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Demographics, Utilization, Workflow, and Outcomes Based on Observational Data From the RSNA-ACR 3D Printing Registry
Wang, Kenneth C; Ryan, Justin R; Chepelev, Leonid; Wake, Nicole; Quigley, Edward P; Santiago, Lumarie; Wentworth, Adam; Alexander, Amy; Morris, Jonathan M; Fleischmann, Dominik; Ballard, David H; Ravi, Prashanth; Hirsch, Jeffrey D; Sturgeon, Gregory M; Huang, Yu-Hui; Decker, Summer J; von Windheim, Natalia; Pugliese, Robert S; Hidalgo, Ronald V; Patel, Pushpak; Colon, Joseb; Thieringer, Florian M; Rybicki, Frank J
PURPOSE/OBJECTIVE:The aim of this study was to report data from the first 3 years of operation of the RSNA-ACR 3D Printing Registry. METHODS:Data from June 2020 to June 2023 were extracted, including demographics, indications, workflow, and user assessments. Clinical indications were stratified by 12 organ systems. Imaging modalities, printing technologies, and numbers of parts per case were assessed. Effort data were analyzed, dividing staff members into provider and nonprovider categories. The opinions of clinical users were evaluated using a Likert scale questionnaire, and estimates of procedure time saved were collected. RESULTS:A total of 20 sites and 2,637 cases were included, consisting of 1,863 anatomic models and 774 anatomic guides. Mean patient ages for models and guides were 42.4 ± 24.5 years and 56.3 ± 18.5 years, respectively. Cardiac models were the most common type of model (27.2%), and neurologic guides were the most common type of guide (42.4%). Material jetting, vat photopolymerization, and material extrusion were the most common printing technologies used overall (85.6% of all cases). On average, providers spent 92.4 min and nonproviders spent 335.0 min per case. Providers spent most time on consultation (33.6 min), while nonproviders focused most on segmentation (148.0 min). Confidence in treatment plans increased after using 3-D printing (P < .001). Estimated procedure time savings for 155 cases was 40.5 ± 26.1 min. CONCLUSIONS:Three-dimensional printing is performed at health care facilities for many clinical indications. The registry provides insight into the technologies and workflows used to create anatomic models and guides, and the data show clinical benefits from 3-D printing.
PMID: 39117182
ISSN: 1558-349x
CID: 5730862
Clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: pediatric congenital heart disease conditions
Ryan, Justin R; Ghosh, Reena; Sturgeon, Greg; Ali, Arafat; Arribas, Elsa; Braden, Eric; Chadalavada, Seetharam; Chepelev, Leonid; Decker, Summer; Huang, Yu-Hui; Ionita, Ciprian; Lee, Joonhyuk; Liacouras, Peter; Parthasarathy, Jayanthi; Ravi, Prashanth; Sandelier, Michael; Sommer, Kelsey; Wake, Nicole; Rybicki, Frank; Ballard, David
BACKGROUND:The use of medical 3D printing (focusing on anatomical modeling) has continued to grow since the Radiological Society of North America's (RSNA) 3D Printing Special Interest Group (3DPSIG) released its initial guideline and appropriateness rating document in 2018. The 3DPSIG formed a focused writing group to provide updated appropriateness ratings for 3D printing anatomical models across a variety of congenital heart disease. Evidence-based- (where available) and expert-consensus-driven appropriateness ratings are provided for twenty-eight congenital heart lesion categories. METHODS:A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with pediatric congenital heart disease indications. Each study was vetted by the authors and strength of evidence was assessed according to published appropriateness ratings. RESULTS:Evidence-based recommendations for when 3D printing is appropriate are provided for pediatric congenital heart lesions. Recommendations are provided in accordance with strength of evidence of publications corresponding to each cardiac clinical scenario combined with expert opinion from members of the 3DPSIG. CONCLUSIONS:This consensus appropriateness ratings document, created by the members of the RSNA 3DPSIG, provides a reference for clinical standards of 3D printing for pediatric congenital heart disease clinical scenarios.
