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STL (stereolithography, "standard tessellation language") file. This common file format stores multiple triangle vertices, displaying the 3D surface as a collection of triangles or facets.
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Current cardiovascular imaging techniques allow anatomical relationships and pathological conditions to be captured in three dimensions. Three-dimensional (3D) printing, or rapid prototyping, has also become readily available and made it possible to transform virtual reconstructions into physical 3D models. This technology has been utilised to demo...
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Context 1
... of the oldest and most widespread is the STL or stereolithography format, which has been used for more than two decades. This breaks down a 3D object into a series of vertices of triangles of various sizes (Figure 8). While simple, this format has a number of deficiencies and it is not uncommon to generate an STL file which contains errors or is otherwise unprintable due to small holes or defects, as well as other errors such as 'inverted triangles' or 'bad edges'. ...
Citations
... Maya (Autodesk), and ZBrush (Pixologic) [67,70], and the final model was either printed [66,71] or used in AR or VR applications [70]. The general workflow comprises three steps: image segmentation, mesh optimization, and 3D printing [64,66,67,[70][71][72][73]. The process of converting CT scans into 3D models begins with overlaying the scans taken at intervals of the defined step. ...
... The 3D modeling process involves the definition of discrete parts that represent the desired structure (segmentation) [66,70,74]. Image segmentation algorithms are based on intensity, discontinuity, and similarity or segmentation techniques [66,70], with the most common techniques including thresholding, edge detection, region growing [70,73,75], and currently machine learning techniques, such as Convolutional Neural Networks (CNN) [64,74,76]. The final result is affected by various scanning parameters, such as the scan step, the adjustment of contrast and brightness, artifacts like noise, streaks, distortions, as well as the parameters for exporting the.stl file format, such as the number of triangles and automatic smoothing [64,73,75]. ...
... Image segmentation algorithms are based on intensity, discontinuity, and similarity or segmentation techniques [66,70], with the most common techniques including thresholding, edge detection, region growing [70,73,75], and currently machine learning techniques, such as Convolutional Neural Networks (CNN) [64,74,76]. The final result is affected by various scanning parameters, such as the scan step, the adjustment of contrast and brightness, artifacts like noise, streaks, distortions, as well as the parameters for exporting the.stl file format, such as the number of triangles and automatic smoothing [64,73,75]. ...
The revelation of the internal structure of objects through computed tomography (CT scan) contributes to a more comprehensive understanding of their creation, the assessment of their preservation status, and the prediction of their future behavior. Consequently, in the case of Yiannis Pappas’ collection, this knowledge aids in the perpetuation of the models it hosts, which are made from malleable materials, such as wax, plasticine, and mazut, on metallic armature. This publication presents the complete methodology for extracting three-dimensional (3D) models (reconstructions) of the individual construction materials of the figurines, with the aim of subsequently utilizing them in research, as well as in their digital preservation and restoration. The 3D reconstructions were obtained by automatic segmentation algorithms based on the absorption measurements of the materials of the specific figurines, and were furthered edited (post-processing) to obtain the final models.
... Another important advantage of CCT in CHD is the consistent threshold characteristics which are particularly advantageous for volume rendering and 3D printing of CHD. This approach has been shown to be able to depict complex anatomy for improved interventional and surgical planning [125]. ...
Purpose of the Review
This review aims to provide a profound overview on most recent studies on the clinical significance of Cardiovascular Computed Tomography (CCT) in diagnostic and therapeutic pathways. Herby, this review helps to pave the way for a more extended but yet purposefully use in modern day cardiovascular medicine.
Recent Findings
In recent years, new clinical applications of CCT have emerged. Major applications include the assessment of coronary artery disease and structural heart disease, with corresponding recommendations by major guidelines of international societies. While CCT already allows for a rapid and non-invasive diagnosis, technical improvements enable further in-depth assessments using novel imaging parameters with high temporal and spatial resolution. Those developments facilitate diagnostic and therapeutic decision-making as well as improved prognostication.
