A systematic review of clinical value of three-dimensional printing in renal disease

Sun, Zhonghua; Liu, Dongting

doi:10.21037/qims.2018.03.09

Cited by 56 publications

(53 citation statements)

References 38 publications

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“…Testing different CT protocols on a 3D printed realistic anatomy model represents a new research direction for investigation of optimal CT angiography protocols as 3D printed models accurately replicate both normal anatomical structures and pathologies (18)(19)(20)(21)(22)(23). In our previous papers, we reported how we developed a patient-specific 3D printed pulmonary artery model with high accuracy, and tested different CTPA protocols on the model with simulation of thrombus in the main pulmonary arteries (24,25).…”

Section: Introductionmentioning

confidence: 99%

Patient-specific 3D printed pulmonary artery model with simulation of peripheral pulmonary embolism for developing optimal computed tomography pulmonary angiography protocols

Aldosari¹,

Jansen²,

Sun³

2019

Quant. Imaging Med. Surg

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Background: Computed tomography pulmonary angiography (CTPA) is the preferred imaging modality for diagnosis of patients with suspected pulmonary embolism (PE). Radiation dose associated with CTPA has been significantly reduced due to the use of dose-reduction strategies, however, investigation of low-dose CTPA with use of different kVp and pitch values has not been systematically studied. The aim of this study was to utilize a 3D printed pulmonary model with simulation of small thrombus in the pulmonary arteries for development of optimal CTPA protocols. Methods: Animal blood clots were inserted into the pulmonary arteries to simulate peripheral embolism based on a realistic 3D printed pulmonary artery model. The 3D printed model was scanned with 192-slice 3 rd generation dual-source CT with 1 mm slice thickness and 0.5 mm reconstruction interval. All images were reconstructed with advanced modelled iterative reconstruction (IR) at a strength level of 3. CTPA scanning parameters were as follows: 70, 80, 100 and 120 kVp, 0.9, 2.2 and 3.2 pitch values. Quantitative assessment of image quality was determined by measuring signal-to-noise ratio (SNR) in both main pulmonary arteries, while qualitative analysis of images was scored by two experienced radiologists (score of 1 indicates poor visualization of thrombus with no confidence, and score of 5 excellent visualization of thrombus with high confidence) to determine the image quality in relation to different scanning protocols for detection of thrombus in the pulmonary arteries. Results: No significant differences were found in SNR measurements among all CTPA protocols (P>0.05), regardless of kVp or pitch values used, although SNR was higher with 120 kVp and 0.9 and 2.2 pitch protocols than that in other protocols. The thrombi were detected in all images, with 70 kVp and 3.2 pitch protocol scored the lowest with a score of 3 by two observers, and images with other protocols were scored 4 or 5. Lowering kVp from 120 to 70 with use of high-pitch 2.2 or 3.2 protocol resulted in up to 80% dose reduction without significantly affecting image quality. Conclusions: Low-dose CT pulmonary angiography protocols comprising 70 kVp and high pitch 2.2 or 3.2 allow for detection of peripheral PE with significant reduction in radiation dose while images are still considered diagnostic.

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Section: Introductionmentioning

confidence: 99%

Patient-specific 3D printed pulmonary artery model with simulation of peripheral pulmonary embolism for developing optimal computed tomography pulmonary angiography protocols

Aldosari¹,

Jansen²,

Sun³

2019

Quant. Imaging Med. Surg

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“…Three-dimensional (3D) printing has been increasingly used in medical applications with creation of accurate patientspecific 3D printed models using medical imaging data (1)(2)(3)(4). 3D printed physical models have been shown to improve our understanding of complex anatomy and pathology, assist clinical decision making by serving as a valuable tool for preoperative planning, simulation and education, as well as develop optimal scanning protocols for radiation dose reduction (5)(6)(7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Patient-specific 3D printed model of biliary ducts with congenital cyst

