Printing in Three Dimensions

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 - Brain

When it comes to 3D printing in healthcare, long gone are the days of rustic, stiff protocols that offered more novelty than real-world use.  Next generation 3D printing technologies are helping medical providers, especially radiologists, revolutionize everything from facial transplants to cardiovascular surgery.

“3D printing has been an opportunity for radiologists for more than 10 years,” said Frank Rybicki, MD, PhD, chief of medical imaging at Ottawa Hospital and former director of the Applied Imaging Science Laboratory at Brigham and Women’s Hospital in Boston. “But it’s mostly in the last five years that the technology has been more available to us and people have become more aware of what a 3D printer can do.”

Rybicki says the value of the technology lies in what it produces—a physical object you can hold.

“Whether it’s a heart or a piece of bone, giving a surgeon the ability to hold the body part in their hands before a surgery is a huge benefit to them when it comes to planning and preparation,” he says.

Bryan Pukenas, MD, an assistant professor of radiology at the Hospital of the University of Pennsylvania, thinks 3D printing will place radiology at the forefront of patient care through education and innovation.

“In terms of education, for the first time patients can ‘hold the disease’ in the palm of their hands,” Pukenas says. “For example, a patient with a brain aneurysm typically undergoes a CT angiogram for diagnosis and treatment planning. At the same time, clinicians can take that model and simulate treating the aneurysm, which may decrease complication rates related to treatment.”

Pukenas says that as a radiologist, he’s most excited about the innovative potential of 3D printing.

“Our team performs many biopsies for our oncology colleagues since tissue sampling is paramount for tailored cancer therapies, and despite our relatively high yields with biopsies, we saw a need for a better needle design in order to make our yields higher,” he says. “Our team was able to design and print a prototype biopsy needle both quickly and inexpensively. That design is now protected with a provisional patent, and we are in preliminary talks with a company interested in this design.”

Another benefit of combining radiology and 3D printing, Rybicki notes, is the ability to have a surgical reconstruction piece prepared before a patient goes into surgery and is placed under anesthesia.

“Previously, the measurements and fitting of the reconstruction piece had to be done while the patient was under general anesthesia,” Rybicki says. “But now, the measurements can be done before surgery and the new part constructed and ready before surgery begins, saving the surgeon a lot of time and that means less time for the patient to be under.”

The future for 3D printing is wide open and Pukenas sees the technology as another way for radiologists to add value in the modern healthcare environment. He uses fetal ultrasound as an example, citing 3D printing’s ability to demonstrate a defect in the fetal spinal canal.

“The 3D ultrasound images could be used to create a life-sized printed 3D model of this individual patient, and surgeons could perfect each step in this particular repair over and over again. Most likely this would decrease operative time and potentially decrease fetal and maternal surgical complications.”

Growing interest

The buzz building around 3D printing in radiology has generated interest in both the broader public and within the radiology community.

“I teach 3D printing workshops at RSNA and this year’s workshops filled up quickly,” Rybicki says. “The technology is becoming much more commonplace and it’s capturing the public’s imagination. It definitely has a place in radiology as the software and the ability to print with less expensive machines becomes more available.”

3D visualization of medical imaging data is routine today. 3D printing is simply an extension of that: instead of printing a 3D picture, it is possible to print a 3D model. The value of 3D printing isn’t necessarily for the radiologists, but for the physicians on the front line of patient care, says Dominik Fleischmann, MD, professor of radiology at the Stanford University Medical Center and director of the medical center’s 3D and Quantitative Imaging Lab “The capability of 3D printing­—like imaging based information in general—best serves the clinical users.”

Fleischmann notes that as surgeons and interventional cardiologists were first interested in