Clinical application of 3D virtual and printed models for cerebrovascular diseases

Lee, Da Yeong; Pang, Chang Hwan; Kim, Jeong Eun; Park, Shin Young; Lee, Doohee; Park, Sang Joon; Cho, Won Sang

doi:10.1016/j.clineuro.2021.106719

Cited by 8 publications

(8 citation statements)

References 14 publications

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“…In this context, senior surgeons may benefit from an anthropomorphic model to evaluate and practice new approaches, methods, and technologies. Moreover, the phantom could easily be modified to become better suited for the evaluation of a desired procedure such as the excision of intra- or extra-axial brain lesions [ 22 , 23 ] or the treatment of complex cerebrovascular cases [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Development of a CT-Compatible, Anthropomorphic Skull and Brain Phantom for Neurosurgical Planning, Training, and Simulation

et al. 2022

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Background: Neurosurgical procedures are complex and require years of training and experience. Traditional training on human cadavers is expensive, requires facilities and planning, and raises ethical concerns. Therefore, the use of anthropomorphic phantoms could be an excellent substitute. The aim of the study was to design and develop a patient-specific 3D-skull and brain model with realistic CT-attenuation suitable for conventional and augmented reality (AR)-navigated neurosurgical simulations. Methods: The radiodensity of materials considered for the skull and brain phantoms were investigated using cone beam CT (CBCT) and compared to the radiodensities of the human skull and brain. The mechanical properties of the materials considered were tested in the laboratory and subsequently evaluated by clinically active neurosurgeons. Optimization of the phantom for the intended purposes was performed in a feedback cycle of tests and improvements. Results: The skull, including a complete representation of the nasal cavity and skull base, was 3D printed using polylactic acid with calcium carbonate. The brain was cast using a mixture of water and coolant, with 4 wt% polyvinyl alcohol and 0.1 wt% barium sulfate, in a mold obtained from segmentation of CBCT and T1 weighted MR images from a cadaver. The experiments revealed that the radiodensities of the skull and brain phantoms were 547 and 38 Hounsfield units (HU), as compared to real skull bone and brain tissues with values of around 1300 and 30 HU, respectively. As for the mechanical properties testing, the brain phantom exhibited a similar elasticity to real brain tissue. The phantom was subsequently evaluated by neurosurgeons in simulations of endonasal skull-base surgery, brain biopsies, and external ventricular drain (EVD) placement and found to fulfill the requirements of a surgical phantom. Conclusions: A realistic and CT-compatible anthropomorphic head phantom was designed and successfully used for simulated augmented reality-led neurosurgical procedures. The anatomic details of the skull base and brain were realistically reproduced. This phantom can easily be manufactured and used for surgical training at a low cost.

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Section: Discussionmentioning

confidence: 99%

Development of a CT-Compatible, Anthropomorphic Skull and Brain Phantom for Neurosurgical Planning, Training, and Simulation

et al. 2022

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“…The earliest and most common target disease for the 3D-printed cerebrovascular disease model is intracranial aneurysm [ 1 , 4 , 20 , 25 , 27 , 49 , 50 , 57 , 90 , 97 , 112 ]. The texture and elasticity of the developed aneurysm model were realistic enough to simulate surgery [ 2 , 55 , 58 , 69 , 84 ]. The 3D-printed aneurysm model was developed not only for conventional surgical planning but also for endovascular treatment [ 53 , 74 ].…”

Section: Cerebrovascular Disease Modelsmentioning

confidence: 99%

“…Other cerebrovascular models, such as dural venous sinus or cavernous angioma models, were also attempted [ 34 , 95 ]. For efficient presurgical planning, all models that include adjacent structures as well as vascular lesions have been shown to be more useful for surgical planning than regional models constructed with only vascular structures [ 2 , 98 ]. The 3D-printed cerebrovascular disease model is also actively used for simulation experiments.…”

Section: Cerebrovascular Disease Modelsmentioning

confidence: 99%

3D-Printed Disease Models for Neurosurgical Planning, Simulation, and Training

Park

2022

J Korean Neurosurg Soc

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Spatial insight into intracranial pathology and structure is important for neurosurgeons to perform safe and successful surgeries. Three-dimensional (3D) printing technology in the medical field has made it possible to produce intuitive models that can help with spatial perception. Recent advances in 3D-printed disease models have removed barriers to entering the clinical field and medical market, such as precision and texture reality, speed of production, and cost. The 3D-printed disease model is now ready to be actively applied to daily clinical practice in neurosurgical planning, simulation, and training. In this review, the development of 3D-printed neurosurgical disease models and their application are summarized and discussed.

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“…It is widely used and can be varied according to application requirements in terms of the lesion type, location, severity, etc. In neurosurgery, 3D-printed models are mainly applied to guide surgical procedures, including preoperative simulation or planning, intraoperative guidance and positioning [35][36][37]. 3D bioprinting can also be employed to improve the understanding of tumor biology and investigate new therapeutic approaches [38][39][40][41].…”

Section: Applications Of 3d Printing In the Neurosurgical Clinicmentioning

confidence: 99%

Application of Three-Dimensional (3D) Printing in Neurosurgery

et al. 2022

Advances in Materials Science and Engineering

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Three-dimensional (3D) printing has been increasingly used in various fields of medicine, such as in auxiliary diagnosis and treatment, medical teaching, and regenerative medicine. Most operations performed by neurosurgeons and associated pathological examinations involve complex, microscopic anatomical structures that cannot be observed outside. 3D-printed models can reproduce anatomical structures, pathological tissues, and cells with high accuracy, enhancing our understanding of complex aspects of anatomy and pathology. They can also assist in preoperative planning and simulation, help in surgical or interventional surgery precision medicine, and improve the effectiveness of treatments. This review comprehensively summarizes and discusses its current application progress and problems, including treatments for common diseases (e.g., intracranial tumors, intracranial hemorrhage, intracranial aneurysms, skull repair, and neural prosthetics), clinical training, and preoperative plans. With its widespread applications, 3D printing as an innovative tool will provide new directions for developing imaging, strategies, and interventions in neurosurgical diseases.

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Clinical application of 3D virtual and printed models for cerebrovascular diseases

Cited by 8 publications

References 14 publications

Development of a CT-Compatible, Anthropomorphic Skull and Brain Phantom for Neurosurgical Planning, Training, and Simulation

Development of a CT-Compatible, Anthropomorphic Skull and Brain Phantom for Neurosurgical Planning, Training, and Simulation

3D-Printed Disease Models for Neurosurgical Planning, Simulation, and Training

Application of Three-Dimensional (3D) Printing in Neurosurgery

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