3D Printing in Medicine

The most common surgical procedure to manage the malunion of the bones is corrective osteotomy. The current gold standard for securing the bone segments after osteotomy is the use of titanium plates and allografts which have disadvantages such as possible allergic reaction, additional operations such as extraction of the graft from other sites and removal operation. The utilization of resorbable materials presents an opportunity to mitigate these drawbacks but has not yet been thoroughly researched in the literature. This study assesses the viability of using biodegradable, 3D-printed patient-specific implants made of Poly(-L-lactide-co-D, L-lactide) (PLDLLA) and β-Tricalcium Phosphate (β-TCP) as an alternative material in an in-vitro biomechanical study involving ex vivo biomechanical compression testing, biodegradation testing, and calorimetric measurements. These implants possess a unique shape, resembling a wedge and are fixated as a connection between the osteotomised bone using resorbable screws. Following point-of-care virtual planning, bio-mechanical compressive tests with (n = 5) ex vivo radii equipped with PLDLLA/ β-TCP implants were performed to prove sufficient stability of the connection. All PLDLLA/ β-TCP implants withstood a compressive force of at least 1'211 N which exceeds the maximum force reported in literature in case of a fall from the height of one meter. Furthermore, the results showed a consistent surface chemistry and slow degradation rate. The outcomes are encouraging, establishing the groundwork for an innovative distal radius corrective osteotomy surgical method. However, further research is necessary to thoroughly evaluate the long-term biodegradability and mechanical efficacy of the implants.

Adam Jakimiuk

Michaela Maintz

Magdalena Müller-Gerbl

Florian Markus Thieringer

Marco Keller

Alissa Guebeli

Philipp Honigmann

3D-printed patient-specific implants made of polylactide (PLDLLA) and β-tricalcium phosphate (β-TCP) for corrective osteotomies of the distal radius

用于远端桡骨矫正截骨术的聚乳酸（PLDLLA）和β-磷酸三钙（β-TCP）3D打印个性化植入物

Selected medical implants and other 3D printed constructs could potentially benefit from the ability to incorporate contrast agents into their structure. The purpose of the present study is to create 3D printed surgical meshes impregnated with iodinated, gadolinium, and barium contrast agents and characterize their computed tomography (CT) imaging characteristics. Commercial fused deposition layering 3D printing was used to construct surgical meshes impregnated with imaging contrast agents in an in vitro model. Polycaprolactone (PCL) meshes were printed containing iodinated, gadolinium, or barium contrast; control PCL meshes without contrast were also fabricated. The three different contrast agents were mixed with PCL powder and directly loaded into the 3D printer. CT images of the three contrast-containing meshes and the control meshes were acquired and analyzed using small elliptical regions of interest to record the Hounsfield units (HU) of each mesh. Subsequently, to test their solubility and sustainability, the contrast-containing meshes were placed in a 37 °C agar solution for 7 days and imaged by CT at days 1, 3 and 7. All 3D printed meshes were visible on CT. Iodinated contrast meshes had the highest attenuation (2528 mean HU), significantly higher than both and gadolinium (1178 mean HU) and barium (592 mean HU) containing meshes. Only barium meshes sustained their visibility in the agar solution; the iodine and gadolinium meshes were poorly perceptible and had significantly lower mean HU compared to their pre-agar solution imaging, with iodine and gadolinium present in the adjacent agar at day 7 CT. 3D prints embedded with contrast materials through this method displayed excellent visibility on CT; however, only barium mesh maintained visibility after 7 days incubation on agar at human body temperature. This method of 3D printing with barium may have potential applications in a variety of highly personalized and CT visible medical devices.

David H. Ballard

Udayabhanu Jammalamadaka

Karthik Tappa

Jeffery A. Weisman

Christen J. Boyer

Jonathan Steven Alexander

Pamela K. Woodard

3D printing of surgical hernia meshes impregnated with contrast agents: in vitro proof of concept with imaging characteristics on computed tomography

手术疝网的三维打印及其浸渍对比剂的体外概念验证与计算机断层扫描成像特征

Breast cancer screening is implemented as part of governmental healthcare policy in many countries. While breast imaging tests contribute to reducing mortality, some breast cancers may emerge between these screenings. Consequently, it is crucial for women to be vigilant about any changes in their breasts to facilitate the early detection of breast cancer. Recently, the application of 3-dimensional printing technology in the medical field has expanded, including uses in medical imaging and surgical training. In this study, we developed 3D-printed palpation models for breast tumor detection and surveyed seven surgeons specializing in breast care to evaluate the usability of the models. As a result of the survey, we created a model that obtained a maximum mean rating of 7.1(maximum rating 10, minimum rating 3) on the item 'How accurately does the model simulate the feel of a real tumor?' on a scale from 1 to 10. Although there is some variation in the average value, through this study, we found that it is possible to create a model that is quite close to the actual tumor depending on the materials and shape of the models. Our findings demonstrated the potential use of personalized models both in medical trainee and patient education.

