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Impact of 3D printed models on quantitative surgical outcomes for patients undergoing robotic-assisted radical prostatectomy: a cohort study

Wake, Nicole; Rosenkrantz, Andrew B; Huang, Richard; Ginocchio, Luke A; Wysock, James S; Taneja, Samir S; Huang, William C; Chandarana, Hersh
BACKGROUND:Three-dimensional (3D) printed anatomic models can facilitate presurgical planning by providing surgeons with detailed knowledge of the exact location of pertinent anatomical structures. Although 3D printed anatomic models have been shown to be useful for pre-operative planning, few studies have demonstrated how these models can influence quantitative surgical metrics. OBJECTIVE:To prospectively assess whether patient-specific 3D printed prostate cancer models can improve quantitative surgical metrics in patients undergoing robotic-assisted radical prostatectomy (RARP). METHODS:Patients with MRI-visible prostate cancer (PI-RADS V2 ≥ 3) scheduled to undergo RARP were prospectively enrolled in our IRB approved study (n = 82). Quantitative surgical metrics included the rate of positive surgical margins (PSMs), operative times, and blood loss. A qualitative Likert scale survey to assess understanding of anatomy and confidence regarding surgical approach was also implemented. RESULTS:The rate of PSMs was lower for the 3D printed model group (8.11%) compared to that with imaging only (28.6%), p = 0.128. The 3D printed model group had a 9-min reduction in operating time (213 ± 42 min vs. 222 ± 47 min) and a 5 mL reduction in average blood loss (227 ± 148 mL vs. 232 ± 114 mL). Surgeon anatomical understanding and confidence improved after reviewing the 3D printed models (3.60 ± 0.74 to 4.20 ± 0.56, p = 0.62 and 3.86 ± 0.53 to 4.20 ± 0.56, p = 0.22). CONCLUSIONS:3D printed prostate cancer models can positively impact quantitative patient outcomes such as PSMs, operative times, and blood loss in patients undergoing RARP.
PMID: 36749368
ISSN: 2366-0058
CID: 5420812

Advanced 3D Visualization and 3D Printing in Radiology

Fidvi, Shabnam; Holder, Justin; Li, Hong; Parnes, Gregory J; Shamir, Stephanie B; Wake, Nicole
Since the discovery of X-rays in 1895, medical imaging systems have played a crucial role in medicine by permitting the visualization of internal structures and understanding the function of organ systems. Traditional imaging modalities including Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasound (US) present fixed two-dimensional (2D) images which are difficult to conceptualize complex anatomy. Advanced volumetric medical imaging allows for three-dimensional (3D) image post-processing and image segmentation to be performed, enabling the creation of 3D volume renderings and enhanced visualization of pertinent anatomic structures in 3D. Furthermore, 3D imaging is used to generate 3D printed models and extended reality (augmented reality and virtual reality) models. A 3D image translates medical imaging information into a visual story rendering complex data and abstract ideas into an easily understood and tangible concept. Clinicians use 3D models to comprehend complex anatomical structures and to plan and guide surgical interventions more precisely. This chapter will review the volumetric radiological techniques that are commonly utilized for advanced 3D visualization. It will also provide examples of 3D printing and extended reality technology applications in radiology and describe the positive impact of advanced radiological image visualization on patient care.
PMID: 37016113
ISSN: 0065-2598
CID: 5463702

Three-Dimensional Printed Anatomic Models Derived From Magnetic Resonance Imaging Data: Current State and Image Acquisition Recommendations for Appropriate Clinical Scenarios

Talanki, Varsha R; Peng, Qi; Shamir, Stephanie B; Baete, Steven H; Duong, Timothy Q; Wake, Nicole
Three-dimensional (3D) printing technologies have been increasingly utilized in medicine over the past several years and can greatly facilitate surgical planning thereby improving patient outcomes. Although still much less utilized compared to computed tomography (CT), magnetic resonance imaging (MRI) is gaining traction in medical 3D printing. The purpose of this study was two-fold: 1) to determine the prevalence in the existing literature of using MRI to create 3D printed anatomic models for surgical planning and 2) to provide image acquisition recommendations for appropriate clinical scenarios where MRI is the most suitable imaging modality. The workflow for creating 3D printed anatomic models from medical imaging data is complex and involves image segmentation of the regions of interest and conversion of that data into 3D surface meshes, which are compatible with printing technologies. CT is most commonly used to create 3D printed anatomic models due to the high image quality and relative ease of performing image segmentation from CT data. As compared to CT datasets, 3D printing using MRI data offers advantages since it provides exquisite soft tissue contrast needed for accurate organ segmentation and it does not expose patients to unnecessary ionizing radiation. MRI, however, often requires complicated imaging techniques and time-consuming postprocessing procedures to generate high-resolution 3D anatomic models needed for 3D printing. Despite these challenges, 3D modeling and printing from MRI data holds great clinical promises thanks to emerging innovations in both advanced MRI imaging and postprocessing techniques. EVIDENCE LEVEL: 2 TECHNICAL EFFICATCY: 5.
PMID: 34046959
ISSN: 1522-2586
CID: 4888362

