Background: The emergence of 3D printing has revolutionized medical training and preoperative planning. However, existing models have limitations, prompting the development of newly designed flexible 3D-printed bone fracture models.
Methods: The designed flexible 3D-printed bone fracture models were evaluated by 133 trauma surgeons with different levels of experience for perceived value as educational tool or as preoperative planning tool.
Results: The models allowed drilling and showed resistance to manipulation and sterilization. Surgeons found the flexible model helpful for teaching and planning the reduction of fractures, planning and simulating osteosynthesis, understanding fractures, visualizing fractures, and planning surgical approaches.
Conclusions: Flexible 3D-printed bone fracture models offer a dynamic and realistic approach to understanding complex fractures, potentially improving surgical training and preoperative planning.
{"title":"Evaluating the value of 3D-printed bone models with fracture fragments connected by flexible rods for training and preoperative planning.","authors":"Monica Ghidinelli, Dankward Höntzsch, Bedran Atici, Stefano Crespan","doi":"10.1186/s41205-025-00250-5","DOIUrl":"10.1186/s41205-025-00250-5","url":null,"abstract":"<p><strong>Background: </strong>The emergence of 3D printing has revolutionized medical training and preoperative planning. However, existing models have limitations, prompting the development of newly designed flexible 3D-printed bone fracture models.</p><p><strong>Methods: </strong>The designed flexible 3D-printed bone fracture models were evaluated by 133 trauma surgeons with different levels of experience for perceived value as educational tool or as preoperative planning tool.</p><p><strong>Results: </strong>The models allowed drilling and showed resistance to manipulation and sterilization. Surgeons found the flexible model helpful for teaching and planning the reduction of fractures, planning and simulating osteosynthesis, understanding fractures, visualizing fractures, and planning surgical approaches.</p><p><strong>Conclusions: </strong>Flexible 3D-printed bone fracture models offer a dynamic and realistic approach to understanding complex fractures, potentially improving surgical training and preoperative planning.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"11 1","pages":"2"},"PeriodicalIF":3.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11737195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-03DOI: 10.1186/s41205-024-00248-5
Zixi Wang, Carlo Saija, Nicholas Raison, Abdullatif Aydin, Zhouyang Xu, Katie Zuo, Kawal Rhode, Antonia Pontiki
Background: Penile implant surgery is the standard surgical treatment for end-stage erectile dysfunction. However, the growing complexity of modern high-tech penile prostheses has increased the demand for more practical training opportunities. The most advanced contemporary training methods involve simulation training using cadavers, with costs exceeding $5,000 per cadaver, inclusive of biohazard fees. This study introduces an innovative and cost-efficient male urogenital simulator designed to enhance penile implant surgery training.
Methods: Utilizing image segmentation of patient pre-operative computed tomography (CT) scans, combined with three-dimensional (3D) printing and silicone molding techniques, we developed a high-fidelity simulator replicating the anatomical structures of the male urogenital system. The simulator incorporates an innovative double-layer structural design encompassing the corpus spongiosum and glans, corpora cavernosa, testes, epididymides, and pelvic bones. Additionally, it utilizes a two-stage skin manufacturing process tailored for different skin regions. The simulator was produced at a low material cost of £10, with an average production time of 3 h. To evaluate its training efficacy, we conducted a penile implant surgery training session involving 15 urology trainees and surgeons ranging from specialty training levels ST3 to ST6. The session began with a demonstration of penile implant surgery and error detection. Trainees, averaging three per simulator, practiced corporotomy, dilation, measurement, penile prosthesis, and scrotal pump placement under expert guidance. Participants' feedback was collected using a Likert scale questionnaire, assessing learning, satisfaction, and anatomical accuracy.
Results: Quantitative analysis of the questionnaire responses indicated highly positive feedback from the participants. Satisfaction rates surpassed 96% in learning effectiveness, over 89% in overall satisfaction, and 86% in anatomical accuracy demonstration. The simulator was favourably reviewed by both urology trainees and experienced surgeons, highlighting its utility as a practical training tool. Its low production cost and high precision make it a viable alternative to current training models.
Conclusions: The development of this cost-efficient, anatomically accurate urogenital simulator through advanced imaging and additive manufacturing techniques represents a significant advancement in penile implant surgical training. This state-of-the-art simulator not only provides a realistic and practical training experience but also underscores the potential for 3D printing technologies to revolutionize medical education and training.
