POC 3D Printing References | Synopsys Simpleware

POC 3D Printing Literature Roundup

Posted on 2 August 2022 by Kerim Genc

 

As part of a new series highlighting the great work of Synopsys Simpleware software users, we have rounded up some of the most interesting papers of the last year featuring point of care (POC) 3D printing applications. POC 3D Printing is a fast-growing area for hospitals and other clinical institutions wanting to add 3D anatomical models to their pre-surgical planning workflows, and the following studies demonstrate why this field creates exciting benefits for patient care.

Algorithms Used in Medical Image Segmentation for 3D Printing and How to Understand and Quantify Their Performance

Fogarasi, M., Coburn, J.C. & Ripley, B., 2022. Algorithms used in medical image segmentation for 3D printing and how to understand and quantify their performance. 3D Printing in Medicine 8, 18.

Volume representations of mandible segmentations with accompanying mask previews. Note the differences in segmentation of the interior wall of the mandible and location of the nerve in each cross-section. Models presented are after Smoothing 1 modifications were applied per program (Image by Fogarasi et al. / CC BY 4.0).

Context

"3D printing (3DP) has enabled medical professionals to create patient-specific medical devices to assist in surgical planning. Anatomical models can be generated from patient scans using a wide array of software, but there are limited studies on the geometric variance that is introduced during the digital conversion of images to models. The final accuracy of the 3D printed model is a function of manufacturing hardware quality control and the variability introduced during the multiple digital steps that convert patient scans to a printable format. This study provides a brief summary of common algorithms used for segmentation and refinement. Parameters for each that can introduce geometric variability are also identified. Several metrics for measuring variability between models and validating processes are explored and assessed."

Use of Simpleware Software

"The four programs selected for this study were Dicom2Print (3D Systems, South Carolina USA), Mimics (Materialise NV; Leuven, Belgium), 3D Slicer (Brigham and Women’s Hospital, Massachusetts USA), and Simpleware (Synposys; California, USA). Throughout, they will be referred to as Programs 1–4 (not ordered as above) because the goal of the study is not to compare the programs themselves. Rather, the goal is to use the programs as examples of different algorithm implementations and to demonstrate the variation that can occur between the workflows of any segmentation software."

Outcomes and Impact

"A basic understanding of the functionality of segmentation software is essential for ensuring patient safety as medical 3DP continues to expand. Methods used in this paper can help 3D printing facilities establish best practices for evaluating variation between segmentation methods and will allow users to develop optimized workflows—ideally accelerating the patient matched instrumentation implementation in industry and at point of care."

A Patient-Specific Proof of Concept with a 3D-Printed Model Before Performing an Endovascular Bentall Procedure

Vallée A, Guihaire J, Ghostine S, Fabre D, Haulon S., 2021. A patient-specific proof of concept with a three-dimensionally printed model before performing an endovascular Bentall procedure. Journal of Vascular Surgery Cases, Innovations and Techniques, 7(4), 750-754.

Three-dimensionally (3D) printed patient-specific model of ascending aorta aneurysm with endovascular Bentall graft after model autopsy (Image by Vallée et al. / CC BY 4.0).

Context

"Three-dimensionally (3D) printed models have been increasingly used in medicine. Few reports have focused on prototype experiments, especially in aortic surgery. Although endovascular repairs are routinely performed for thoracoabdominal aortic aneurysms and lesions involving the aortic arch, endovascular treatment of the ascending aorta is still at an early stage of development. Using a 3D model, based on patient computed tomography scans and manufactured by Biomodex (Paris, France), we performed a patient-specific rehearsal of an endovascular Bentall repair to treat an ascending aorta aneurysm involving the aortic root. We achieved a patient-specific proof of concept of a new technique using an in vitro 3D model."

Use of Simpleware Software

"The 3D printed model (Fig 1) was manufactured by Biomodex (Paris, France) using Stratasys polyjet 3D printer (Rehovot, Israel). The training model was manufactured using information from the latest computed tomography (CT) scan of the patient. The imaging dataset was segmented using the CE-marked/Food and Drug Administration approved Simpleware ScanIP software tool (Synopsys, Inc. Mountain View, Calif)."