PMCID:10823658
PMID: 38282094
ISSN: 2365-6271
CID: 5627742
Applications of 3D Printing in the Abdomen and Pelvis
Chapter by: Chokshi, Shivum; Ballard, David H.; Gupta, Rajul; Chadalavada, Seetharam C.; Wake, Nicole
in: 3D Printing at Hospitals and Medical Centers: A Practical Guide for Medical Professionals, Second Edition by
[S.l.] : Springer International Publishing, 2024
pp. 267-283
ISBN: 9783031428500
CID: 5715742
Clinical situations for which 3D Printing is considered an appropriate representation or extension of data contained in a medical imaging examination: vascular conditions
Lee, Joonhyuk; Chadalavada, Seetharam C; Ghodadra, Anish; Ali, Arafat; Arribas, Elsa M; Chepelev, Leonid; Ionita, Ciprian N; Ravi, Prashanth; Ryan, Justin R; Santiago, Lumarie; Wake, Nicole; Sheikh, Adnan M; Rybicki, Frank J; Ballard, David H
BACKGROUND:Medical three-dimensional (3D) printing has demonstrated utility and value in anatomic models for vascular conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (3DPSIG) provides appropriateness recommendations for vascular 3D printing indications. METHODS:A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with vascular indications. Each study was vetted by the authors and strength of evidence was assessed according to published appropriateness ratings. RESULTS:Evidence-based recommendations for when 3D printing is appropriate are provided for the following areas: aneurysm, dissection, extremity vascular disease, other arterial diseases, acute venous thromboembolic disease, venous disorders, lymphedema, congenital vascular malformations, vascular trauma, vascular tumors, visceral vasculature for surgical planning, dialysis access, vascular research/development and modeling, and other vasculopathy. Recommendations are provided in accordance with strength of evidence of publications corresponding to each vascular condition combined with expert opinion from members of the 3DPSIG. CONCLUSION/CONCLUSIONS:This consensus appropriateness ratings document, created by the members of the 3DPSIG, provides an updated reference for clinical standards of 3D printing for the care of patients with vascular conditions.
PMCID:10688120
PMID: 38032479
ISSN: 2365-6271
CID: 5616942
Clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: neurosurgical and otolaryngologic conditions
Ali, Arafat; Morris, Jonathan M; Decker, Summer J; Huang, Yu-Hui; Wake, Nicole; Rybicki, Frank J; Ballard, David H
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.
PMCID:10680204
PMID: 38008795
ISSN: 2365-6271
CID: 5617562
Assessment of Staphylococcus Aureus growth on biocompatible 3D printed materials
Senderovich, Nicole; Shah, Sharan; Ow, Thomas J; Rand, Stephanie; Nosanchuk, Joshua; Wake, Nicole
The customizability of 3D printing allows for the manufacturing of personalized medical devices such as laryngectomy tubes, but it is vital to establish the biocompatibility of printing materials to ensure that they are safe and durable. The goal of this study was to assess the presence of S. aureus biofilms on a variety of 3D printed materials (two surgical guide resins, a photopolymer, an elastomer, and a thermoplastic elastomer filament) as compared to standard, commercially available laryngectomy tubes.C-shaped discs (15 mm in height, 20 mm in diameter, and 3 mm in thickness) were printed with five different biocompatible 3D printing materials and S. aureus growth was compared to Shiley™ laryngectomy tubes made from polyvinyl chloride. Discs of each material were inoculated with S. aureus cultures and incubated overnight. All materials were then removed from solution, washed in phosphate-buffered saline to remove planktonic bacteria, and sonicated to detach biofilms. Some solution from each disc was plated and colony-forming units were manually counted the following day. The resulting data was analyzed using a Kruskal-Wallis and Wilcoxon Rank Sum test to determine pairwise significance between the laryngectomy tube material and the 3D printed materials.The Shiley™ tube grew a median of 320 colonies (IQR 140-520), one surgical guide resin grew a median of 640 colonies (IQR 356-920), the photopolymer grew a median of 340 colonies (IQR 95.5-739), the other surgical guide resin grew a median of 431 colonies (IQR 266.5-735), the thermoplastic elastomer filament grew a median of 188 colonies (IQR 113.5-335), and the elastomer grew a median of 478 colonies (IQR 271-630). Using the Wilcoxon Rank Sum test, manual quantification showed a significant difference between biofilm formation only between the Shiley™ tube and a surgical guide resin (p = 0.018).This preliminary study demonstrates that bacterial colonization was comparable among most 3D printed materials as compared to the conventionally manufactured device. Continuation of this work with increased replicates will be necessary to determine which 3D printing materials optimally resist biofilm formation.
PMCID:10621153
PMID: 37914942
ISSN: 2365-6271
CID: 5736512
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.
PMCID:8554989
PMID: 34709482
ISSN: 2365-6271
CID: 5042602