{"title":"Low-cost male urogenital simulator for penile implant surgery training: a 3D printing approach.","authors":"Zixi Wang, Carlo Saija, Nicholas Raison, Abdullatif Aydin, Zhouyang Xu, Katie Zuo, Kawal Rhode, Antonia Pontiki","doi":"10.1186/s41205-024-00248-5","DOIUrl":"10.1186/s41205-024-00248-5","url":null,"abstract":"<p><strong>Background: </strong>Penile implant surgery is the standard surgical treatment for end-stage erectile dysfunction. However, the growing complexity of modern high-tech penile prostheses has increased the demand for more practical training opportunities. The most advanced contemporary training methods involve simulation training using cadavers, with costs exceeding $5,000 per cadaver, inclusive of biohazard fees. This study introduces an innovative and cost-efficient male urogenital simulator designed to enhance penile implant surgery training.</p><p><strong>Methods: </strong>Utilizing image segmentation of patient pre-operative computed tomography (CT) scans, combined with three-dimensional (3D) printing and silicone molding techniques, we developed a high-fidelity simulator replicating the anatomical structures of the male urogenital system. The simulator incorporates an innovative double-layer structural design encompassing the corpus spongiosum and glans, corpora cavernosa, testes, epididymides, and pelvic bones. Additionally, it utilizes a two-stage skin manufacturing process tailored for different skin regions. The simulator was produced at a low material cost of £10, with an average production time of 3 h. To evaluate its training efficacy, we conducted a penile implant surgery training session involving 15 urology trainees and surgeons ranging from specialty training levels ST3 to ST6. The session began with a demonstration of penile implant surgery and error detection. Trainees, averaging three per simulator, practiced corporotomy, dilation, measurement, penile prosthesis, and scrotal pump placement under expert guidance. Participants' feedback was collected using a Likert scale questionnaire, assessing learning, satisfaction, and anatomical accuracy.</p><p><strong>Results: </strong>Quantitative analysis of the questionnaire responses indicated highly positive feedback from the participants. Satisfaction rates surpassed 96% in learning effectiveness, over 89% in overall satisfaction, and 86% in anatomical accuracy demonstration. The simulator was favourably reviewed by both urology trainees and experienced surgeons, highlighting its utility as a practical training tool. Its low production cost and high precision make it a viable alternative to current training models.</p><p><strong>Conclusions: </strong>The development of this cost-efficient, anatomically accurate urogenital simulator through advanced imaging and additive manufacturing techniques represents a significant advancement in penile implant surgical training. This state-of-the-art simulator not only provides a realistic and practical training experience but also underscores the potential for 3D printing technologies to revolutionize medical education and training.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"11 1","pages":"1"},"PeriodicalIF":3.2,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-27DOI: 10.1186/s41205-024-00244-9
Arnau Valls-Esteve, Rubén I García, Anna Bellmunt, Harkaitz Eguiraun, Ines Jauregui, Cristina Del Amo, Nuria Adell-Gomez, Lucas Krauel, Josep Munuera
Background: 3D technologies [Virtual and Augmented 3D planning, 3D printing (3DP), Additive Manufacturing (AM)] are rapidly being adopted in the healthcare sector, demonstrating their relevance in personalized medicine and the rapid development of medical devices. The study's purpose was to understand the state and evolution of 3DP/AM technologies at the Point-of-Care (PoC), its adoption, organization and process in Spanish hospitals and to understand and compare the evolution of the models, clinical applications, and challenges in utilizing the technology during the COVID-19 pandemic and beyond.
Methods: This was a questionnaire-based qualitative and longitudinal study. Data on 3DP and AM activities in Spain were collected from 73 hospitals/institutions falling under the ITEMAS (Platform for Innovation in Medical and Health Technologies) and the Plataforma ISCIII Biomodelos y Biobancos from January 2019 to May 2020 for the first study, and at the end of 2022 and 2023 for the second study.
Results: A total of 23 (31.5%) hospitals during the first study, while 30 (41.09%) during the second study reported having at least one 3DP/AM initiative. Post-covid, the majority of hospitals had onsite 3DP/AM services with a well-defined, structured, and centralized system. Traumatology and maxillofacial surgery services were found to be the most involved in 3DP projects for the production of custom-made surgical guides, prostheses and orthoses. Bioprinting initiatives were also noted to be expanding. Human resources, cost, and regulatory compliance were the key hurdles in introducing 3D/AM in hospitals.
Conclusions: In-house 3DP/AM units, with Mixed-Model is the most common model in Spain; The COVID-19 pandemic influenced the 3D planning activity and adoption. Further research and clinical trials, and improvements in resources, reimbursement and regulatory compliance are critical for the Point-of-care hospital growth of this breakthrough technology.