Outcomes and Impact

"We successfully achieved a patient-specufuc proof of concept by performing an endovascular treatment for aortic root aneurysm using a 3D printed patient-specific modern consistent with an endovascular Bentall repair. Patient-specific rehersal will play a major role in the ethical field of experimental procedures involving humans by its significant increase in patient safety."

Designing a 3D Printed Model of the Skull-Base: A Collaboration Between Clinicians and Industry

Saleh Y, Piper R, Richard M, Jeyaretna S, Cosker T., 2022. Designing a 3D Printed Model of the Skull-Base: A Collaboration Between Clinicians and Industry. Journal of Medical Education and Curricular Development.

Final model. Printed skull base model viewed from the medial side (A) and anteriorly (B) (Image by Saleh et al. / CC BY 4.0).

Context

"The role of three dimensional (3D) printing in neurosurgical education is becoming increasingly common. Notably, 3D printing can simulate complex anatomical pathways that may be difficult to regularly and accurately reproduce in cadavers. One such example is the course of the facial nerve within the temporal bone and its relation to the labyrinth. This can aid pre-surgical planning and minimise surgical complications. Here we aim to develop a novel anatomically accurate model of the skull base which demonstrates key neuro vascular components and the course of the facial nerve within the temporal bone by developing a 3D printed model of the skull-base that can be used for medical education and pre-surgical planning."

Use of Simpleware Software

"Anonymised DICOM data was uploaded onto a software (Simpleware Scan IP P-2019.09; www.simpleware.com/software/scanip/), which semi-automatically registered and subsequently segmented the image contents into bone, the cochlea, the labyrinth and the neurovasculature (Figure 2). A combination of the landmark and automated registration methods were used within the Simpleware Scan IP software."

Outcomes and Impact

"Through a collaboration with industry and a multidisciplinary team, we were able to reproduce the base of the skull from patient neuro-imaging. Our model is both cost-effective, reproducible and can aid both medical students and neurosurgical trainees in their training/education."

Accuracy of Guide Wire Placement for Femoral Neck Stabilization Using 3D Printed Drill Guides

Roytman, G.R., Ramji, A.F., Beitler, B. et al. Accuracy of guide wire placement for femoral neck stabilization using 3D printed drill guides. 3D Printing in Medicine, 8, 19.

3D overlay of expected model over CT-scan generated mask simulations. Green structures are the femur, gold are the ideal guide wires generated by the 3D modelling software, and the red structures are actual wires from 3D generated models based on overlayed CT scans (left to right: Percutaneous Screw Guide, FNS Guide, DHS Guide). Drill-bit tip guide wires were used in all scenarios (Image by Roytman et al. / CC BY 4.0).

Context

"The goal of stabilization of the femoral neck is to limit morbidity and mortality from fracture. Of three potential methods of fixation, (three percutaneous screws, the Synthes Femoral Neck System, and a dynamic hip screw), each requires guide wire positioning of the implant(s) in the femoral neck and head. Consistent and accurate positioning of these systems is paramount to reduce surgical times, stabilize fractures effectively, and reduce complications. To help expedite surgery and achieve ideal implant positioning in the geriatric population, we have developed and validated a surgical planning methodology using 3D modelling and printing technology."

Use of Simpleware Software

"Using Synopsys Simpleware ScanIP image processing software, the three implant systems (three percutaneous screws, FNS, and DHS), were positioned and implanted in consultation with two fellowship trained orthopedic trauma surgeons."

Outcomes and Impact

"The custom 3D printed drill guides provided for a robust accurate application of Percutaneous Screw, FNS, and DHS systems’ guide wires. Drill guides which are used in the placement of more than 1 guide wire were found to have a lower relative positional accuracy. This work, along with the iterations of guides that we have completed, will inform future development of drill guides for use in cadaveric models and, ultimately, personalized and tailored for patients who require femoral neck stabilization."

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