Haruna Katori

Atsushi Fushimi

Soichiro Fujimura

Rei Kudo

Makiko Kamio

Hiroko Nogi

Development and evaluation of 3D-printed tumor palpation models for surgical training and patient education

3D打印肿瘤触诊模型在手术训练和患者教育中的开发与评估

Abstract Background The development of phantoms to reduce animal testing or to validate new instruments or operation techniques is of increasing importance. For this reason, a blood circulation phantom was developed to test a newly designed retractor system with an integrated oxygen sensor. This phantom was used to evaluate the impact of the 3D printed blood vessel on the measurement of the oxygen saturation. Methods A solution of nickel sulfate and copper sulfate was prepared as a substitute for real blood. The absorption spectra of these solutions were recorded and compared with those of blood. Subsequently, the oxygen sensor used was calibrated to the blood substitute. Additionally, blood vessels with a simplified geometry were designed and manufactured using inverted vat polymerization and an elastic material ( Formlabs Elastic 50 A ). To determine the orientation during the printing process, various vessels were printed. Measurements to assess the effects of disturbance (rotation of the vessels during measurements) on the sensor readouts were prepared. Results The impact of disturbances was verified through the rotation of the 3D printed vessels. It was demonstrated that a direct measurement on the disturbances led to outliers and higher values. An optimal orientation was determined to be a lateral placement (90° or 270°) of the sensor. Regarding the orientation of the vessels within the printing space, an orientation of 45° yielded the best results, as the individual layers had the least impact on the light emitted and received by the oxygen sensor. Conclusion The achieved results demonstrate the influence of the orientation of the vessel during 3D printing as well as the influence of the position of the vessel during the measurement using a conventional oxygen sensor.

Svenja Jung

Martin Hoffmann

Dirk Winkler

Erdem Güresir

Fabian Kropla

Sebastian Scholz

Ronny Grunert

Influence of the orientation of constructed blood vessels during the 3D printing on the measurement of the pseudo-oxygen saturation of an artificial blood substitute using conventional oxygen sensors: a test series

3D打印构建血管方向对使用常规氧传感器测量人造血液替代品伪氧饱和度的影响：一项测试系列

Jonathan M. Ford

Frank J. Rybicki

Jonathan M. Morris

Summer J. Decker

3D Print Med

Stratifying complexity among the widespread use of 3D printing in United States health care facilities

美国医疗机构广泛使用3D打印中的复杂性分层

Abstract Aim This study compares the precision, accuracy, and user experience of 3D body surface scanning of human subjects using the Artec Leo hand-held scanner and the iPad Pro as 3D scanning devices for capturing cervical and craniofacial data. The investigation includes assessing methods for correcting 'dropped head syndrome' during scanning, to demonstrate the ability of the scanner to be used to reconstruct body surface of patients. Methods Eighteen volunteers with no prior history of neck weakness were scanned three times in three different positions, using the two different devices. Surface area, scanning time, and participant comfort scores were evaluated for both devices. Precision and accuracy were assessed using Mean Absolute Deviation (MAD), Mean Absolute Percentage Error (MAPE), and Intra-Class Correlation Coefficients (ICC). Results Surface area comparisons revealed no significant differences between devices and positions. Scanning times showed no significant difference between devices or positions. Comfort scores varied across positions. MAD analysis identified chin to chest measurements as having the highest variance, especially in scanning position 3. However, no statistical differences were found. MAPE results confirmed accuracy below 5% error for both devices. ICC scores indicated good reliability for both measurement methods, particularly for chin to chest measurements in positions 1 and 3. Conclusion The iPad Pro using the Qlone app demonstrates a viable alternative to the Artec Leo, particularly for capturing head and neck surface area within a clinical setting. The scanning resolution, with an error margin within ±5%, is consistent with clinically accepted standards for orthosis design, where padding and final fit adjustments allow for bespoke devices that accommodate patient comfort. This study highlights the comparative performance of the iPad, as well as suggests two methods which can be used within clinics to correct head drop for scanning.