{"title":"Point-of-care additive manufacturing: state of the art and adoption in Spanish hospitals during pre to post COVID-19 era.","authors":"Arnau Valls-Esteve, Rubén I García, Anna Bellmunt, Harkaitz Eguiraun, Ines Jauregui, Cristina Del Amo, Nuria Adell-Gomez, Lucas Krauel, Josep Munuera","doi":"10.1186/s41205-024-00244-9","DOIUrl":"10.1186/s41205-024-00244-9","url":null,"abstract":"<p><strong>Background: </strong>3D technologies [Virtual and Augmented 3D planning, 3D printing (3DP), Additive Manufacturing (AM)] are rapidly being adopted in the healthcare sector, demonstrating their relevance in personalized medicine and the rapid development of medical devices. The study's purpose was to understand the state and evolution of 3DP/AM technologies at the Point-of-Care (PoC), its adoption, organization and process in Spanish hospitals and to understand and compare the evolution of the models, clinical applications, and challenges in utilizing the technology during the COVID-19 pandemic and beyond.</p><p><strong>Methods: </strong>This was a questionnaire-based qualitative and longitudinal study. Data on 3DP and AM activities in Spain were collected from 73 hospitals/institutions falling under the ITEMAS (Platform for Innovation in Medical and Health Technologies) and the Plataforma ISCIII Biomodelos y Biobancos from January 2019 to May 2020 for the first study, and at the end of 2022 and 2023 for the second study.</p><p><strong>Results: </strong>A total of 23 (31.5%) hospitals during the first study, while 30 (41.09%) during the second study reported having at least one 3DP/AM initiative. Post-covid, the majority of hospitals had onsite 3DP/AM services with a well-defined, structured, and centralized system. Traumatology and maxillofacial surgery services were found to be the most involved in 3DP projects for the production of custom-made surgical guides, prostheses and orthoses. Bioprinting initiatives were also noted to be expanding. Human resources, cost, and regulatory compliance were the key hurdles in introducing 3D/AM in hospitals.</p><p><strong>Conclusions: </strong>In-house 3DP/AM units, with Mixed-Model is the most common model in Spain; The COVID-19 pandemic influenced the 3D planning activity and adoption. Further research and clinical trials, and improvements in resources, reimbursement and regulatory compliance are critical for the Point-of-care hospital growth of this breakthrough technology.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"10 1","pages":"43"},"PeriodicalIF":3.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-18DOI: 10.1186/s41205-024-00240-z
Adam Jakimiuk, Michaela Maintz, Magdalena Müller-Gerbl, Florian Markus Thieringer, Marco Keller, Alissa Guebeli, Philipp Honigmann
The most common surgical procedure to manage the malunion of the bones is corrective osteotomy. The current gold standard for securing the bone segments after osteotomy is the use of titanium plates and allografts which have disadvantages such as possible allergic reaction, additional operations such as extraction of the graft from other sites and removal operation. The utilization of resorbable materials presents an opportunity to mitigate these drawbacks but has not yet been thoroughly researched in the literature. This study assesses the viability of using biodegradable, 3D-printed patient-specific implants made of Poly(-L-lactide-co-D, L-lactide) (PLDLLA) and β-Tricalcium Phosphate (β-TCP) as an alternative material in an in-vitro biomechanical study involving ex vivo biomechanical compression testing, biodegradation testing, and calorimetric measurements. These implants possess a unique shape, resembling a wedge and are fixated as a connection between the osteotomised bone using resorbable screws. Following point-of-care virtual planning, bio-mechanical compressive tests with (n = 5) ex vivo radii equipped with PLDLLA/ β-TCP implants were performed to prove sufficient stability of the connection. All PLDLLA/ β-TCP implants withstood a compressive force of at least 1'211 N which exceeds the maximum force reported in literature in case of a fall from the height of one meter. Furthermore, the results showed a consistent surface chemistry and slow degradation rate. The outcomes are encouraging, establishing the groundwork for an innovative distal radius corrective osteotomy surgical method. However, further research is necessary to thoroughly evaluate the long-term biodegradability and mechanical efficacy of the implants.
治疗骨不愈合最常见的外科手术是矫正截骨术。目前用于截骨后固定骨段的金标准是使用钛板和同种异体移植物,其缺点是可能产生过敏反应,需要进行额外的手术,如从其他部位取出移植物和切除手术。可吸收材料的利用提供了一个机会,以减轻这些缺点,但尚未在文献中进行彻底的研究。本研究评估了使用可生物降解的3d打印患者特异性植入物的可行性,该植入物由聚(- l -丙交酯-co- d, l -丙交酯)(pldla)和β-磷酸三钙(β-TCP)制成,作为体外生物力学研究的替代材料,包括体外生物力学压缩测试、生物降解测试和量热测量。这些植入物具有独特的形状,类似于楔子,并使用可吸收螺钉固定作为截骨骨之间的连接。根据护理点虚拟规划,使用(n = 5)离体半径配备pldla / β-TCP植入物进行生物力学压缩测试,以证明连接具有足够的稳定性。所有pldla / β-TCP植入物都能承受至少1'211 N的压缩力,这超过了文献报道的从一米高处坠落时的最大压力。此外,结果表明,表面化学性质一致,降解速度慢。结果令人鼓舞,为创新桡骨远端矫正截骨手术方法奠定了基础。然而,需要进一步的研究来彻底评估植入物的长期生物降解性和机械功效。
{"title":"3D-printed patient-specific implants made of polylactide (PLDLLA) and β-tricalcium phosphate (β-TCP) for corrective osteotomies of the distal radius.","authors":"Adam Jakimiuk, Michaela Maintz, Magdalena Müller-Gerbl, Florian Markus Thieringer, Marco Keller, Alissa Guebeli, Philipp Honigmann","doi":"10.1186/s41205-024-00240-z","DOIUrl":"10.1186/s41205-024-00240-z","url":null,"abstract":"<p><p>The most common surgical procedure to manage the malunion of the bones is corrective osteotomy. The current gold standard for securing the bone segments after osteotomy is the use of titanium plates and allografts which have disadvantages such as possible allergic reaction, additional operations such as extraction of the graft from other sites and removal operation. The utilization of resorbable materials presents an opportunity to mitigate these drawbacks but has not yet been thoroughly researched in the literature. This study assesses the viability of using biodegradable, 