Hello the Biomedical 3D Printing community, it's Devarsh Vyas here writing after a really long time!
This time i'd like to share my personal experience and challenges faced with respect to medical 3D Printing from the MRI data. This can be a knowledge sharing and a debatable topic and I am looking forward to hear and know what other experts here think of this as well with utmost respect.
In the Just recently concluded RSNA conference at Chicago had a wave of technology advancements like AI and 3D Printing in radiology. Apart from that the shift of radiologists using more and more MR studies for investigations and the advancements with the MRI technology have forced radiologists and radiology centers (Private or Hospitals) to rely heavily on MRI studies.
We are seeing medical 3D Printing becoming mainstream and gaining traction and excitement in the entire medical fraternity, for designers who use the dicom to 3D softwares, whether opensource or FDA approved software know that designing from CT is fairly automated because of the segmentation based on the CT hounsifield units however seldom we see the community discuss designing from MRI, Automation of segmentation from MRI data, Protocols for MRI scan for 3D Printing, Segmentation of soft tissues or organs from MRI data or working on an MRI scan for accurate 3D modeling.
Currently designing from MRI is feasible, but implementation is challenging and time consuming. We should also note reading a MRI scan is a lot different than reading a CT scan, MRI requires high level of anatomical knowledge and expertise to be able to read, differentiate and understand the ROI to be 3D Printed. MRI shows a lot more detailed data which maybe unwanted in the model that we design. Although few MRI studies like the contrast MRI of the brain, Heart and MRI angiograms can be automatically segmented but scans like MRI of the spine or MRI of the liver, Kidney or MRI of knee for example would involve a lot of efforts, expertise and manual work to be done in order to reconstruct and 3D Print it just like how the surgeon would want it.
Another challenge MRI 3D printing faces is the scan protocols, In CT the demand of high quality thin slices are met quite easily but in MRI if we go for protocols for T1 & T2 weighted isotropic data with equal matrix size and less than 1mm cuts, it would increase the scan time drastically which the patient has to bear in the gantry and the efficiency of the radiology department or center is affected.
There is a lot of excitement to create 3D printed anatomical models from the ultrasound data as well and a lot of research is already being carried out in that direction, What i strongly believe is the community also need advancements in terms of MRI segmentation for 3D printing. MRI, in particular, holds great potential for 3D printing, given its excellent tissue characterization and lack of ionizing radiation but model accuracy, manual efforts in segmentation, scan protocols and expertise in reading and understanding the data for engineers have come up as a challenge the biomedical 3D printing community needs to address.
These are all my personal views and experiences I've had with 3D Printing from MRI data. I'm open to and welcome any tips, discussions and knowledge sharing from all the other members, experts or enthusiasts who read this.
Thank you very much!
Dear Community Members,
After many months of work, we are happy to announce the addition of a feature that will allow you to sell medical models you have designed on Embodi3D.com. While we always have encouraged our members to consider allowing their medical STL files to be downloaded for free, we understand that when a ton of time is invested in creating a valuable and high-quality model, it is reasonable to ask for something in return. Now Embodi3D members have two options: 1) You can share your medical models for free, or 2) you can charge for them. We hope these two options encourage more sharing and file uploads. The more models available, the more it helps the medical 3D printing community.
For more details on how to sell your medical masterpieces on Embodi3D, go to the selling page.
Thanks, and happy 3D printing!
Please note the democratiz3D service was previously named "Imag3D"
In this tutorial you will learn how to quickly and easily make 3D printable bone models from medical CT scans using the free online service democratiz3D®. The method described here requires no prior knowledge of medical imaging or 3D printing software. Creation of your first model can be completed in as little as 10 minutes.
You can download the files used in this tutorial by clicking on this link. You must have a free Embodi3D member account to do so. If you don't have an account, registration is free and takes a minute. It is worth the time to register so you can follow along with the tutorial and use the democratiz3D service.
>> DOWNLOAD TUTORIAL FILES AND FOLLOW ALONG <<
Both video and written tutorials are included in this page.
