. Among the various technologies available, fused deposition modeling (FDM) has emerged as the most popular and widely used method. However, achieving optimal results with FDM presents a significant challenge due to the selection of appropriate process parameters. Therefore, the objective of this research was to investigate the impact of process parameters on the tribological and frictional behavior of acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA) 3D-printed parts. The design of experiments (DOE) technique was used considering the input design parameters (infill percentage and layer thickness) as variables. The friction coefficient values and the wear were determined by experimental testing of the polymers on a universal tribometer employing plane friction coupling. Multi-response optimization methodology and analysis of variance (ANOVA) were used to highlight the dependency between the coefficient of friction, surface roughness parameters, and wear on the process parameters. The optimization analysis revealed that the optimal 3D printing input parameters for achieving the minimum coefficient of friction and linear wear were found to be an infill percentage of 50% and layer thickness of 0.1 mm (for ABS material), and an infill percentage of 50%, layer thickness of 0.15 mm (for PLA material). The suggested optimization methodology (which involves minimizing the coefficient of friction and cumulative linear wear) through the optimized parameter obtained provides the opportunity to select the most favorable design conditions contributing to a more sustainable approach to manufacturing by reducing overall material consumption. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective case-control study. Objective: We aimed to evaluate the value of 3-dimensional printing (3DP) spine model in the surgical treatment of severe spinal deformity since the prosperous development of 3DP technology. Methods: Severe scoliosis or hyper-kyphosis patients underwent posterior fixation and fusion surgery using the 3DP spine models were reviewed (3DP group). Spinal deformity surgeries operated by free-hand screw implantation during the same period were selected as the control group after propensity score matching (PSM). The correction rate, pedicle screw accuracy, and complications were analyzed. Class A and B screws were defined as accurate according to Gertzbein and Robbins criteria. Results: 35 patients were enrolled in the 3DP group and 35 matched cases were included in the control group. The perioperative baseline data and deformity correction rate were similar between both groups (P >.05). However, the operation time and blood loss were significantly less in the 3DP group (296.14 ± 66.18 min vs. 329.43 ± 67.16 min, 711.43 ± 552.28 mL vs. 1322.29 ± 828.23 mL, P <.05). More three-column osteotomies (Grade 3-6) were performed in the 3DP group (30/35, 85.7% vs. 21/35, 60.0%. P =.016). The screw placement accuracy was significantly higher in the 3DP group (422/582, 72.51% vs. 397/575, 69.04%. P =.024). The screw misplacement related complication rate was significantly higher in the free-hand group (6/35 vs. 1/35, P =.046). Conclusions: The study provided solid evidence that 3DP spine models can enhance surgeons' confidence in performing higher grade osteotomies and improve the safety and efficiency in severe spine deformity correction surgery. 3D printing technology has a good prospect in spinal deformity surgery. [ABSTRACT FROM AUTHOR]

This in-vitro study aimed to evaluate the influence of the printing orientation on parallelism, distance, and thickness between adjacent cylinders of 3D-printed surgical guides. CAD software was used to design a surgical guide with two adjacent parallel cylinders (reference); the design was saved as standard tessellation software (STL) and 63 samples were printed using three different orientations (0, 45, and 90 degrees). A metrology digital microscope was used to measure the distance, the angle and the thickness of the guides cylinders. Afterwards, the printed guides were scanned and cloud comparison software was used to compare STL files from the printed guides against the reference CAD model. One-way analysis of variance and Tukey test were used for multiple comparisons between groups and significance was p < 0.05. The printing orientation affected the distance between cylinders, the parallelism and the wall thickness. In addition, there were global deviations in all printing orientations. Printing with 90 degrees orientation produced almost-parallel cylinders but walls thicker than the reference model; all the cylinders converged toward the coronal but printing at 0 degrees produced the closest distance to the reference value. Within the limitations of this experimental in-vitro study it can be concluded that all the printing orientations influence the angle, the distance, and the thickness between adjacent cylinders of a surgical guide. Printing at 90 degrees produces the best global correspondence with the master model. [ABSTRACT FROM AUTHOR]

This interdisciplinary review focuses on how flexible three-dimensional printing (3DP) technology can aid patients with neurological diseases. It covers a wide variety of current and possible applications ranging from neurosurgery to customizable polypill along with a brief description of the various 3DP techniques. The article goes into detail about how 3DP technology can aid delicate neurosurgical planning and its consequent outcome for patients. It also covers areas such as how the 3DP model can be utilized in patient counseling along with designing specific implants involved in cranioplasty and customization of a specialized instrument such as 3DP optogenetic probes. Furthermore, the review includes how a 3DP nasal cast can contribute to the development of nose-to-brain drug delivery along with looking into how bioprinting could be used for regenerating nerves and how 3D-printed drugs could offer practical benefits to patients suffering from neurological diseases via polypill. [ABSTRACT FROM AUTHOR]

Background: Simulation-based techniques using three-dimensional models are gaining popularity in neurosurgical training. Most pre-existing models are expensive, so we felt a need to develop a real-life model using 3D printing technology to train in endoscopic third ventriculostomy. Methods: The brain model was made using a 3D-printed resin mold from patient-specific MRI data. The mold was filled with silicone Ecoflex™ 00-10 and mixed with Silc Pig® pigment additives to replicate the color and consistency of brain tissue. The dura mater was made from quick-drying silicone paste admixed with gray dye. The blood vessels were made from a silicone 3D-printed mold based on magnetic resonance imaging. Liquid containing paprika oleoresin dye was used to simulate blood and was pumped through the vessels to simulate pulsatile motion. Results: Seven residents and eight senior neurosurgeons were recruited to test our model. The participants reported that the size and anatomy of the elements were very similar to real structures. The model was helpful for training neuroendoscopic 3D perception and navigation. Conclusions: We developed an endoscopic third ventriculostomy training model using 3D printing technology that provides anatomical precision and a realistic simulation. We hope our model can provide an indispensable tool for young neurosurgeons to gain operative experience without exposing patients to risk. [ABSTRACT FROM AUTHOR]