Summary
This review determined that recent advancements in both hardware and software components of CCT allow for highly advanced examinations with little radiation exposure. This particularly strengthens its role in preventive care and coronary artery disease. The addition of functional analyses within and beyond coronary artery disease offers solutions in wide-ranging patient populations. Many techniques still require improvement and validation, however, CCT possesses potential to become a “one-stop-shop” examination.
... The increased access to 3D printers, decreased material costs, and prevalence of opensource computer-assisted design programs such as 3D-Slicer have marked an explosion of 3D model applications in the medical field [1]. High fidelity anatomic models are increasingly being used in pre-surgical planning, patient education, and simulation-based medical education [2]. ...
... In medical education, studies have suggested that prior didactic education followed by handling of a tangible model enhances understanding of the complex relationships between adjacent anatomic structures [2]. Unique 3D models of a patient's cardiovascular system have been utilized to improve surgeons' technical skills and assist with planning difficult procedures (e.g., selecting appropriate instruments for complex cases) and handling intraoperative troubleshooting [3][4][5]. ...
... In medical education, 3D models can enhance learning by emphasizing visual, spatial, and tactile information. Unlike formalin-preserved cadavers, 3D-printed models are reusable, less expensive, and less toxic [2,3,8]. Moreover, they have been used in the development of technical skills in simulation-based medical education, particularly in the field of interventional radiology for training vascular access techniques [9]. ...
Three-dimensional (3D)-printed models with high anatomic fidelity are an increasingly viable tool in simulation-based medical education. One advantage of 3D models is they provide enhanced tactile and spatial understanding of complex anatomy to develop technical skills used in minimally invasive procedures. We propose that 3D anatomical models can improve the development of interventional radiology vascular access skills—first described in the 1950s as the Seldinger technique—for pre-clerkship medical students. The early adoption of 3D-printed technology in pre-clinical medical education can lead to improved student engagement and satisfaction when learning procedural techniques. This study involved creating a 3D model of the upper limb vasculature from an anonymized Computed tomography (CT) angiogram, using it as a medical education tool for 31 pre-clinical medical students practicing the Seldinger Technique on a prefabricated venipuncture upper limb, and assessing student satisfaction with this form of learning. Overall, attendees responded positively to the incorporation of the 3D model in medical education to improve their anatomic understanding and application of the Seldinger technique. These results indicate that the use of 3D models in simulation-based medical education can provide benefits in acquiring technical skills and the potential to decrease training costs without harming a patient.
... Clinicians including cardiac surgeons are more familiar with multiplanar and 3D images than with axial CT images, and these reconstructions can significantly improve the communication between radiologists and clinicians. There is a growing role of 3D printing of cardiovascular models that may be used for planning CHD surgical repair enabling a thorough understanding of a patient's anatomy [25]. ...
An aortopulmonary septal defect or aortopulmonary window (APW) is a rare cardiovascular anomaly with direct communication between the ascending aorta and the main pulmonary artery leading to a left-to-right shunt. It is accompanied by other cardiovascular anomalies in approximately half of patients. In order to avoid irreversible sequelae, interventional or surgical treatment should be performed as soon as possible. Cardiovascular CT, as a fast, non-invasive technique with excellent spatial resolution, has an increasing role in the evaluation of patients with APW, enabling precise and detailed planning of surgical treatment of APW and associated anomalies if present. This article aims to review the anatomical and clinical features of aortopulmonary septal defect with special emphasis on its detection and characterization by a CT examination.
... The increased access to 3D printers, decreased material costs, and prevalence of open-source computer-assisted design programs such as 3D-Slicer have marked an explosion of 3D model applications in the medical field [1]. High fidelity anatomic models are increasingly being used in pre-surgical planning, patient education, and simulation-based medical education [2]. ...