Before we start you'll need to have a copy of a CT scan. If you are interested in 3D printing your own CT scan, you can go to the radiology department of the hospital or clinic that did the scan and ask for the scan to be put on a CD or DVD for you. Figures 1 and 2 show the radiology department at my hospital, called Image Management, and the CDs that they give out. Most radiology departments will have you sign a written release and give you a CD or DVD for free or with a small processing fee. If you are a doctor or other healthcare provider and want to 3D print a model for a patient, the radiology department can also help you. There are multiple online repositories of anonymized CT scans for research that are also available.
Figure 1: The radiology department window at my hospital.
Figure 2: An example of what a DVD containing a CT scan looks like. This looks like a standard CD or DVD.
Step 1: Register for an Embodi3D account
If you haven't already done so, you'll need to register for an embodi3d account. Registration is free and only takes a minute. Once you are registered you'll receive a confirmatory email that verifies you are the owner of the registered email account. Click the link in the email to activate your account. The democratiz3D service will use this email account to send you notifications when your files are ready for download.
Step 2: Create an NRRD file with Slicer
If you haven't already done so, go to slicer.org and download Slicer for your operating system. Slicer is a free software program for medical imaging research. It also has the ability to save medical imaging scans in a variety of formats, which is what we will use it for in this tutorial.
Next, launch Slicer. Insert your CD or DVD containing the CT scan into your computer and open the CD with File Explorer or equivalent file browsing application for your operating system. You should find a folder that contains numerous DICOM files in it, as shown in Figure 3. Drag-and-drop the entire DICOM folder onto the Slicer welcome page, as shown in Figure 4. Click OK when asked to load the study into the DICOM database. Click Copy when asked if you want to copy the images into the local database directory.
Figure 3: A typical DICOM data set contains numerous individual DICOM files.
Figure 4: Dragging and dropping the DICOM folder onto the Slicer application. This will load the CT scan.
Once Slicer has finished loading the study, click the save icon in the upper left-hand corner as shown in Figure 5. One of the files in the list will be of type NRRD. make sure that this file is checked and all other files are unchecked. click on the directory button for the NRRD file and select an appropriate directory to save the file. then click Save, as shown in Figure 6.
Figure 5: The Save button
Figure 6: The Save File box
The NRRD file is much better for uploading then DICOM. Instead of having multiple files in a DICOM data set, the NRRD file encapsulates the entire study in a single file. Also, identifiable patient information is removed from the NRRD file. The file is thus anonymized. This is important when sending information over the Internet because we do not want identifiable patient information transmitted.
Step 3: Upload the NRRD file to Embodi3D
Now go to www.embodi3d.com, click on the democratiz3D navigation menu and select Launch App, as shown in Figure 7. Drag and drop your NRRD file where indicated. While NRRD file is uploading, fill in the "File Name" and "About This File" fields, as shown in Figure 8.
Figure 7: Launching the democratiz3D application
Figure 8: Uploading the NRRD file and entering basic information
Figure 9: Basic information fields about your uploaded NRRD file
Next, turn on democratiz3D Processing by selecting the slider under democratiz3D Processing. Make sure the operation CT NRRD to Bone STL is selected. Leave the default threshold of 150 in place. Choose an appropriate quality. Low quality produces small files quickly but the output resolution is low. Medium quality is good for most applications and produces a relatively good file that is not too large. High quality takes the longest to process and produces large output files. Bear in mind that if you upload a low quality NRRD file don't expect the high quality setting to produce a stellar bone model. Medium quality is good enough for most applications.
If you wish, you have the option to specify whether you want your output file to be Private or Shared. If you're not sure, click Private. You can always change the visibility of the file later. If you're happy with your settings, click Save & Submit Files. This is shown in Figure 10.
Figure 10: Entering the democratiz3D Processing parameters.
Step 4: Review Your Completed Bone Model
After about 10 to 20 minutes you should receive an email informing you that your file is ready for download. The actual processing time may vary depending on the size and complexity of the file and the load on the processing servers. Click on the link within the email. If you are already on the embodied site, you can access your file by going to your profile. Click your account in the upper right-hand corner and select Profile, as shown in Figure 11.