Samuel D. J. Spears

Thomas Lester

Ryo Torii

Deepak M. Kalaskar

Comparative evaluation of Artec Leo hand-held scanner and iPad Pro for 3D scanning of cervical and craniofacial data: assessing precision, accuracy, and user experience

手持式扫描仪Artec Leo与iPad Pro在颈椎和颅面数据三维扫描中的比较评估：评估精度、准确性和用户体验

Abstract Background The use of 3D-printing in medicine requires a context-specific quality assurance program to ensure patient safety. The process of medical 3D-printing involves several steps, each of which might be prone to its own set of errors. The segmentation error (SegE), the digital editing error (DEE) and the printing error (PrE) are the most important partial errors. Approaches to evaluate these have not yet been implemented in a joint concept. Consequently, information on the stability of the overall process is often lacking and possible process optimizations are difficult to implement. In this study, SegE, DEE, and PrE are evaluated individually, and error propagation is used to examine the cumulative effect of the partial errors. Methods The partial errors were analyzed employing surface deviation analyses. The effects of slice thickness, kernel, threshold, software and printers were investigated. The total error was calculated as the sum of SegE, DEE and PrE. Results The higher the threshold value was chosen, the smaller were the segmentation results. The deviation values varied more when the CT slices were thicker and when the threshold was more distant from a value of around -400 HU. Bone kernel-based segmentations were prone to artifact formation. The relative reduction in STL file size [as a proy for model complexity] was greater for higher levels of smoothing and thinner slice thickness of the DICOM datasets. The slice thickness had a minor effect on the surface deviation caused by smoothing, but it was affected by the level of smoothing. The PrE was mainly influenced by the adhesion of the printed part to the build plate. Based on the experiments, the total error was calculated for an optimal and a worst-case parameter configuration. Deviations of 0.0093 mm ± 0.2265 mm and 0.3494 mm ± 0.8001 mm were calculated for the total error. Conclusions Various parameters affecting geometric deviations in medical 3D-printing were analyzed. Especially, soft reconstruction kernels seem to be advantageous for segmentation. The concept of error propagation can contribute to a better understanding of the process specific errors and enable future analytical approaches to calculate the total error based on process parameters.

Lukas Juergensen

Robert Rischen

Julian Hasselmann

Max Toennemann

Arne Pollmanns

Georg Gosheger

Martin Schulze

Insights into geometric deviations of medical 3d-printing: a phantom study utilizing error propagation analysis

医学3D打印几何偏差的洞察：利用误差传播分析的仿体研究

Abbreviation	3D Print Med
Journal Impact	3.08
Quartiles(Global)	RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING(Q1)

Publication Information	Publisher: BioMed Central Ltd，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2019，Proportion of original research papers: 96.97%，Self Citation Rate:12.50%， Gold OA Rate: 100.00%
Journal Fees	$2090Details
Average review cycle	网友分享经验：5 Weeks

3D Printing in Medicine

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3D-printed patient-specific implants made of polylactide (PLDLLA) and β-tricalcium phosphate (β-TCP) for corrective osteotomies of the distal radius

3D printing of surgical hernia meshes impregnated with contrast agents: in vitro proof of concept with imaging characteristics on computed tomography

Development and evaluation of 3D-printed tumor palpation models for surgical training and patient education

Influence of the orientation of constructed blood vessels during the 3D printing on the measurement of the pseudo-oxygen saturation of an artificial blood substitute using conventional oxygen sensors: a test series

Stratifying complexity among the widespread use of 3D printing in United States health care facilities

3D-printed patient-specific implants made of polylactide (PLDLLA) and β-tricalcium phosphate (β-TCP) for corrective osteotomies of the distal radius

Development and evaluation of 3D-printed tumor palpation models for surgical training and patient education

Influence of the orientation of constructed blood vessels during the 3D printing on the measurement of the pseudo-oxygen saturation of an artificial blood substitute using conventional oxygen sensors: a test series

Comparative evaluation of Artec Leo hand-held scanner and iPad Pro for 3D scanning of cervical and craniofacial data: assessing precision, accuracy, and user experience

Insights into geometric deviations of medical 3d-printing: a phantom study utilizing error propagation analysis