... In medical education, studies have suggested prior didactic education followed by handling of a tangible model enhances understanding of the complex relationships between adjacent anatomic structures [2]. Unique 3D models of a patient's cardiovascular system have been utilized to improve surgeons' technical skills, assist with planning difficult procedures (e.g., selecting appropriate instruments for complex cases) and handling intraoperative troubleshooting [3][4][5]. ...
... In medical education, 3D models can enhance learning by emphasizing visual, spatial, and tactile information. Unlike formalin preserved cadavers, 3D-printed models are reusable, less expensive, and less toxic [2,3,8]. Moreover, they have been used in the development of technical skills in simulation-based medical education particularly in the field of Interventional Radiology for training vascular access techniques [9]. ...
3D-printed models with high anatomic fidelity are an increasingly viable tool in simulation-based medical education. One advantage of 3D models is they provide enhanced tactile and spatial understanding of complex anatomy to develop technical skills used in minimally invasive procedures. We propose that 3D anatomical models can improve the development of Interventional Radiology vascular access skills – first described in the 1950s as the Seldinger Technique – for pre-clerkship medical students. Early adoption of 3D-printed technology in pre-clinical medical education can lead to improved student engagement and satisfaction when learning procedural techniques. This study involved creating a 3D model of the upper extremity vasculature from an anonymized CT angiogram, using it as a medical education tool for 31 pre-clinical medical students practicing the Seldinger Technique on a prefabricated venipuncture arm, and assessing student satisfaction with this form of learning. Overall, attendees responded positively to the incorporation of the 3D model in medical education to improve their anatomic understanding and application to the Seldinger Technique. These results indicate that the use of 3D models in simulation-based medical education can provide benefits to acquiring technical skills and the potential to decrease training costs without harming a patient.
... The applications of material jetting include the production of high-resolution prototypes and intricate multi-material products. In the biomedical field, it finds use in drug delivery systems that utilize multiple materials, bio-printed tissues and scaffolds, surgical models and guidance, and more [18][19][20]. ...
Precision manufacturing requirements are the key to ensuring the quality and reliability of biomedical implants. The powder bed fusion (PBF) technique offers a promising solution, enabling the creation of complex, patient-specific implants with a high degree of precision. This technology is revolutionizing the biomedical industry, paving the way for a new era of personalized medicine. This review explores and details powder bed fusion 3D printing and its application in the biomedical field. It begins with an introduction to the powder bed fusion 3D-printing technology and its various classifications. Later, it analyzes the numerous fields in which powder bed fusion 3D printing has been successfully deployed where precision components are required, including the fabrication of personalized implants and scaffolds for tissue engineering. This review also discusses the potential advantages and limitations for using the powder bed fusion 3D-printing technology in terms of precision, customization, and cost effectiveness. In addition, it highlights the current challenges and prospects of the powder bed fusion 3D-printing technology. This work offers valuable insights for researchers engaged in the field, aiming to contribute to the advancement of the powder bed fusion 3D-printing technology in the context of precision manufacturing for biomedical applications.
... Furthermore, the available CAD software cannot accurately convert a series of 2D images into 3D models since it should identify a fixed relationship between every point of the current image and the corresponding element on other images (Otton et al. 2017). Failure in observing a relationship may need an estimation/interpolation of hidden points, leading to artifact creation. ...
Three-dimensional (3D) printing, or additive manufacturing (AM), is a technique that creates a 3D product from a digital model, allowing for the production of complex shapes with increased design freedom and the possibility of personalization. This makes 3D printing ideal for the construction of biomedical products, such as surgical implants and heart organs, from imaging scan data. Although the development of cardiac 3D models has improved cardiovascular health in various ways, there are challenges associated with the manufacturing of cardiac 3D models, which can be addressed with the use of artificial intelligence (AI) techniques. In this chapter, we review the role of AI in improving the “design” and “in-situ monitoring” phases. In the design phase, AI techniques can be applied to improve accuracy and reduce the time required during whole cardiac segmentation. The in-situ monitoring phase can be enhanced through the automatic detection of surface and geometry defects during the fabrication process of cardiac models. In this chapter, we survey AI techniques for accurate image segmentation, the automatic detection of anomalies during the fabrication process, and the optimization of process parameter settings. The unresolved challenges in 3D printing and future directions for addressing them are also summarized.