A workflow to generate patient-specific three-dimensional augmented reality models from medical imaging data and example applications in urologic oncology

Wake, Nicole; Rosenkrantz, Andrew B; Huang, William C; Wysock, James S; Taneja, Samir S; Sodickson, Daniel K; Chandarana, Hersh
Augmented reality (AR) and virtual reality (VR) are burgeoning technologies that have the potential to greatly enhance patient care. Visualizing patient-specific three-dimensional (3D) imaging data in these enhanced virtual environments may improve surgeons' understanding of anatomy and surgical pathology, thereby allowing for improved surgical planning, superior intra-operative guidance, and ultimately improved patient care. It is important that radiologists are familiar with these technologies, especially since the number of institutions utilizing VR and AR is increasing. This article gives an overview of AR and VR and describes the workflow required to create anatomical 3D models for use in AR using the Microsoft HoloLens device. Case examples in urologic oncology (prostate cancer and renal cancer) are provided which depict how AR has been used to guide surgery at our institution.
PMID: 34709482
ISSN: 2365-6271
CID: 5042602

A guideline for 3D printing terminology in biomedical research utilizing ISO/ASTM standards

Alexander, Amy E; Wake, Nicole; Chepelev, Leonid; Brantner, Philipp; Ryan, Justin; Wang, Kenneth C
First patented in 1986, three-dimensional (3D) printing, also known as additive manufacturing or rapid prototyping, now encompasses a variety of distinct technology types where material is deposited, joined, or solidified layer by layer to create a physical object from a digital file. As 3D printing technologies continue to evolve, and as more manuscripts describing these technologies are published in the medical literature, it is imperative that standardized terminology for 3D printing is utilized. The purpose of this manuscript is to provide recommendations for standardized lexicons for 3D printing technologies described in the medical literature. For all 3D printing methods, standard general ISO/ASTM terms for 3D printing should be utilized. Additional, non-standard terms should be included to facilitate communication and reproducibility when the ISO/ASTM terms are insufficient in describing expository details. By aligning to these guidelines, the use of uniform terms for 3D printing and the associated technologies will lead to improved clarity and reproducibility of published work which will ultimately increase the impact of publications, facilitate quality improvement, and promote the dissemination and adoption of 3D printing in the medical community.
PMID: 33751279
ISSN: 2365-6271
CID: 4822402

The Future of Medical 3D Printing in Radiology

Chapter by: Jakus, Adam E; Huang, Yu-Hui; Wake, Nicole
in: 3D printing for the radiologist by Wake, Nicole (Ed)
[S.l.] : Elsevier, 2021
pp. 201-214
ISBN: 032377573x
CID: 4903422

3D Printing in Interventional Radiology

Chapter by: Wattamwar, Kapil; Wake, Nicole
in: 3D printing for the radiologist by Wake, Nicole (Ed)
[S.l.] : Elsevier, 2021
pp. 131-142
ISBN: 032377573x
CID: 4903382

3D Printing in Radiology Education

Chapter by: Burns, Judah; Mansouri, Mohammad; Wake, Nicole
in: 3D printing for the radiologist by Wake, Nicole (Ed)
[S.l.] : Elsevier, 2021
pp. 117-129
ISBN: 032377573x
CID: 4903372

Regulatory Perspectives for 3D Printing in Hospitals

Chapter by: Christensen, Andy; Wake, Nicole
in: 3D printing for the radiologist by Wake, Nicole (Ed)
[S.l.] : Elsevier, 2021
pp. 109-116
ISBN: 032377573x
CID: 4903362

3D Printed Anatomic Models and Guides

Chapter by: Alexander, Amy E; Wake, Nicole
in: 3D printing for the radiologist by Wake, Nicole (Ed)
[S.l.] : Elsevier, 2021
pp. 75-88
ISBN: 032377573x
CID: 4903342