Background  3D printing—also known as additive manufacturing—has a wide range of applications. Reproduction of low-cost, high-fidelity, disease- or patient-specific models presents a key developmental area in simulation and education research for complex cranial surgery. Methods  Using cadaveric dissections as source materials, skull base models were created, printed, and tested for educational value in teaching complex cranial approaches. In this pilot study, assessments were made on the value of 3D printed models demonstrating the retrosigmoid and posterior petrosectomy approaches. Models were assessed and tested in a small cohort of neurosurgery resident subjects (n  = 3) using a series of 10 radiographic and 2 printed case examples, with efficacy determined via agreement survey and approach selection accuracy. Results  All subjects indicated agreement or strong agreement for all study endpoints that 3D printed models provided significant improvements in understanding of neuroanatomic relationships and principles of approach selection, as compared to 2D dissections or patient cross-sectional imaging alone. Models were not superior to in-person hands-on teaching. Mean approach selection accuracy was 90% (±13%) for 10 imaging-based cases, or 92% (±7%) overall. Trainees strongly agreed that approach decision-making was enhanced by adjunctive use of 3D models for both radiographic and printed cases. Conclusion  3D printed models incorporating skull base approaches and/or pathologies provide a compelling addition to the complex cranial education armamentarium. Based on our preliminary analysis, 3D printed models offer substantial potential for pedagogical value as dissection guides, adjuncts to preoperative study and case preparation, or tools for approach selection training and evaluation. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy and safety of 3D printed artificial vertebral body for patients who underwent multilevel total en bloc spondylectomy (TES) and analyze whether it could reduce the incidence of implant subsidence. Methods: This is a retrospective study. From January 2017 to May 2018, eight consecutive cases with spine tumor undergoing multilevel TES were analyzed. All patients underwent X‐ray and CT examinations to evaluate the stability of internal fixation during the postoperative follow‐up. Demographic, surgical details, clinical data, and perioperative complications was collected. Visual analog scale, Frankel score, and spinal instability neoplastic score (SINS) classification were also recorded. Results: There were six cases of primary spinal tumor and two cases of metastatic spinal tumor. All patients achieved remarkable pain relief and improvement in neurological function. Five patients underwent operation through the posterior approach, one patient underwent operation through the anterior approach and the remaining two patients through a combined anterior and posterior approach. At the last follow‐up period, X‐rays showed that the 3D printed artificial vertebral body of all cases matched well, and the fixation was reliable. Hardware failure such as loosening, sinking, breaking, and displacement wasn't observed during the follow‐up period. Conclusion: 3D printed customized artificial vertebral body can provide satisfying good clinical and radiological outcomes for patients who have undergone multilevel TES. [ABSTRACT FROM AUTHOR]

Purpose: The progressive expansion of the technology that facilitates the development of three-dimensional (3D) printing within the field of otorhinolaryngology has opened up a new study front in medicine. The objective of this study is to systematically review scientific publications describing the development of 3D models having applications in otorhinolaryngology, with emphasis on subareas with a large number of publications, as well as the countries in which the publications are concentrated. Methods: In this literature review, specific criteria were used to search for publications on 3D models. The review considered articles published in English on the development of 3D models to teach otorhinolaryngology. The studies with presurgical purposes or without validation of the task by surgeons were excluded from this review. Results: This review considered 39 articles published in 10 countries between 2012 and 2021. The works published prior to 2012 were not considered as per the inclusion criteria for the research. Among the 39 simulators selected for review, otology models comprised a total of 15 publications (38%); they were followed by rhinology, with 12 (31%); laryngology, with 8 (21%); and head and neck surgery, with 4 publications (10%). Conclusion: The use of 3D technology and printing is well established in the context of surgical education and simulation models. The importance of developing new technological tools to enhance 3D printing and the current limitations in obtaining appropriate animal and cadaver models signify the necessity of investing more in 3D models. [ABSTRACT FROM AUTHOR]

Background: Manual moulding of cranioplasty implants after craniectomy is feasible, but does not always yield satisfying cosmetic results. In contrast, 3D printing can provide precise templates for intraoperative moulding of polymethylmethacrylate (PMMA) implants in cranioplasty. Here, we present a novel and easily implementable 3D printing workflow to produce patient-specific, sterilisable templates for PMMA implant moulding in cranioplastic neurosurgery. Methods: 3D printable templates of patients with large skull defects before and after craniectomy were designed virtually from cranial CT scans. Both templates — a mould to reconstruct the outer skull shape and a ring representing the craniectomy defect margins — were printed on a desktop 3D printer with biocompatible photopolymer resins and sterilised after curing. Implant moulding and implantation were then performed intraoperatively using the templates. Clinical and radiological data were retrospectively analysed. Results: Sixteen PMMA implants were performed on 14 consecutive patients within a time span of 10 months. The median defect size was 83.4 cm2 (range 57.8–120.1 cm2). Median age was 51 (range 21–80) years, and median operating time was 82.5 (range 52–152) min. No intraoperative complications occurred; PMMA moulding was uneventful and all implants fitted well into craniectomy defects. Excellent skull reconstruction could be confirmed in all postoperative computed tomography (CT) scans. In three (21.4%) patients with distinct risk factors for postoperative haematoma, revision surgery for epidural haematoma had to be performed. No surgery-related mortality or new and permanent neurologic deficits were recorded. Conclusion: Our novel 3D printing-aided moulding workflow for elective cranioplasty with patient-specific PMMA implants proved to be an easily implementable alternative to solely manual implant moulding. The "springform" principle, focusing on reconstruction of the precraniectomy skull shape and perfect closure of the craniectomy defect, was feasible and showed excellent cosmetic results. The proposed method combines the precision and cosmetic advantages of computer-aided design (CAD) implants with the cost-effectiveness of manually moulded PMMA implants. [ABSTRACT FROM AUTHOR]