3D-printed patient-specific implants made of Poly(-L-lactide-co-D, L-lactide) (PLDLLA) and β-Tricalcium Phosphate (β-TCP) as an alternative material in an in-vitro biomechanical study involving ex vivo biomechanical compression testing, biodegradation testing, and calorimetric measurements. These implants possess a unique shape, resembling a wedge and are fixated as a connection between the osteotomised bone using resorbable screws. Following point-of-care virtual planning, bio-mechanical compressive tests with (n = 5) ex vivo radii equipped with PLDLLA/ β-TCP implants were performed to prove sufficient stability of the connection. All PLDLLA/ β-TCP implants withstood a compressive force of at least 1'211 N which exceeds the maximum force reported in literature in case of a fall from the height of one meter. Furthermore, the results showed a consistent surface chemistry and slow degradation rate. The outcomes are encouraging, establishing the groundwork for an innovative distal radius corrective osteotomy surgical method. However, further research is necessary to thoroughly evaluate the long-term biodegradability and mechanical efficacy of the implants.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"10 1","pages":"42"},"PeriodicalIF":3.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Breast cancer screening is implemented as part of governmental healthcare policy in many countries. While breast imaging tests contribute to reducing mortality, some breast cancers may emerge between these screenings. Consequently, it is crucial for women to be vigilant about any changes in their breasts to facilitate the early detection of breast cancer. Recently, the application of 3-dimensional printing technology in the medical field has expanded, including uses in medical imaging and surgical training. In this study, we developed 3D-printed palpation models for breast tumor detection and surveyed seven surgeons specializing in breast care to evaluate the usability of the models. As a result of the survey, we created a model that obtained a maximum mean rating of 7.1(maximum rating 10, minimum rating 3) on the item 'How accurately does the model simulate the feel of a real tumor?' on a scale from 1 to 10. Although there is some variation in the average value, through this study, we found that it is possible to create a model that is quite close to the actual tumor depending on the materials and shape of the models. Our findings demonstrated the potential use of personalized models both in medical trainee and patient education.
{"title":"Development and evaluation of 3D-printed tumor palpation models for surgical training and patient education.","authors":"Haruna Katori, Atsushi Fushimi, Soichiro Fujimura, Rei Kudo, Makiko Kamio, Hiroko Nogi","doi":"10.1186/s41205-024-00234-x","DOIUrl":"10.1186/s41205-024-00234-x","url":null,"abstract":"<p><p>Breast cancer screening is implemented as part of governmental healthcare policy in many countries. While breast imaging tests contribute to reducing mortality, some breast cancers may emerge between these screenings. Consequently, it is crucial for women to be vigilant about any changes in their breasts to facilitate the early detection of breast cancer. Recently, the application of 3-dimensional printing technology in the medical field has expanded, including uses in medical imaging and surgical training. In this study, we developed 3D-printed palpation models for breast tumor detection and surveyed seven surgeons specializing in breast care to evaluate the usability of the models. As a result of the survey, we created a model that obtained a maximum mean rating of 7.1(maximum rating 10, minimum rating 3) on the item 'How accurately does the model simulate the feel of a real tumor?' on a scale from 1 to 10. Although there is some variation in the average value, through this study, we found that it is possible to create a model that is quite close to the actual tumor depending on the materials and shape of the models. Our findings demonstrated the potential use of personalized models both in medical trainee and patient education.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"10 1","pages":"41"},"PeriodicalIF":3.2,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-27DOI: 10.1186/s41205-024-00246-7
Svenja Jung, Martin Hoffmann, Dirk Winkler, Erdem Güresir, Fabian Kropla, Sebastian Scholz, Ronny Grunert
Background: The development of phantoms to reduce animal testing or to validate new instruments or operation techniques is of increasing importance. For this reason, a blood circulation phantom was developed to test a newly designed retractor system with an integrated oxygen sensor. This phantom was used to evaluate the impact of the 3D printed blood vessel on the measurement of the oxygen saturation.
Methods: A solution of nickel sulfate and copper sulfate was prepared as a substitute for real blood. The absorption spectra of these solutions were recorded and compared with those of blood. Subsequently, the oxygen sensor used was calibrated to the blood substitute. Additionally, blood vessels with a simplified geometry were designed and manufactured using inverted vat polymerization and an elastic material (Formlabs Elastic 50 A). To determine the orientation during the printing process, various vessels were printed. Measurements to assess the effects of disturbance (rotation of the vessels during measurements) on the sensor readouts were prepared.
Results: The impact of disturbances was verified through the rotation of the 3D printed vessels. It was demonstrated that a direct measurement on the disturbances led to outliers and higher values. An optimal orientation was determined to be a lateral placement (90° or 270°) of the sensor. Regarding the orientation of the vessels within the printing space, an orientation of 45° yielded the best results, as the individual layers had the least impact on the light emitted and received by the oxygen sensor.