Figure 11: Finding your profile.
Your processed file will have the same name as the uploaded NRRD file, except it will end in "– processed". Renders of your new 3D model will be automatically generated within about 6 to 10 minutes. From your new model page you can click "Download this file" to download. If you wish to share your file with the community, you can toggle the privacy setting by clicking Privacy in the lower right-hand corner. You can edit your file or move it from one category to another under the File Actions button on the lower left. These are shown in Figure 12.
Figure 12: Downloading, sharing, and editing your new 3D printable model.
If you wish to sell your new file, you can change your selling settings under File Actions, Edit Details. Set the file type to be Paid, and specify a price. Please note that your file must be shared in order for other people to see it. This is shown in Figure 13. If you are going to sell your file, be sure you select General Paid File License from the License Type field, or specify your own customized license. For more information about selling files, click here.
Figure 13: Making your new file available for sale on the Embodi3D marketplace.
That's it! Now you can create your own 3D printable bone models in minutes for free and share or sell them with the click of a button.If you want to download the STL file created in this tutorial, you can download it here. Happy 3D printing!
In this tutorial we will learn how to use the free medical imaging conversion service on embodi3D.com to create detailed anatomic muscle and skin 3D printable models in STL file format from medical CT scans. Muscle models show the detailed musculature by subtracting away the skin and fat. Even when created from a scan of an obese person, the model looks like it comes from a bodybuilder, Figure 1A. Skin models show an exact replica of the skin surface. The finest details are captured, including wrinkles and veins underneath the skin. Hair however is not captured in a CT scan and thus the model does not have any hair, Figure 1B.
Figure 1A (left): A muscle 3D printable model. Figure 1B (right): A skin 3D printable model
These models can be used for a variety of purposes such as medical and scientific education and research. Additionally, the skin models can be used to re-create a person's likeness in 3D from a medical scan. If you have had a CT scan of the head, you can create a lifelike replica of your head. You can create replicas of your friends, family, or even pets if they have had a medical CT scan. Alternatively, if you have a loved one who passed away but had a CT scan prior to death, you can use the scan to re-create an exact replica of their face. Even scans that are years old can be used for this purpose. Some people may consider this to be a little creepy, so if you are considering doing this think carefully first.
Before proceeding please register for an embodi3D.com account if you haven't already. You will need an account to use the service.
It is highly recommended that you download the associated file pack for this tutorial so that you can follow along with the exact same files that are used in this tutorial.
>> DOWNLOAD THE FREE FILE PACK BY CLICKING HERE <<
If you are interested in learning how to use the free embodi3D.com service, see my prior tutorials on creating bone models, processing multiple models simultaneously, and sharing and selling your models on the embodi3D.com website.
If you are interested in converting your own CT scan or that of a friend or family member, you can go to the radiology department of the hospital or clinic that did the scan and ask for the scan to be put on a CD or DVD for you. Figure 2 shows the radiology department at my hospital, called Image Management, and the CDs that they give out. Most radiology departments will have you sign a written release and give you a CD or DVD for free or with a small processing fee. If you are a doctor or other healthcare provider and want to 3D print a model for a patient, the radiology department can also help you. There are multiple online repositories of anonymized CT scans for research that are also available. If you have downloaded the file pack for this tutorial, example CT scans are included
Figure 2A, the Image Management (radiology) department at my hospital, where you can pick up a DVD of your CT scan as shown in Figure 2B (right). My hospital does this for free, but some may charge a trivial fee.
PART 1: Creating a Muscle STL model from NRRD File
Before we begin please bear in mind that this process only works for CT scan images. It will not work for MRI images. Before proceeding please check that the scan you wish to convert is a CT (CAT) scan!