Objectives: Oral and maxillofacial surgery (OMFS) has undergone pioneering progress through the development of three-dimensional (3D) printing technologies. The aim of this study was to evaluate the use of 3D printing at OMFS university and non-university hospitals and private practices in Germany. Materials and methods: For explorative assessment, a dynamic online questionnaire containing 10–22 questions about the current use of 3D printing and the reasons behind it was sent to OMFS university and non-university hospitals and private practices in Germany by the study group from the German Association of Oral and Maxillofacial Surgery (DGMKG). Results: In total, 156 participants responded from university (23 [14.7%]) and non-university hospitals (19 [12.2%]) and private practices without (85 [50.5%]) and with 29 (18.6%) inpatient treatment facility. Highest applications of 3D printing were in implantology (57%), microvascular bone reconstructions (25.6%), and orthognathics (21.1%). Among the participants, 37.8% reportedly were not using 3D printing. Among the hospitals and private practices, 21.1% had their own 3D printer, and 2.5% shared it with other departments. The major reason for not having a 3D printer was poor cost efficiency (37.6%). Possessing a 3D printer was motivated by independence from external providers (91.3%) and rapid template production (82.6%). The preferred printing methods were stereolithography (69.4 %) and filament printing (44.4%). Conclusions: OMFS 3D printing is established in Germany with a wide range of applications. Clinical relevance: The prevalence of 3D printing in hospitals and private practices is moderate. This may be enhanced by future innovations including improved cost efficiency. [ABSTRACT FROM AUTHOR]

3D printing technology has evolved over the years and there is a growing interest in its application in paediatric neurosurgery. Modern 3D printers have enabled the development of patient-specific 3D models that provide a realistic representation of complex anatomies and will aid in planning complex procedures. Paediatric neurosurgical operations are challenging and hands-on training is restricted. Surgical simulation training with biomodel has provided a new paradigm for trainees to master their surgical skills before encountering similar scenarios in real-life environment. This paper reviews the aspects of 3D printing for preoperative planning and simulation-based surgical training in paediatric neurosurgery. [ABSTRACT FROM AUTHOR]

The usefulness of 3-dimensional (3D)-printed disease models has been recognized in various medical fields. This study aims to introduce a production platform for patient-specific 3D-printed brain tumor model in clinical practice and evaluate its effectiveness. A full-cycle platform was created for the clinical application of a 3D-printed brain tumor model (3D-printed model) production system. Essential elements included automated segmentation software, cloud-based interactive communication tools, customized brain models with exquisite expression of brain anatomy in transparent material, adjunctive devices for surgical simulation, and swift process cycles to meet practical needs. A simulated clinical usefulness validation was conducted in which neurosurgeons assessed the usefulness of the 3D-printed models in 10 cases. We successfully produced clinically applicable patient-specific models within 4 days using the established platform. The simulated clinical usefulness validation results revealed the significant superiority of the 3D-printed models in surgical planning regarding surgical posture (p = 0.0147) and craniotomy design (p = 0.0072) compared to conventional magnetic resonance images. The benefit was more noticeable for neurosurgeons with less experience. We established a 3D-printed brain tumor model production system that is ready to use in daily clinical practice for neurosurgery. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article summarizes technical aspects of preparing printable 3D anatomical models created from radiological data (CT, MRI) and discusses their usefulness in surgery of the human skull. Interdisciplinary approach to the capabilities of the 3D printers, and the materials used for manufacturing 3D objects oriented on replicating anatomical structures has created new possibilities for simulating and planning surgical procedures in clinical practice settings. [ABSTRACT FROM AUTHOR]

The excavation in layered rocks is an issue for a number of geoengineering applications; these kinds of rocks all exhibit transverse isotropic features due to the process of metamorphic differentiation. This paper focuses on providing two methods, i.e., the 3D printing technology and the combined finite-discrete element method, to simulate the anisotropic characteristics of layered rocks. The results showed that both the 3D-printed samples and the FDEM numerical models are considered as a good match, and both revealed that as the inclined angle increased, the UCS of the sample first decreased and then increased, showing a U-shaped pattern. The results of this paper served as a reference to the promotion of the 3D printing technology and the combined finite-discrete element method in the geotechnical engineering field and laboratory test research. [ABSTRACT FROM AUTHOR]

This study adopted the latest self‐developed bioabsorbable material lactide–glycolide–1,3‐trimethylene carbonate (LA–GA–TMC) and applied the three‐dimensional (3D) printing technique to manufacture the occluder for cardiac septal defects, so as to realize the individualized treatment of cardiac septal defects. At the same time, its biosafety was evaluated, with an aim to establish foundation for futural large‐scale animal experiment and clinical trial. The traditional "one‐pot synthesis" was modified, and the "two‐step synthesis method" was utilized to synthesize the LA–GA–TMC terpolymer at the lactide: glycolide: trimethylene carbonate ratio of 6:1:1.7. Afterward, the synthesized terpolymer was used as the raw material to fabricate the occluder model via using 3D printing technique. Then, its biocompatibility was comprehensively evaluated through cytocompatibility, blood compatibility, and histocompatibility. The occluder made from LA–GA–TMC 3D printing had favorable ductility and recoverability; besides, it possessed the temperature‐control feature, and the relative cell proliferation rates in extract liquids at various concentrations were all >70%, suggesting that it had favorable cytocompatibility. Moreover, hemolytic experiment revealed that its hemolytic rate was <5%, dynamic blood coagulation experiment demonstrated that the sample material moderately activated the blood coagulation, and the above findings suggested that it had good blood compatibility. In addition, implanting experiment in vivo revealed that its histocompatibility was superior to the traditional nitinol and the emerging poly‐l‐lactic acid. It is completely feasible to manufacture the cardiac septal defects occluder based on the novel absorbable material LA–GA–TMC, which has favorable biocompatibility, through 3D printing technique and it possesses broad prospects in large‐scale animal experiment and clinical trial. [ABSTRACT FROM AUTHOR]