Conclusion: The achieved results demonstrate the influence of the orientation of the vessel during 3D printing as well as the influence of the position of the vessel during the measurement using a conventional oxygen sensor.
背景:开发模型以减少动物试验或验证新仪器或操作技术的重要性与日俱增。为此,我们开发了一个血液循环模型,用于测试新设计的带有集成氧气传感器的牵引器系统。该模型用于评估 3D 打印血管对血氧饱和度测量的影响:方法:制备了硫酸镍和硫酸铜溶液作为真实血液的替代品。记录这些溶液的吸收光谱,并与血液的吸收光谱进行比较。随后,根据血液替代物对所用的氧气传感器进行了校准。此外,使用倒置槽聚合和弹性材料(Formlabs Elastic 50 A)设计并制造了几何形状简化的血管。为了确定打印过程中的方向,打印了各种血管。为评估干扰(测量过程中容器的旋转)对传感器读数的影响,准备了测量结果:结果:通过旋转 3D 打印容器验证了干扰的影响。结果表明,直接测量干扰会导致异常值和更高的数值。最佳方向被确定为传感器的横向放置(90° 或 270°)。关于印刷空间内血管的方向,45°方向产生的结果最好,因为各层对氧气传感器发射和接收的光线影响最小:所取得的结果证明了三维打印过程中容器方向的影响,以及使用传统氧气传感器测量过程中容器位置的影响。
{"title":"Influence of the orientation of constructed blood vessels during the 3D printing on the measurement of the pseudo-oxygen saturation of an artificial blood substitute using conventional oxygen sensors: a test series.","authors":"Svenja Jung, Martin Hoffmann, Dirk Winkler, Erdem Güresir, Fabian Kropla, Sebastian Scholz, Ronny Grunert","doi":"10.1186/s41205-024-00246-7","DOIUrl":"10.1186/s41205-024-00246-7","url":null,"abstract":"<p><strong>Background: </strong>The development of phantoms to reduce animal testing or to validate new instruments or operation techniques is of increasing importance. For this reason, a blood circulation phantom was developed to test a newly designed retractor system with an integrated oxygen sensor. This phantom was used to evaluate the impact of the 3D printed blood vessel on the measurement of the oxygen saturation.</p><p><strong>Methods: </strong>A solution of nickel sulfate and copper sulfate was prepared as a substitute for real blood. The absorption spectra of these solutions were recorded and compared with those of blood. Subsequently, the oxygen sensor used was calibrated to the blood substitute. Additionally, blood vessels with a simplified geometry were designed and manufactured using inverted vat polymerization and an elastic material (Formlabs Elastic 50 A). To determine the orientation during the printing process, various vessels were printed. Measurements to assess the effects of disturbance (rotation of the vessels during measurements) on the sensor readouts were prepared.</p><p><strong>Results: </strong>The impact of disturbances was verified through the rotation of the 3D printed vessels. It was demonstrated that a direct measurement on the disturbances led to outliers and higher values. An optimal orientation was determined to be a lateral placement (90° or 270°) of the sensor. Regarding the orientation of the vessels within the printing space, an orientation of 45° yielded the best results, as the individual layers had the least impact on the light emitted and received by the oxygen sensor.</p><p><strong>Conclusion: </strong>The achieved results demonstrate the influence of the orientation of the vessel during 3D printing as well as the influence of the position of the vessel during the measurement using a conventional oxygen sensor.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"10 1","pages":"40"},"PeriodicalIF":3.2,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-25DOI: 10.1186/s41205-024-00245-8
Samuel D J Spears, Thomas Lester, Ryo Torii, Deepak M Kalaskar
Aim: This study compares the precision, accuracy, and user experience of 3D body surface scanning of human subjects using the Artec Leo hand-held scanner and the iPad Pro as 3D scanning devices for capturing cervical and craniofacial data. The investigation includes assessing methods for correcting 'dropped head syndrome' during scanning, to demonstrate the ability of the scanner to be used to reconstruct body surface of patients.
Methods: Eighteen volunteers with no prior history of neck weakness were scanned three times in three different positions, using the two different devices. Surface area, scanning time, and participant comfort scores were evaluated for both devices. Precision and accuracy were assessed using Mean Absolute Deviation (MAD), Mean Absolute Percentage Error (MAPE), and Intra-Class Correlation Coefficients (ICC).
Results: Surface area comparisons revealed no significant differences between devices and positions. Scanning times showed no significant difference between devices or positions. Comfort scores varied across positions. MAD analysis identified chin to chest measurements as having the highest variance, especially in scanning position 3. However, no statistical differences were found. MAPE results confirmed accuracy below 5% error for both devices. ICC scores indicated good reliability for both measurement methods, particularly for chin to chest measurements in positions 1 and 3.
Conclusion: The iPad Pro using the Qlone app demonstrates a viable alternative to the Artec Leo, particularly for capturing head and neck surface area within a clinical setting. The scanning resolution, with an error margin within ±5%, is consistent with clinically accepted standards for orthosis design, where padding and final fit adjustments allow for bespoke devices that accommodate patient comfort. This study highlights the comparative performance of the iPad, as well as suggests two methods which can be used within clinics to correct head drop for scanning.