Step 1: Convert Your CT scan to an Anonymized NRRD File with 3D Slicer
Open 3D Slicer. If you don't have the software program you can download it for free from slicer.org. Once Slicer has opened, take the folder from the download pack that is called STS_004. This folder contains anonymized DICOM images from a CT scan of the legs of a 24-year-old woman who had a muscle tumor. Drag and drop the entire folder onto the Slicer window, as shown in Figure 3. Slicer will ask you if you want to load the images into the DICOM database. Click OK. Slicer will also ask you if it should copy the images into the database, click Copy. Slicer will take about one minute to load the scanned.
Figure 3: Drag-and-drop the STS_004 DICOM folder from the file pack onto the Slicer window
Next, load the scan into the active wor king area in slicer. If the DICOM browser is not open, click on the Show DICOM browser button, as shown in Figure 4. Click on the STS_004 patient and series, and click the Load button, as shown in Figure 4. The leg CT scan will now load into the active seen within Slicer, as shown in Figure 5.
Figure 4: Open the DICOM browser and load the study into the active seen
Figure 5: The leg CT scan is shown in the active seen
Step 2: Trim the Scan so that only the Right Thigh is included.
Click on the Volume Rendering module from the Modules drop-down menu as shown in Figure 6. Turn on volume rendering by clicking on the eyeball button, as shown in Figure 7. Then, center the model in the 3D pane by clicking on the crosshairs button, Figure 7. If you don't have the same window layout as shown in Figure 7, you can correct this by clicking on the Four-Up window layout from the window layout drop-down menu, as shown in Figure 8.
Figure 6: Turn on the volume rendering module
Figure 7: Center the rendered volume.
Figure 8: Make sure you are in the Four-Up window layout
Next we are going to crop the volume so that we exclude everything other than the right knee and thigh. From the modules menu, select All Modules, Crop Volume, as shown in Figure 9. Turn on ROI visibility by clicking on the eyeball button, as shown in Figure 10. Then, move the region of interest box so that it only encapsulates the right thigh, as shown in Figure 10. You can adjust the size of the box by grabbing on the colored circular handles and moving the sides of the box as needed.
Figure 9: The Crop Volume module.
Figure 10: Turning on and adjusting the crop volume ROI (Region Of Interest)
Once the crop volume ROI is adjusted to the area that you want, perform the crop by clicking on the Crop button, Figure 11.
Figure 11: the Crop button.
The new, smaller volume that encompasses the right fight and knee has been assigned a cryptic name. The entire scan had a name of "2: CT IMAGES – RESEARCH," and the new thigh volume has a name "2: CT IMAGES-RESEARCH-subvolume-scale_1." That's a mouthful and I want to rename it to something more descriptive. I'm going to select the Volumes module, and then select the "2: CT IMAGES-RESEARCH-subvolume-scale_1" from the Active Volume drop-down menu. Then, from the same drop-down menu I'm going to select "Rename Current Volume". Type in whatever name you want. In this case I'm choosing "right thigh."
Figure 12: Renaming the newly cropped volume.
Step 3: Save the right thigh volume as an anonymized NRRD file.
Click on the Save button in the upper left-hand corner. The save window is then shown. All the checkboxes on the left except for the one that corresponds to the right by. Make sure the file format for this line says NRRD (.nrrd). Make sure you specify the proper directory you want the file to be saved as. When you are satisfied click on save. This is demonstrated in Figure 13. In the specified directory you should see a called right thigh.nrrd.
Figure 13: The save file options.
Step 4: Upload the NRRD file to embodi3D.com
Make sure you are logged into your embodi3D.com account. Click on Imag3D from the nav bar, Launch App. Then drag-and-drop your NRRD file onto the upload pain, as shown in Figure 14.
Figure 14: Uploading the NRRD file to embodi3D.com.
Figure 15: File processing options.
Step 5: Download your new STL file after processing is completed.
In about 5 to 15 minutes you should receive an email that says your file has finished processing and is ready to download. Follow the link in the email or access the new file via your profile on the embodi3D.com website. Your newly created STL file should have several rendered thumbnails associated with it on its download page. If you want to download the file click on the Download button, as shown in Figure 16.