Three‐dimensional (3D) printing becomes an attractive technique to fabricate tissue engineering scaffolds through its high control on fabrication and repeatability using the printing parameters. This technique can be combined by the finite element method (FEM), and tissue‐specific scaffolds with desirable morphological and mechanical properties can be designed and manufactured. In this study, the influential 3D printing parameters on the morphological and mechanical properties of polycaprolactone (PCL) filament and scaffold were studied experimentally and numerically. First, the effects of printing parameters and process on the properties of extruded PCL filament were investigated. Then, using FEM, the effects of filament specifications on the overall characteristics of the scaffold were evaluated. Results showed that both the printing process in terms of resting time and remaining time and the printing parameters like pressure, printing speed, and printing path length have influenced the filament properties. In addition, both the filament diameter and elastic modulus had significant effects on the properties of scaffold especially, a 20% increase in the filament diameter caused the scaffold compressive elastic modulus to rise by around 72%. It is concluded that the printing parameters and process must be tuned very well in fabricating scaffolds with the desired morphology and mechanical property. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effectiveness and practicality of 3D-printed model-guided endoscopic surgery for the treatment of basal ganglia hemorrhage. The authors retrospectively analyzed the data of all patients who underwent endoscopic evacuation of basal ganglia hemorrhage in the Department of Neurosurgery at Dalang Hospital and Shipai Hospital between December 2017 and February 2019. Twelve patients, in whom the 3D-printed model guidance was used for endoscopic evacuation, were included in this investigation. Using 3D reconstructed technology, we designed the appropriate surgical approach. Then, an individualized facial model with the guide orifice was printed by a 3D printer. Further, the 3D-printed model was employed to guide the insertion of the endoscope sheath. As a result, the average evacuation rate was 97.2% (range 90.1–100.0%). The GCS and mRS score were improved in each patient from admission to discharge examination. All patients had a good prognosis based on their functional independence measure (FIM) scores at the 6-month follow-up. The 3D-printed model-guided endoscopic evacuation was effective and safe for basal ganglia hemorrhage. This technique deserves further investigation to determine its role in intracerebral hemorrhage management. [ABSTRACT FROM AUTHOR]

Learning anatomy is commonly facilitated by use of cadavers, plastic models and more recently three-dimensional printed (3DP) anatomical models as they allow students to physically touch and hold the body segments. However, most existing models are limited to surface features of the specimen, with little opportunity to manipulate the structures. There is much interest in developing better 3DP models suitable for anatomy education. This study aims to determine the feasibility of developing a multi-material 3DP heart model, and to evaluate students' perceptions of the model. Semi-automated segmentation was performed on computed tomgoraphy plastinated heart images to develop its 3D digital heart model. Material jetting was used as part of the 3D printing process so that various colors and textures could be assigned to the individual segments of the model. Morphometric analysis was conducted to quantify the differences between the printed model and the plastinated heart. Medical students' opinions were sought using a 5-point Likert scale. The 3DP full heart was anatomically accurate, pliable and compressible to touch. The major vessels of the heart were color-coded for easy recognition. Morphometric analysis of the printed model was comparable with the plastinated heart. Students were positive about the quality of the model and the majority of them reported that the model was useful for their learning and that they would recommend their use for anatomical education. The successful feasibility study and students' positive views suggest that the development of multimaterial 3DP models is promising for medical education. [ABSTRACT FROM AUTHOR]

Keywords: Highly stressed soft rock; 3D printing; Vacuum pressure; Mechanical and fracture properties In addition, to further illustrate the feasibility of the proposed method in reproducing the mechanical behavior of highly stressed soft rock, the stress-strain behavior and failure modes of the 3D-printed samples are compared with those of a natural soft rock in detail. Furthermore, the overall mechanical behaviors of real highly stressed soft rock are very sensitive to the constituent particle interface properties and the geological conditions, which have to be considered for warranting a more realistic replication of real highly stressed soft rocks. [Extracted from the article]

Featured Application: The proposed models can be used to train general practitioners in minor surgery courses in primary care centers. In order to increase the efficiency of the Spanish health system, minor surgery programs are currently carried out in primary care centers. This organizational change has led to the need to train many general practitioners (GPs) in this discipline on a practical level. Due to the cost of the existing minor surgery training models in the market, pig's feet or chicken thighs are used to practice the removal of figured lesions and the suture of wounds. In the present work, the use of 3D printing is proposed, to manufacture models that reproduce in a realistic way the most common lesions in minor surgery practice, and that allow doctors to be trained in an adequate way. Four models with the most common dermal lesions have been designed and manufactured, and then evaluated by a panel of experts. Face validity was demonstrated with four items on a five-point Likert scale that was completed anonymously. The models have obtained the following results: aesthetic recreation, 4.6 ± 0.5; realism during anesthesia infiltration, 4.8 ± 0.4; realism during lesion removal, 2.8 ± 0.4; realism during surgical wound closure, 1.2 ± 0.4. The score in this last section could be improved if a more elastic skin-colored filament were found on the market. [ABSTRACT FROM AUTHOR]

Background: In the discipline of rhinology and endoscopic skull base surgery (ESBS), 3-dimensional (3D) printing has found meaningful application in areas including preoperative surgical planning as well as in surgical education. However, its scope of use may be limited due to the perception among surgeons that there exists a prohibitively high initial investment in resources and time to acquire the requisite technical expertise. Nevertheless, given the ever decreasing cost of advancing technology coupled with the need to understand the complex spatial relationships of the paranasal sinuses and skull base, the use of 3D printing in rhinology and ESBS is poised to blossom. Objective: Help the reader identify current or potential future uses of 3D printing technology relevant to their rhinologic clinical or educational practice. Methods: A review of published literature relating to 3D printing in rhinology and ESBS was performed. Results: Results were reviewed and organized into 5 overarching categories including an overview of the 3D printing process as well as applications of 3D printing including (1) surgical planning, (2) custom prosthetics and implants, (3) patient education, and (4) surgical teaching and assessment. Conclusion: In the discipline of rhinology and ESBS, 3D printing finds use in the areas of presurgical planning, patient education, prosthesis creation, and trainee education. As this technology moves forward, these products will be more broadly available to providers in the clinical and educational setting. The possible applications are vast and have great potential to positively impact surgical training, patient satisfaction, and most importantly, patient outcomes. [ABSTRACT FROM AUTHOR]