{"title":"Comparative evaluation of Artec Leo hand-held scanner and iPad Pro for 3D scanning of cervical and craniofacial data: assessing precision, accuracy, and user experience.","authors":"Samuel D J Spears, Thomas Lester, Ryo Torii, Deepak M Kalaskar","doi":"10.1186/s41205-024-00245-8","DOIUrl":"10.1186/s41205-024-00245-8","url":null,"abstract":"<p><strong>Aim: </strong>This study compares the precision, accuracy, and user experience of 3D body surface scanning of human subjects using the Artec Leo hand-held scanner and the iPad Pro as 3D scanning devices for capturing cervical and craniofacial data. The investigation includes assessing methods for correcting 'dropped head syndrome' during scanning, to demonstrate the ability of the scanner to be used to reconstruct body surface of patients.</p><p><strong>Methods: </strong>Eighteen volunteers with no prior history of neck weakness were scanned three times in three different positions, using the two different devices. Surface area, scanning time, and participant comfort scores were evaluated for both devices. Precision and accuracy were assessed using Mean Absolute Deviation (MAD), Mean Absolute Percentage Error (MAPE), and Intra-Class Correlation Coefficients (ICC).</p><p><strong>Results: </strong>Surface area comparisons revealed no significant differences between devices and positions. Scanning times showed no significant difference between devices or positions. Comfort scores varied across positions. MAD analysis identified chin to chest measurements as having the highest variance, especially in scanning position 3. However, no statistical differences were found. MAPE results confirmed accuracy below 5% error for both devices. ICC scores indicated good reliability for both measurement methods, particularly for chin to chest measurements in positions 1 and 3.</p><p><strong>Conclusion: </strong>The iPad Pro using the Qlone app demonstrates a viable alternative to the Artec Leo, particularly for capturing head and neck surface area within a clinical setting. The scanning resolution, with an error margin within ±5%, is consistent with clinically accepted standards for orthosis design, where padding and final fit adjustments allow for bespoke devices that accommodate patient comfort. This study highlights the comparative performance of the iPad, as well as suggests two methods which can be used within clinics to correct head drop for scanning.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"10 1","pages":"39"},"PeriodicalIF":3.2,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142712033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-22DOI: 10.1186/s41205-024-00242-x
Lukas Juergensen, Robert Rischen, Julian Hasselmann, Max Toennemann, Arne Pollmanns, Georg Gosheger, Martin Schulze
Background: The use of 3D-printing in medicine requires a context-specific quality assurance program to ensure patient safety. The process of medical 3D-printing involves several steps, each of which might be prone to its own set of errors. The segmentation error (SegE), the digital editing error (DEE) and the printing error (PrE) are the most important partial errors. Approaches to evaluate these have not yet been implemented in a joint concept. Consequently, information on the stability of the overall process is often lacking and possible process optimizations are difficult to implement. In this study, SegE, DEE, and PrE are evaluated individually, and error propagation is used to examine the cumulative effect of the partial errors.
Methods: The partial errors were analyzed employing surface deviation analyses. The effects of slice thickness, kernel, threshold, software and printers were investigated. The total error was calculated as the sum of SegE, DEE and PrE.
Results: The higher the threshold value was chosen, the smaller were the segmentation results. The deviation values varied more when the CT slices were thicker and when the threshold was more distant from a value of around -400 HU. Bone kernel-based segmentations were prone to artifact formation. The relative reduction in STL file size [as a proy for model complexity] was greater for higher levels of smoothing and thinner slice thickness of the DICOM datasets. The slice thickness had a minor effect on the surface deviation caused by smoothing, but it was affected by the level of smoothing. The PrE was mainly influenced by the adhesion of the printed part to the build plate. Based on the experiments, the total error was calculated for an optimal and a worst-case parameter configuration. Deviations of 0.0093 mm ± 0.2265 mm and 0.3494 mm ± 0.8001 mm were calculated for the total error.
Conclusions: Various parameters affecting geometric deviations in medical 3D-printing were analyzed. Especially, soft reconstruction kernels seem to be advantageous for segmentation. The concept of error propagation can contribute to a better understanding of the process specific errors and enable future analytical approaches to calculate the total error based on process parameters.
