Utility of three-dimensional models in resident education on simple and complex intracardiac congenital heart defects

White, Shelby; Sedler, Jennifer; Jones, Trahern W.; Seckeler, Michael D.

doi:10.1111/chd.12673

Cited by 80 publications

(92 citation statements)

References 18 publications

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“…Their results showed that 3D-printed models enhanced residents' understanding and satisfaction during the teaching sessions when compared to 2D images, and increased their confidence in managing patients with ToF. Similar findings are reported by White et al (29) who divided 60 pediatric residents into two groups, 29 participating in the control group and 31 in the intervention group. Both groups received the same 20-min lecture including 2D images of ventricular septal defect (VSD) or ToF, while the intervention group was given 3D-printed models of normal hearts and each CHD.…”

Section: D-printed Models In Chdsupporting

confidence: 74%

“…Studies support the clinical value of 3D-printed models in CHD, specifically with reported usefulness of 3D printing in pre-surgical planning and simulation of complex situations (9,18,(23)(24)(25). Although most of the current literature on 3D printing in CHD is dominated by case reports and case series, emerging evidence based on randomized controlled trials and multicenter studies further confirms its incremental value over traditional visualization tools (26)(27)(28)(29)(30)(31).…”

Section: D-printed Models In Chdmentioning

confidence: 79%

See 1 more Smart Citation

3D printing in medicine: current applications and future directions

Sun¹

2018

Quant. Imaging Med. Surg

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Section: D-printed Models In Chdsupporting

confidence: 74%

Section: D-printed Models In Chdmentioning

confidence: 79%

3D printing in medicine: current applications and future directions

Sun¹

2018

Quant. Imaging Med. Surg

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“…3D printed models derived from patient's imaging data are increasingly used in medical applications, with most of the studies focusing on the clinical value of patientspecific 3D printed models such as pre-surgical planning and simulation, medical education and patient-doctor communication (18)(19)(20)(21)(22)(23)29,30). A new research direction of clinical application of 3D printed models is to develop optimal CT scanning protocols for radiation dose reduction.…”

Section: Discussionmentioning

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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“…Image processing and additive manufacturing technologies enable the creation of 3D models based on computer tomography (CT) or magnetic resonance imaging (MRI) scans and subsequently the printing of realistic threedimensional replicas of human hearts. 3D printed heart models are suitable for morphology courses (5)(6)(7)(8)(9)(10)(11)(12), education of nurses (13), surgical training (14)(15)(16)(17)(18)(19)(20), surgical planning (3) and patient education (21)(22)(23). The cardiac 3D replicas produced in this study have been successfully utilized in hands-on catheterization courses for students, residents and experienced cardiologists.…”

Section: European Pediatric Immediate Life Support (Epils) and Europementioning

confidence: 97%

Engineering on Anatomy to Avoid the Necessity of Invasive Imaging in Medical 3D Printing: Examples from Pediatric Cardiology

Hopfner¹,

Jakob²,

Tengler³

et al. 2020

Preprint

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Background: 3D printed models of pediatric hearts with congenital heart disease (CHD) have been proven helpful in simulation training of diagnostic and interventional catheterization. However, anatomically accurate 3D printed models are traditionally based on real 2D scans of patients requiring specific imaging techniques, i.e. computer tomography (CT) or magnetic resonance imaging (MRI). In small children both imaging technologies often require deep sedation and involve radiation (CT) being of special impact in this population. Hence, cardiac image data acquired by these invasive technologies is rare in pediatrics where minimization of radiation and sedation is key. Therefore, an alternative solution to create variant 3D printed heart models for teaching and hands-on training has been established. Methods: In this study different methods utilizing image processing and computer aided design (software: Mimics Innovation Suite, Materialise NV) have been established to overcome this shortage and to allow unlimited variations of 3D heart models based on a single patient scan. Patient-specific models based on a CT or MRI image stack were modified by performing virtual engineering on the original shape and structure of the heart. Thereby, 3D hearts including several pathological findings were created and CHD training models were adapted to training level and aims of hands-on classes, particularly for invasive procedures such as interventional cardiology. Results: By changing the shape and structure of the 3D anatomy various training models were created of which four examples are presented in this paper: 1. a heart model with a patent ductus arteriosus (PDA) augmented by perimembranous ventricular septal defect (pmVSD) and muscular ventricular septal defect (mVSD), 2. a model of solely the right heart with pulmonary valve stenosis (PS) augmented by the left heart and myocardium, 3. a series of heart models with atrial septal defect (ASD) showing the hemodynamic effect on the right atrial and ventricular wall, 4. a model of solely the left heart with isthmus stenosis augmented with an engineered aortic valve. All presented models have been successfully utilized in teaching or hands-on training courses. Conclusions: It has been demonstrated that structure and shape of 3D heart models can be modified virtually by engineering on anatomy. Therefore, anatomical variants can be created without the necessity for real, patient-specific CT or MRI imaging. Further investigations are required to evaluate the resemblance of reality of non-patient-specific 3D models and to prove the effectiveness of training using these designed heart models.

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Utility of three-dimensional models in resident education on simple and complex intracardiac congenital heart defects

Cited by 80 publications

References 18 publications

3D printing in medicine: current applications and future directions

3D printing in medicine: current applications and future directions

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

Engineering on Anatomy to Avoid the Necessity of Invasive Imaging in Medical 3D Printing: Examples from Pediatric Cardiology

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