To demonstrate the 3D printed appearance of glenoid morphologies relevant to shoulder replacement surgery and to evaluate the benefits of printed models of the glenoid with regard to surgical planning. A retrospective review of patients referred for shoulder CT was performed, leading to a cohort of nine patients without arthroplasty hardware and exhibiting glenoid changes relevant to shoulder arthroplasty planning. Thin slice CT images were used to create both humerus-subtracted volume renderings of the glenoid, as well as 3D surface models of the glenoid, and 11 printed models were created. Volume renderings, surface models, and printed models were reviewed by a musculoskeletal radiologist for accuracy. Four fellowship-trained orthopaedic surgeons specializing in shoulder surgery reviewed each case individually as follows: First, the source CT images were reviewed, and a score for the clarity of the bony morphologies relevant to shoulder arthroplasty surgery was given. The volume rendering was reviewed, and the clarity was again scored. Finally, the printed model was reviewed, and the clarity again scored. Each printed model was also scored for morphologic complexity, expected usefulness of the printed model, and physical properties of the model. Mann–Whitney–Wilcoxon signed rank tests of the clarity scores were calculated, and the Spearman's ρ correlation coefficient between complexity and usefulness scores was computed. Printed models demonstrated a range of glenoid bony changes including osteophytes, glenoid bone loss, retroversion, and biconcavity. Surgeons rated the glenoid morphology as more clear after review of humerus-subtracted volume rendering, compared with review of the source CT images (p = 0.00903). Clarity was also better with 3D printed models compared to CT (p = 0.00903) and better with 3D printed models compared to humerus-subtracted volume rendering (p = 0. 00879). The expected usefulness of printed models demonstrated a positive correlation with morphologic complexity, with Spearman's ρ 0.73 (p = 0.0108). 3D printing of the glenoid based on pre-operative CT provides a physical representation of patient anatomy. Printed models enabled shoulder surgeons to appreciate glenoid bony morphology more clearly compared to review of CT images or humerus-subtracted volume renderings. These models were more useful as glenoid complexity increased. [ABSTRACT FROM AUTHOR]

Objective: Assess construct validity of a low-cost medium-fidelity silicone injection molded model task trainer for endoscopic sinus surgery (ESS) training.Methods: Fellowship-trained rhinologists, otolaryngology attendings, and otolaryngology residents at various levels of training performed sinus endoscopy and seven procedures on the model. Construct validity was evaluated by comparing novice to various levels of experienced performance using a validated checklist.Results: Thirty-two subjects participated in this study. Otolaryngology attendings and postgraduate year (PGY) 3 to 5 otolaryngology residents significantly outperformed PGY 1 to 2 otolaryngology residents on most tasks in the task-specific checklist.Conclusions: This study demonstrated the construct validity of the low-cost medium-fidelity ESS model.Level Of Evidence: NA Laryngoscope, 129:1505-1509, 2019. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Interfacing anatomically conformal electronic components, such as sensors, with biology is central to the creation of next-generation wearable systems for health care and human augmentation applications. Thus, there is a need to establish computer-aided design and manufacturing methods for producing personalized anatomically conformal systems, such as wearable devices and human-machine interfaces (HMIs). Here, we show that a three-dimensional (3D) scanning and 3D printing process enabled the design and fabrication of a sensor-integrated anatomical human-machine interface (AHMI) in the form of personalized prosthetic hands that contain anatomically conformal electrode arrays for children affected by amniotic band syndrome, a common birth defect. A methodology for identifying optimal scanning parameters was identified based on local and global metrics of registered point cloud data quality. This method identified an optimal rotational angle step size between adjacent 3D scans. The sensitivity of the optimization process to variations in organic shape (i.e., geometry) was examined by testing other anatomical structures, including a foot, an ear, and a porcine kidney. We found that personalization of the prosthetic interface increased the tissue-prosthesis contact area by 408% relative to the non-personalized devices. Conformal 3D printing of carbon nanotube-based polymer inks across the personalized AHMI facilitated the integration of electronic components, specifically, conformal sensor arrays for measuring the pressure distribution across the AHMI (i.e., the tissue-prosthesis interface). We found that the pressure across the AHMI exhibited a non-uniform distribution and became redistributed upon activation of the prosthetic hand’s grasping action. Overall, this work shows that the integration of 3D scanning and 3D printing processes offers the ability to design and fabricate wearable systems that contain sensor-integrated AHMIs. [ABSTRACT FROM AUTHOR]

Three-dimensional (3-D) printers have the potential to print samples that can be used as a scaffold for a variety of applications in different industries. In this paper, cement-based materials including ordinary portland cement, calcium aluminate cement (passing 150 µm [0.0059 in.] size sieve), and fine sand were investigated as the cement-based materials in inkjet 3-D printing. Prism specimens were printed for the three-point bending test; and cubic specimens were printed for the uniaxial compressive strength test. Prism samples were printed along different directional axes (X, Y, and Z). The tests were conducted at different saturation levels (water-cement ratio [w/c]) as represented by S100C200, S125C250, S150C300, and S170C340. The prism specimens were cured in water for 7 and 28 days while cubic specimens were cured in Ca(OH)2 and water for 7 and 28 days at the same ambient temperatures. In general, the results changed according to the directional axes of the prisms. However, following water curing, the cubic samples were heated up to 40°C (104°F) in an oven and a higher compressive strength was evident compared to the samples which were only cured in the room-temperature water. The wettability test for both powders has been conducted in the presented study. [ABSTRACT FROM AUTHOR]

This study aimed to determine if 3D printing can affect surgeon's selection of plate for distal tibia fracture surgery and to find out whether orthopedic surgeons consider this technology necessary and would use it in their practice. A total of 102 orthopedic surgeons were asked to choose anatomically contoured locking plates among 5 most commonly used types for one simple and one complex distal tibia fracture based on X-ray and CT images. Next, they were provided real-size 3D printed models of the same fractures, allowed to apply each of the 5 plates to these models, and asked if they would change their choice of plate. A 10-point numeric rating scale was provided to measure the extent of the help that 3D printing provided on preoperative planning. Finally, we asked the surgeons if they would use 3D printing in their practice. Seventy-four percent of inexperienced surgeons changed their selection of plate after using 3D printed models for the complex fracture. In contrast, only 9% of experienced surgeons changed their selection of plate for the simple fracture. Surgeons rated the extent of usefulness of the 3D models in preoperative planning as a mean of 4.84 ± 2.54 points for the simple fracture and 6.63 ± 2.54 points for the complex fracture. The difference was significant (p < 0.001). Eighty-six percent of inexperienced surgeons wanted to use 3D models for complex fractures. However, only 18% of experienced surgeons wanted to use 3D printed models for simple fractures. The use of a real-size 3D-printed model often changed surgeon's preoperative selection of locking plates, especially when inexperienced surgeons evaluated a complex fracture. However, experienced surgeons did not find 3D models very useful when assessing simple fractures. Future applications of 3D models should focus on training beginners in fracture surgery, especially when complex fractures are concerned. [ABSTRACT FROM AUTHOR]