Allan¹,

Kealley²,

Squelch³

et al. 2019

Quant. Imaging Med. Surg

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Background: 3D printing has shown great promise in medical applications, with increasing reports in liver diseases. However, research on 3D printing in biliary disease is limited with lack of studies on validation of model accuracy. In this study, we presented our experience of creating a realistic 3D printed model of biliary ducts with congenital cyst. Measurements of anatomical landmarks were compared at different stages of model generation to determine dimensional accuracy. Methods: Contrast-enhanced computed tomography (CT) images of a patient diagnosed with congenital cyst in the common bile duct with dilated hepatic ducts were used to create the 3D printed model. The 3D printed model was scanned on a 64-slice CT scanner using the similar abdominal CT protocol. Measurements of anatomical structures including common hepatic duct (CHD), right hepatic duct (RHD), left hepatic duct (LHD) and the cyst at left to right and anterior to posterior dimensions were performed and compared between original CT images, the standard tessellation language (STL) image and CT images of the 3D model. Results: The 3D printing model was successfully generated with replication of biliary ducts and cyst. Significant differences in measurements of these landmarks were found between the STL and the original CT images, and the CT images of the 3D printed model and the original CT images (P<0.05). Measurements of the RHD and LHD diameters from the original CT images were significantly larger than those from the CT images of 3D model or STL file (P<0.05), while measurements of the CHD diameters were significantly smaller than those of the other two datasets (P<0.05). No significant differences were reached in measurements of the CHD, RHD, LHD and the biliary cyst between CT images of the 3D printed model and STL file (P=0.08-0.98). Conclusions: This study shows our experience in producing a realistic 3D printed model of biliary ducts and biliary cyst. The model was found to replicate anatomical structures and cyst with high accuracy between the STL file and the CT images of the 3D model. Large discrepancy in dimensional measurements was noted between the original CT and STL file images, and the original CT and CT images of the 3D model, highlighting the necessity of further research with inclusion of more cases of biliary disease to validate accuracy of 3D printed biliary models.

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“…In RCC, however, 3D-printed moulds remain comparatively underexplored 19 , as the disease presents unique challenges. The first challenge arises from the pathology guidelines for assessment of radical nephrectomy specimens, which require optimal visualisation of the renal sinus-tumour interface.…”

Section: Introductionmentioning

confidence: 99%

3D-printed moulds for image-guided surgical biopsies: an open source computational platform

Crispín-Ortuzar

Gehrung

Ursprung

et al. 2019

Preprint

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PURPOSESpatial heterogeneity of tumours is a major challenge in precision oncology. The relationship between molecular and imaging heterogeneity is still poorly understood, as it relies on the accurate co-registration of medical images and tissue biopsies. tumour moulds can guide the localization of biopsies, but their creation is time consuming, technologically challenging, and di cult to interface with routine clinical practice. These hurdles have so far hindered the progress in the area of multiscale integration of tumour heterogeneity data. METHODSWe have developed an open source computational framework to automatically produce patientspecific 3D-printed moulds that can be used in the clinical setting. Our approach achieves accurate co-registration of sampling location between tissue and imaging, and integrates seamlessly with clinical, imaging and pathology workflows. RESULTSWe applied our framework to patients with renal cancer undergoing radical nephrectomy. We created personalised moulds for five patients, obtaining Dice similarity coe cients between imaging and tissue sections ranging from 0.86 to 0.93 for tumour regions, and between 0.70 and 0.76 for healthy kidney. The framework required minimal manual intervention, producing the final mould design in just minutes, while automatically taking into account clinical considerations such as a preference for specific cutting planes. CONCLUSIONOur work provides a robust and automated interface between imaging and tissue samples, enabling the development of clinical studies to probe tumour heterogeneity on multiple spatial scales.

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A systematic review of clinical value of three-dimensional printing in renal disease

Cited by 56 publications

References 38 publications

Patient-specific 3D printed pulmonary artery model with simulation of peripheral pulmonary embolism for developing optimal computed tomography pulmonary angiography protocols

Patient-specific 3D printed pulmonary artery model with simulation of peripheral pulmonary embolism for developing optimal computed tomography pulmonary angiography protocols

Patient-specific 3D printed model of biliary ducts with congenital cyst

3D-printed moulds for image-guided surgical biopsies: an open source computational platform

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