背景:在医学中使用 3D 打印技术需要针对具体情况制定质量保证计划,以确保患者安全。医学三维打印过程涉及多个步骤,每个步骤都可能容易产生一系列错误。分割错误(SegE)、数字编辑错误(DEE)和打印错误(PrE)是最重要的部分错误。评估这些误差的方法尚未在联合概念中实施。因此,往往缺乏有关整个流程稳定性的信息,也很难实施可能的流程优化。在本研究中,对 SegE、DEE 和 PrE 分别进行了评估,并使用误差传播来检查局部误差的累积效应:方法:采用表面偏差分析法对部分误差进行分析。研究了切片厚度、内核、阈值、软件和打印机的影响。总误差计算为 SegE、DEE 和 PrE 的总和:结果:选择的阈值越高,分割结果越小。CT 切片越厚,阈值越远离-400 HU 左右的值时,偏差值的变化越大。基于骨核的分割容易形成伪影。DICOM 数据集的平滑度越高,切片厚度越薄,STL 文件大小[与模型复杂度成正比]相对减小的幅度就越大。切片厚度对平滑造成的表面偏差影响不大,但会受到平滑程度的影响。PrE 主要受打印部件与构建板的附着力影响。根据实验结果,计算了最佳参数配置和最差参数配置的总误差。计算得出的总误差偏差为 0.0093 毫米 ± 0.2265 毫米和 0.3494 毫米 ± 0.8001 毫米:分析了影响医疗 3D 打印几何偏差的各种参数。尤其是软重构核似乎在分割方面更具优势。误差传播的概念有助于更好地理解特定工艺误差,并使未来的分析方法能够根据工艺参数计算总误差。
{"title":"Insights into geometric deviations of medical 3d-printing: a phantom study utilizing error propagation analysis.","authors":"Lukas Juergensen, Robert Rischen, Julian Hasselmann, Max Toennemann, Arne Pollmanns, Georg Gosheger, Martin Schulze","doi":"10.1186/s41205-024-00242-x","DOIUrl":"10.1186/s41205-024-00242-x","url":null,"abstract":"<p><strong>Background: </strong>The use of 3D-printing in medicine requires a context-specific quality assurance program to ensure patient safety. The process of medical 3D-printing involves several steps, each of which might be prone to its own set of errors. The segmentation error (SegE), the digital editing error (DEE) and the printing error (PrE) are the most important partial errors. Approaches to evaluate these have not yet been implemented in a joint concept. Consequently, information on the stability of the overall process is often lacking and possible process optimizations are difficult to implement. In this study, SegE, DEE, and PrE are evaluated individually, and error propagation is used to examine the cumulative effect of the partial errors.</p><p><strong>Methods: </strong>The partial errors were analyzed employing surface deviation analyses. The effects of slice thickness, kernel, threshold, software and printers were investigated. The total error was calculated as the sum of SegE, DEE and PrE.</p><p><strong>Results: </strong>The higher the threshold value was chosen, the smaller were the segmentation results. The deviation values varied more when the CT slices were thicker and when the threshold was more distant from a value of around -400 HU. Bone kernel-based segmentations were prone to artifact formation. The relative reduction in STL file size [as a proy for model complexity] was greater for higher levels of smoothing and thinner slice thickness of the DICOM datasets. The slice thickness had a minor effect on the surface deviation caused by smoothing, but it was affected by the level of smoothing. The PrE was mainly influenced by the adhesion of the printed part to the build plate. Based on the experiments, the total error was calculated for an optimal and a worst-case parameter configuration. Deviations of 0.0093 mm ± 0.2265 mm and 0.3494 mm ± 0.8001 mm were calculated for the total error.</p><p><strong>Conclusions: </strong>Various parameters affecting geometric deviations in medical 3D-printing were analyzed. Especially, soft reconstruction kernels seem to be advantageous for segmentation. The concept of error propagation can contribute to a better understanding of the process specific errors and enable future analytical approaches to calculate the total error based on process parameters.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"10 1","pages":"38"},"PeriodicalIF":3.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1186/s41205-024-00243-w
Jonathan M Ford, Frank J Rybicki, Jonathan M Morris, Summer J Decker
{"title":"Stratifying complexity among the widespread use of 3D printing in United States health care facilities.","authors":"Jonathan M Ford, Frank J Rybicki, Jonathan M Morris, Summer J Decker","doi":"10.1186/s41205-024-00243-w","DOIUrl":"10.1186/s41205-024-00243-w","url":null,"abstract":"","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"10 1","pages":"37"},"PeriodicalIF":3.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-14DOI: 10.1186/s41205-024-00239-6
Nicole Wake, Yenpo Lin, Ek T Tan, Darryl B Sneag, Sarah Ianucci, Maggie Fung
Background: Patient-specific three-dimensional (3D) printed anatomic models are valuable clinical tools that facilitate enhanced visualization of pertinent anatomic structures and have demonstrated benefits of reduced surgical times, increased surgeon confidence, and improved operative results and subsequent patient outcomes. Medical image-based 3D printed anatomic models are generally created from computed tomography (CT), however magnetic resonance imaging (MRI), which offers exquisite soft tissue characterization and flexible contrast avoiding the use of ionizing radiation, is an attractive alternative. Herein, the application of 3D printing incorporating both MR neurography and zero-echo time (ZTE) MRI for visualization of the brachial plexus anatomy in a subject with thoracic outlet syndrome (TOS) is described.
Methods: A 28-year-old man presented with chronic right upper limb discomfort and paresthesias extending from the shoulder region to the third and fourth digits. The subject underwent evaluation with a unilateral brachial plexus MR neurography protocol at 3.0 Tesla for suspicion of TOS. The protocol included T2-weighted, 3D fast spin echo short-tau inversion recovery (STIR-FSE) and 3D radial ZTE sequences for depiction of the nerves and bones, respectively. The first rib and its synostosis impinged upon the inferior aspect of the T1 nerve root (T1NR), with accompanying mild enlargement of the T1NR. A 3D printed anatomic model was created and included: (1) bone (spine, ribs, clavicle, scapula, and humerus), (2) brachial plexus, and (3) costal cartilage.
