Rahul Gupta, MBBS MS DNB, Robert A Andrews, MD, Theodore Korelitz, Crispin Weinberg, PHD, Kung Justin, MD, Scott Johnson, MD, Daniel B Jones, MD MS FACS. Beth Israel Deaconess Medical Center
Objective
To create clinically relevant 3 dimensional models from CT Scans.
Methods
With IRB exemption, our group acquired various de-identified images of interesting anatomic pathology in CT format. The images were electronically converted using BioCAD software to create usable 3 dimensional representations. Subsequently synthetic models were generated using different colored and textured resins to emphasize tissues/lesions.
Results
3 –D model of Aortic Aneurysm.
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Liver and Klatskin tumor.
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Proposed Application of 3 D Modeling and Limitations
1 Surgical Planning and Preparation:
A: Aortic Aneurysm:
• Pre selection and sizing of graft material for endovascular aortic aneurysm repair
• Sizing of access sheaths for endovascular interventions
• Understanding the patient specific tortuosity of certain vessels in preparation for an endovascular intervention.
B: Hepatic resections and live donor Liver Transplantation.
• Anatomic-functional classification may provide valuable insight into hepatic vein dominance patterns.
• Creation of graft and remnant graft volume/body weight ratios using volumetric assessments and virtual resections.
• Assessment of congestion volumes.
• Planning of bilio-enteric anastomosis after klatskin resection.
2 Communication:
• Enhance the ability of the physician to communicate effectively with patients regarding their personal pathology.
3 Education and Testing:
• The use of high resolution models in preoperative discussion with residents resulting in enhanced operative experience and improved co-ordination during surgery.
• Acquisition of anatomical knowledge in a real time environment simulated preoperatively by 3-D models. This can be used as a testing tool or adjunct to contemporary methods.
4 Limitations
Color texture contrast and fine structures are more difficult to replicate secondary to limitations of the printing technology and resins. For example, current printing technology allows for only two resins to be utilized during one printing session.So models that require a greater level of detail often require the model to be “printed” in two or more sessions, and then assembled to make the final product. Multiple tissue depictions therefore increase potential rendering inaccuracies.
Conclusions
• 3-D printing can be used to create personalized patient specific models to replicate human anatomy and pathology utilizing conventional imaging as a source.
• The spatial orientation and accuracy is currently limited by the complexity and multiplicity of tissue depictions and further development may resolve these shortcomings.
Session: Emerging Technology
Program Number: ET004