... Certain complex shapes may be easier to reproduce accurately through direct AM because of the high design freedom allowed by AM techniques, which make it a suitable tool for manufacturing biological features. In addition, the layer wise model build process of AM has the potential to simplify designs incorporating internal structures such as vasculature, biopsy targets and foreign bodies, both for training and education or for replicating patientspecific anatomy from imaging data (Otton et al., 2017). ...
... Currently, CT is the preferred modality for cardiovascular 3D printing due to its rapid data acquisition, excellent spatial and density resolution, and its ability to provide both cardiac and extracardiac information for 3D model generation [32,33]. When it comes to constructing whole heart cine 4D models, encompassing both 3D and temporal aspects, CT proves more advantageous, as demonstrated in previous studies [34]. ...
This study aims to evaluate the feasibility and utility of virtual reality (VR) for baffle planning in congenital heart disease (CHD), specifically by creating patient-specific 3D heart models and assessing a user-friendly VR interface. Patient-specific 3D heart models were created using high-resolution imaging data and a VR interface was developed for baffle planning. The process of model creation and the VR interface were assessed for their feasibility, usability, and clinical relevance. Collaborative and interactive planning within the VR space were also explored. The study findings demonstrate the feasibility and usefulness of VR in baffle planning for CHD. Patient-specific 3D heart models generated from imaging data provided valuable insights into complex spatial relationships. The developed VR interface allowed clinicians to interact with the models, simulate different baffle configurations, and assess their impact on blood flow. The VR space’s collaborative and interactive planning enhanced the baffle planning process. This study highlights the potential of VR as a valuable tool in baffle planning for CHD. The findings demonstrate the feasibility of using patient-specific 3D heart models and a user-friendly VR interface to enhance surgical planning and patient outcomes. Further research and development in this field are warranted to harness the full benefits of VR technology in CHD surgical management.
... The process of 3D modeling involves the fabrication and reconstruction of a virtual 3D representation of a physical object or surface from imaging data [25]. This technology has enabled the transformation of 2D data into 3D data [26]. Traditionally, this method has been used in the manufacturing industry, but it is now used in the medical and dental fields, as well as in plastic surgery and orthodontic surgery. ...
... These images are used to build various 3D-printed objects such as occlusal splints, anatomical models, patient-specific implants, and cutting guides [47]. 3D-printed surgical guides help in cutting bones, as well as placement of implants, and enable the surgery with maximum accuracy and minimal invasive involvement [26]. 3D-printed guiding splints of the jaw bones specific to the patient exactly replicate their original form and function providing an exact fit for the graft [47]. ...
Three-dimensional (3D) printing refers to a wide range of additive manufacturing processes that enable the construction of structures and models. It has been rapidly adopted for a variety of surgical applications, including the printing of patient-specific anatomical models, implants and prostheses, external fixators and splints, as well as surgical instrumentation and cutting guides. In comparison to traditional methods, 3D-printed models and surgical guides offer a deeper understanding of intricate maxillofacial structures and spatial relationships. This review article examines the utilization of 3D printing in orthognathic surgery, particularly in the context of treatment planning. It discusses how 3D printing has revolutionized this sector by providing enhanced visualization, precise surgical planning, reduction in operating time, and improved patient communication. Various databases, including PubMed, Google Scholar, ScienceDirect, and Medline, were searched with relevant keywords. A total of 410 articles were retrieved, of which 71 were included in this study. This article concludes that the utilization of 3D printing in the treatment planning of orthognathic surgery offers a wide range of advantages, such as increased patient satisfaction and improved functional and aesthetic outcomes.