Results: The 3D printed model clearly demonstrated a T1NR impingement from the synostosis, confirming the diagnosis of neurologic thoracic outlet syndrome (TOS) and guided the treatment approach in prescribing TOS-specific physical therapy, which led to significant improvements in the patient's condition.
Conclusion: To our knowledge, this is the first in-vivo human 3D printed case for TOS using MRI-only data. The 3D printed model allowed for improved visualization and understanding of the spatial relationships between the nerves of the brachial plexus and surrounding osseous structures responsible for the patient's symptoms.
Clinical trial number: Not applicable.
背景:患者特异性三维(3D)打印解剖模型是非常有价值的临床工具,有助于增强相关解剖结构的可视化,并具有缩短手术时间、增强外科医生信心、改善手术效果和患者后续预后等优点。基于医学影像的 3D 打印解剖模型通常是通过计算机断层扫描(CT)创建的,但磁共振成像(MRI)可提供细腻的软组织特征和灵活的对比度,避免使用电离辐射,是一种极具吸引力的替代方法。本文介绍了结合磁共振神经成像和零回波时间(ZTE)磁共振成像的 3D 打印技术在胸廓出口综合征(TOS)患者臂丛神经解剖学可视化中的应用:方法:一名 28 岁的男子因慢性右上肢不适和从肩部延伸至第三和第四个手指的麻痹而就诊。该患者因怀疑患有 TOS 而接受了 3.0 特斯拉单侧臂丛磁共振神经成像检查。该方案包括 T2 加权、三维快速自旋回波短陶反转恢复(STIR-FSE)和三维径向 ZTE 序列,分别用于描绘神经和骨骼。第一根肋骨及其突起物侵犯了 T1 神经根(T1NR)的下侧,并伴有 T1NR 的轻度增大。创建的 3D 打印解剖模型包括(结果:结果:3D 打印模型清楚地显示了来自关节突的 T1NR 撞击,证实了神经性胸廓出口综合征(TOS)的诊断,并指导了治疗方法,为患者开出了针对 TOS 的物理治疗处方,使患者的病情得到了显著改善:据我们所知,这是首个使用纯核磁共振成像数据的TOS体内人体3D打印病例。三维打印模型提高了对臂丛神经和导致患者症状的周围骨性结构之间空间关系的可视化和理解:临床试验编号:不适用。
{"title":"3D printing of the brachial plexus and its osseous landmarks using magnetic resonance neurography for thoracic outlet syndrome evaluation.","authors":"Nicole Wake, Yenpo Lin, Ek T Tan, Darryl B Sneag, Sarah Ianucci, Maggie Fung","doi":"10.1186/s41205-024-00239-6","DOIUrl":"10.1186/s41205-024-00239-6","url":null,"abstract":"<p><strong>Background: </strong>Patient-specific three-dimensional (3D) printed anatomic models are valuable clinical tools that facilitate enhanced visualization of pertinent anatomic structures and have demonstrated benefits of reduced surgical times, increased surgeon confidence, and improved operative results and subsequent patient outcomes. Medical image-based 3D printed anatomic models are generally created from computed tomography (CT), however magnetic resonance imaging (MRI), which offers exquisite soft tissue characterization and flexible contrast avoiding the use of ionizing radiation, is an attractive alternative. Herein, the application of 3D printing incorporating both MR neurography and zero-echo time (ZTE) MRI for visualization of the brachial plexus anatomy in a subject with thoracic outlet syndrome (TOS) is described.</p><p><strong>Methods: </strong>A 28-year-old man presented with chronic right upper limb discomfort and paresthesias extending from the shoulder region to the third and fourth digits. The subject underwent evaluation with a unilateral brachial plexus MR neurography protocol at 3.0 Tesla for suspicion of TOS. The protocol included T2-weighted, 3D fast spin echo short-tau inversion recovery (STIR-FSE) and 3D radial ZTE sequences for depiction of the nerves and bones, respectively. The first rib and its synostosis impinged upon the inferior aspect of the T1 nerve root (T1NR), with accompanying mild enlargement of the T1NR. A 3D printed anatomic model was created and included: (1) bone (spine, ribs, clavicle, scapula, and humerus), (2) brachial plexus, and (3) costal cartilage.</p><p><strong>Results: </strong>The 3D printed model clearly demonstrated a T1NR impingement from the synostosis, confirming the diagnosis of neurologic thoracic outlet syndrome (TOS) and guided the treatment approach in prescribing TOS-specific physical therapy, which led to significant improvements in the patient's condition.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first in-vivo human 3D printed case for TOS using MRI-only data. The 3D printed model allowed for improved visualization and understanding of the spatial relationships between the nerves of the brachial plexus and surrounding osseous structures responsible for the patient's symptoms.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":72036,"journal":{"name":"3D printing in medicine","volume":"10 1","pages":"36"},"PeriodicalIF":3.2,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}