Purpose: This study was aimed to compare conventional surgery and surgery assisted by 3D printing technology in the treatment of calcaneal fractures. In addition, we also investigated the effect of 3D printing technology on the communication between doctors and patients. Methods: we enrolled 75 patients with calcaneal fracture from April 2014 to August 2016. They were divided randomly into two groups: 35 cases of 3D printing group, 40 cases of conventional group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan in 3D printing group. Operation duration, blood loss volume during the surgery, number of intraoperative fluoroscopy and fracture union time were recorded. The radiographic outcomes Böhler angle, Gissane angle, calcaneal width and calcaneal height and final functional outcomes including VAS and AOFAS score as well as the complications were also evaluated. Besides, we made a simple questionnaire to verify the effectiveness of the 3D-printed model for both doctors and patients. Results: The operation duration, blood loss volume and number of intraoperative fluoroscopy for 3D printing group was 71.4 ± 6.8 minutes, 226.1 ± 22.6 ml and 5.6 ± 1.9 times, and for conventional group was 91.3 ± 11.2 minutes, 288.7 ± 34.8 ml and 8.6 ± 2.7 times respectively. There was statistically significant difference between the conventional group and 3D printing group (p < 0.05). Additionally, 3D printing group achieved significantly better radiographic results than conventional group both postoperatively and at the final follow-up (p < 0.05). However, No significant difference was noted in the final functional outcomes between the two groups. As for complications, there was no significant difference between the two groups. Furthermore, the questionnaire showed that both doctors and patients exhibited high scores of overall satisfaction with the use of a 3D printing model. Conclusion: This study suggested the clinical feasibility of 3D printing technology in treatment of calcaneal fractures. [ABSTRACT FROM AUTHOR]

Purpose This paper aims to review the latest applications in terms of three-dimensional printed (3DP) metal implants in orthopedics, and, importantly, the design of 3DP metal implants through a series of cases operated at The Second Hospital of Jilin University were presented.Design/methodology/approach This paper is available to practitioners who are use 3DP implants in orthopedics. This review began with the deficiency of traditional prostheses and basic concepts of 3DP implants. Then, representative 3DP clinical cases were summarized and compared, and the experiences using customized prostheses and directions for future potential development are also shown.Findings The results obtained from the follow-up of clinical applications of 3DP implants show that the 3D designed and printed metal implants could exhibit good bone defect matching, quick and safe joint functional rehabilitation as well as saving time in surgery, which achieved high patient satisfaction collectively.Originality/value Single center experiences of 3DP metal implants design were shared and the detailed technical points between various regions were compared and analyzed. In conclusion, the 3DP technology is infusive and will present huge potential to reform future orthopedic practice. [ABSTRACT FROM AUTHOR]

Improvements in technology and reduction in costs have led to widespread interest in three-dimensional (3D) printing. 3D-printed anatomical models contribute to personalized medicine, surgical planning, and education across medical specialties, and these models are rapidly changing the landscape of clinical practice. A physical object that can be held in one’s hands allows for significant advantages over standard two-dimensional (2D) or even 3D computer-based virtual models. Radiologists have the potential to play a significant role as consultants and educators across all specialties by providing 3D-printed models that enhance clinical care. This article reviews the basics of 3D printing, including how models are created from imaging data, clinical applications of 3D printing within the abdomen and pelvis, implications for education and training, limitations, and future directions. [ABSTRACT FROM AUTHOR]

The purpose of this review is to analyse current literature related to the clinical applications of 3D printed models in liver disease. A search of the literature was conducted to source studies from databases with the aim of determining the applications and feasibility of 3D printed models in liver disease. 3D printed model accuracy and costs associated with 3D printing, the ability to replicate anatomical structures and delineate important characteristics of hepatic tumours, and the potential for 3D printed liver models to guide surgical planning are analysed. Nineteen studies met the selection criteria for inclusion in the analysis. Seventeen of them were case reports and two were original studies. Quantitative assessment measuring the accuracy of 3D printed liver models was analysed in five studies with mean difference between 3D printed models and original source images ranging from 0.2 to 20%. Fifteen studies provided qualitative assessment with results showing the usefulness of 3D printed models when used as clinical tools in preoperative planning, simulation of surgical or interventional procedures, medical education, and training. The cost and time associated with 3D printed liver model production was reported in 11 studies, with costs ranging from US$13 to US$2000, duration of production up to 100 h. This systematic review shows that 3D printed liver models demonstrate hepatic anatomy and tumours with high accuracy. The models can assist with preoperative planning and may be used in the simulation of surgical procedures for the treatment of malignant hepatic tumours. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D) printing is based on additive technology in which layers of materials are gradually placed to create 3D objects. The world of 3D printing is a rapidly evolving field in the medical industry as well as in most sectors of our lives. In this report we present current technological possibilities for 3D printing in the surgical field. There are different 3D printing modalities and much confusion among clinicians regarding the differences between them. Three-dimensional printing technologies can be classified based on the basic material used: solid, liquid, and powder. We describe the main printing methods from each modality and present their advantages while focusing on their applications in different fields of surgery, starting from 3D printing of models for preoperative planning up to patient-specific implants (PSI). We present the workflow of 3D printing for the different applications and our experience in 3D printing surgical guides as well as PSI. We include examples of 3D planning as well as clinical and radiological imaging of cases. Three-dimensional printing of models for preoperative planning enhances the 3D perception of the planned operation and allows for preadaptation of surgical instruments, thus shortening operation duration and improving precision. Three-dimensional printed PSI allow for accurate reconstruction of anatomic relations as well as efficiently restoring function. The application of PSI is expanding rapidly, and we will see many more innovative treatment modalities in the near future based on this technology. [ABSTRACT FROM AUTHOR]

Introduction: 3D-printed anatomical models play an important role in medical and research settings. The recent successes of 3D anatomical models in healthcare have led many institutions to adopt the technology. However, there remain several issues that must be addressed before it can become more wide-spread. Of importance are the problems of cost and time of manufacturing. Machine learning (ML) could be utilized to solve these issues by streamlining the 3D modeling process through rapid medical image segmentation and improved patient selection and image acquisition. The current challenges, potential solutions, and future directions for ML and 3D anatomical modeling in healthcare are discussed. Areas covered: This review covers research articles in the field of machine learning as related to 3D anatomical modeling. Topics discussed include automated image segmentation, cost reduction, and related time constraints. Expert commentary: ML-based segmentation of medical images could potentially improve the process of 3D anatomical modeling. However, until more research is done to validate these technologies in clinical practice, their impact on patient outcomes will remain unknown. We have the necessary computational tools to tackle the problems discussed. The difficulty now lies in our ability to collect sufficient data. [ABSTRACT FROM AUTHOR]

Purpose The usage of additive manufacturing (AM) technology in industries has reached up to 50 per cent as prototype or end-product. However, for AM products to be directly used as final products, AM product should be produced through advanced quality control process, which has a capability to be able to prove and reach their desire repeatability, reproducibility, reliability and preciseness. Therefore, there is a need to review quality-related research in terms of AM technology and guide AM industry in the future direction of AM development.Design/methodology/approach This paper overviews research progress regarding the QC in AM technology. The focus of the study is on manufacturing quality issues and needs that are to be developed and optimized, and further suggests ideas and directions toward the quality improvement for future AM technology. This paper is organized as follows. Section 2 starts by conducting a comprehensive review of the literature studies on progress of quality control, issues and challenges regarding quality improvement in seven different AM techniques. Next, Section 3 provides classification of the research findings, and lastly, Section 4 discusses the challenges and future trends.Findings This paper presents a review on quality control in seven different techniques in AM technology and provides detailed discussions in each quality process stage. Most of the AM techniques have a trend using in-situ sensors and cameras to acquire process data for real-time monitoring and quality analysis. Procedures such as extrusion-based processes (EBP) have further advanced in data analytics and predictive algorithms-based research regarding mechanical properties and optimal printing parameters. Moreover, compared to others, the material jetting progresses technique has advanced in a system integrated with closed-feedback loop, machine vision and image processing to minimize quality issues during printing process.Research limitations/implications This paper is limited to reviewing of only seven techniques of AM technology, which includes photopolymer vat processes, material jetting processes, binder jetting processes, extrusion-based processes, powder bed fusion processes, directed energy deposition processes and sheet lamination processes. This paper would impact on the improvement of quality control in AM industries such as industrial, automotive, medical, aerospace and military production.Originality/value Additive manufacturing technology, in terms of quality control has yet to be reviewed. [ABSTRACT FROM AUTHOR]

The success of an implant depends on the type of biomaterial used for its fabrication. An ideal implant material should be biocompatible, inert, mechanically durable, and easily moldable. The ability to build patient specific implants incorporated with bioactive drugs, cells, and proteins has made 3D printing technology revolutionary in medical and pharmaceutical fields. A vast variety of biomaterials are currently being used in medical 3D printing, including metals, ceramics, polymers, and composites. With continuous research and progress in biomaterials used in 3D printing, there has been a rapid growth in applications of 3D printing in manufacturing customized implants, prostheses, drug delivery devices, and 3D scaffolds for tissue engineering and regenerative medicine. The current review focuses on the novel biomaterials used in variety of 3D printing technologies for clinical applications. Most common types of medical 3D printing technologies, including fused deposition modeling, extrusion based bioprinting, inkjet, and polyjet printing techniques, their clinical applications, different types of biomaterials currently used by researchers, and key limitations are discussed in detail. [ABSTRACT FROM AUTHOR]

The development of sand mold three-dimensional printing technologies enables the manufacturing of molds without the use of a physical model. However, the effects of the three-dimensional printing process parameters on the mold permeability and strength are not well known, leading the industries to keep old settings until castings have recurring defects. In the present work, the influence of these parameters was experimentally investigated to understand their effect on the mold strength and permeability. Cylindrical and bar-shaped test specimens were printed to perform, respectively, permeability and bending strength measurements. Experiments were designed to statistically quantify the individual and combined effect of these process parameters. While the binder quantity only affects the mold strength, increasing the recoater speed leads to both greater permeability and reduced strength due to the reduced sand compaction. Recommendations for optimizing some 3D printer settings are proposed to attain predefined mold properties and minimize the anisotropic behavior of the sand mold in regard to both the orientation and the position in the job box. [ABSTRACT FROM AUTHOR]

Introduction: Endoscopic skull base surgery allows minimal invasive therapy through the nostrils to treat infectious or tumorous diseases. Surgical and anatomical education in this field is limited by the lack of validated training models in terms of geometric and mechanical accuracy. We choose to evaluate several consumer-grade materials to create a patient-specific 3D-printed skull base model for anatomical learning and surgical training. Methods: Four 3D-printed consumer-grade materials were compared to human cadaver bone: calcium sulfate hemihydrate (named Multicolor), polyamide, resin and polycarbonate. We compared the geometric accuracy, forces required to break thin walls of materials and forces required during drilling. Results: All materials had an acceptable global geometric accuracy (from 0.083mm to 0.203mm of global error). Local accuracy was better in polycarbonate (0.09mm) and polyamide (0.15mm) than in Multicolor (0.90mm) and resin (0.86mm). Resin and polyamide thin walls were not broken at 200N. Forces needed to break Multicolor thin walls were 1.6–3.5 times higher than in bone. For polycarbonate, forces applied were 1.6–2.5 times higher. Polycarbonate had a mode of fracture similar to the cadaver bone. Forces applied on materials during drilling followed a normal distribution except for the polyamide which was melted. Energy spent during drilling was respectively 1.6 and 2.6 times higher on bone than on PC and Multicolor. Conclusion: Polycarbonate is a good substitute of human cadaver bone for skull base surgery simulation. Thanks to short lead times and reasonable production costs, patient-specific 3D printed models can be used in clinical practice for pre-operative training, improving patient safety. [ABSTRACT FROM AUTHOR]

Background: In a preliminary experience, we claimed the potential value of 3D printing technology for pre-operative counseling and surgical planning. However, no objective analysis has ever assessed its additional benefit in transferring anatomical information from radiology to final users. We decided to validate the pre-operative use of 3D-printed anatomical models in patients with solid organs' diseases as a new tool to deliver morphological information.Methods: Fifteen patients scheduled for laparoscopic splenectomy, nephrectomy, or pancreatectomy were selected and, for each, a full-size 3D virtual anatomical object was reconstructed from a contrast-enhanced MDCT (Multiple Detector Computed Tomography) and then prototyped using a 3D printer. After having carefully evaluated-in a random sequence-conventional contrast MDCT scans, virtual 3D reconstructions on a flat monitor, and 3D-printed models of the same anatomy for each selected case, thirty subjects with different expertise in radiological imaging (10 medical students, 10 surgeons and 10 radiologists) were administered a multiple-item questionnaire. Crucial issues for the anatomical understanding and the pre-operative planning of the scheduled procedure were addressed.Results: The visual and tactile inspection of 3D models allowed the best anatomical understanding, with faster and clearer comprehension of the surgical anatomy. As expected, less experienced medical students perceived the highest benefit (53.9% ± 4.14 of correct answers with 3D-printed models, compared to 53.4 % ± 4.6 with virtual models and 45.5% ± 4.6 with MDCT), followed by surgeons and radiologists. The average time spent by participants in 3D model assessing was shorter (60.67 ± 25.5 s) than the one of the corresponding virtual 3D reconstruction (70.8 ± 28.18 s) or conventional MDCT scan (127.04 ± 35.91 s).Conclusions: 3D-printed models help to transfer complex anatomical information to clinicians, resulting useful in the pre-operative planning, for intra-operative navigation and for surgical training purposes. [ABSTRACT FROM AUTHOR]

The articl discusses the pilot study which assess the operative time, patient safety and cost benefit of using three-dimensional (3D) craniofacial models in undergoing midfacial distraction surgery. Topics mentioned include the measuring of blood loss, complications and estimated cost of the operation, the retrospective review of the patients in academic tertiary care hospital, and the result that shows the importance of the models in hardware precontouring and preoperative planning.

Purpose Patient-specific 3D-printed phantoms have many potential applications, both research and clinical. However, they have been limited in size and complexity because of the small size of most commercially available 3D printers as well as material warping concerns. We aimed to overcome these limitations by developing and testing an effective 3D printing workflow to fabricate a large patient-specific radiotherapy phantom with minimal warping errors. In doing so, we produced a full-scale phantom of a real postmastectomy patient. Methods We converted a patient's clinical CT DICOM data into a 3D model and then sliced the model into eleven 2.5-cm-thick sagittal slices. The slices were printed with a readily available thermoplastic material representing all body tissues at 100% infill, but with air cavities left open. Each slice was printed on an inexpensive and commercially available 3D printer. Once the printing was completed, the slices were placed together for imaging and verification. The original patient CT scan and the assembled phantom CT scan were registered together to assess overall accuracy. Results The materials for the completed phantom cost $524. The printed phantom agreed well with both its design and the actual patient. Individual slices differed from their designs by approximately 2%. Registered CT images of the assembled phantom and original patient showed excellent agreement. Conclusions Three-dimensional printing the patient-specific phantom in sagittal slices allowed a large phantom to be fabricated with high accuracy. Our results demonstrate that our 3D printing workflow can be used to make large, accurate, patient-specific phantoms at 100% infill with minimal material warping error. [ABSTRACT FROM AUTHOR]

Purpose The design process of a bio-model involves multiple factors including data acquisition technique, material requirement, resolution of the printing technique, cost-effectiveness of the printing process and end-use requirements. This paper aims to compare and highlight the effects of these design factors on the printing outcome of bio-models.Design/methodology/approach Different data sources including engineering drawing, computed tomography (CT), and optical coherence tomography (OCT) were converted to a printable data format. Three different bio-models, namely, an ophthalmic model, a retina model and a distal tibia model, were printed using two different techniques, namely, PolyJet and fused deposition modelling. The process flow and 3D printed models were analysed.Findings The data acquisition and 3D printing process affect the overall printing resolution. The design process flows using different data sources were established and the bio-models were printed successfully.Research limitations/implications Data acquisition techniques contained inherent noise data and resulted in inaccuracies during data conversion.Originality/value This work showed that the data acquisition and conversion technique had a significant effect on the quality of the bio-model blueprint and subsequently the printing outcome. In addition, important design factors of bio-models were highlighted such as material requirement and the cost-effectiveness of the printing technique. This paper provides a systematic discussion for future development of an engineering design process in three-dimensional (3D) printed bio-models. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of contrast medium dilution during tracheal balloon dilation on balloon deflation time and visibility using a 3-dimensional (3D) printed airway phantom.Materials and Methods: A comparison study to investigate balloon deflation times and image quality was performed using two contrast agents with different viscosities, i.e., iohexol and ioxithalamate, and six contrast dilutions with a 3D printed airway phantom.Results: Compared to 1:0 concentration, 3:1, 2:1, 1:1, 1:2, and 1:3, contrast/saline ratios resulted in a 46% (56.2 s), 59.8% (73.1 s), 74.9% (91.6 s), 81.7% (99.8 s), and 83.5% (102 s) reduction for iohexol, respectively, and a 51.8% (54.7 s), 63.8% (67.6 s), 74.7% (79.2 s), 80.5% (85.3 s), and 82.4% (87.4 s) reduction for ioxithalamate, respectively, in the mean balloon deflation time, although at the expense of decreased balloon opacity (3.5, 6.9, 11.1, 12.4, and 13.9%, for iohexol, respectively, and 3.2, 6, 9.6, 10.8, and 12.4%, for ioxithalamate, respectively).Conclusions: Use of a lower viscosity contrast agent and higher contrast dilution is considered to be able to reduce balloon deflation times and then simultaneously decrease visualization of balloons. The rapid balloon deflation time is likely to improve the safe performance of interventional procedures. [ABSTRACT FROM AUTHOR]