Figure 16: the download page for your new muscle STL file
I opened the file in AutoDesk MeshMixer to have another look at it, and it looks terrific, as shown in Figure 17. This file is ready to 3D print!
Figure 17: The final 3D printable muscle model.
PART 2: Creating a Skin Model STL File Ready for 3D Printing
Creating a skin model is essentially identical to creating the muscle model, except instead of choosing the CT NRRD to Muscle STL on the embodi3D.com service, we choose CT NRRD to Skin STL.
Step 1: Load DICOM image set into Slicer
Launch Slicer. From the tutorial file pack drag and drop the MANIX folder onto the Slicer window to load this head and neck CT scan data set. This is shown in Figure 18.
Figure 18: Loading the head and neck CT scan into Slicer. It may take a minute or two to load. From the DICOM browser, click on the ANGIO CT series as shown in Figure 19.
Figure 19: Loading the ANGIO CT series from the MANIX data set
Step 2: Skip the trimming and crop volume operations
In this case we don't need to trim and crop a volume as we did with the muscle file above. We can skip Step 2.
Step 3: Save the CT scan in NRRD format.
Just as with the muscle file above, save the volume in NRRD format. Click on the save button, make sure that the checkbox for the nrrd file is selected and all other checkboxes are deselected. Specify the correct directory you want the file to be saved in, and click Save.
Step 4: Upload your NRRD file of the head to the embodi3D website.
Just as with the muscle file process as shown above, upload the head NRRD file to the embodi3D.com website. Enter in the required fields. In this case, however, under Operation choose the CT NRRD to Skin STL operation, as shown in Figure 20.
Figure 20: Selecting the CT NRRD to Skin STL file operation
Step 5: Download your new Skin STL file
After about 5 to 15 minutes, you should receive an email that says your file processing has been completed. Follow the link in the email or look for your file in the list the files you own in your profile. You should see that your skin STL file has been completed, with several rendered images, as shown in Figure 21. Go ahead and download your file. You can then check the quality of your file in Meshmixer as shown in Figure 22. In this instance everything looks great and the file is error free and ready for 3D printing.
Figure 21: The download page for your newly created 3D printable skin STL file.
Figure 22: Opening the file in Meshmixer for quality control checks. The file is error free and incredibly lifelike. It is ready for 3D printing.
Thank you very much! I hope you enjoyed this tutorial. If you use this service to create 3D printable models, please consider sharing your models with the embodi3D community. Here is a detailed tutorial that I wrote on exactly how to do this. This community is built on medical 3D makers helping each other. Please share the models that you create!
The Additive Manufacturing and 3D Printing Research Group (3DPRG) at the University of Nottingham has just unveiled a new research lab, thanks to a £2.7 Million grant from the Engineering and Physical Sciences Research Council (EPSRC).
Promising Research Goals
Equipped with the latest and greatest 3D printing equipment, the lab’s researchers hope to test new ideas and develop more practical applications for 3D printing. Their first order of business, in partnership with the School of Pharmacy, is to investigate ways that 3D printing can improve the pharmaceutical world, including dosages, delivery, and the development of implants.
Their secondary but no less important project, entitled Added Scientific, is an endeavor in additive manufacturing. The goal is to develop ways for 3D printing to be of more practical use to a myriad of sectors, including medicine, aerospace, electronics and nanotechnology. The innovative results could result in higher quality and more affordable products, as well as greater productivity for businesses.
“This new lab and Added Scientific represent a huge step forward in additive manufacturing research and development. We aren’t about printing just shapes or creating objects for their own sake, but about using science and engineering to find new ways to apply additive manufacturing to the real world,” said Professor Richard Hague, project leader for 3DPRG and Director of the University’s EPSRC Centre for Innovative Manufacturing in Additive Manufacturing. “The state-of-the-art equipment in our new lab will allow us to refine the process of multi-functional 3D printing, working with research organizations and industry partners to make 3D printed electronics, pharmaceuticals, and conductive materials a safe, viable, and cost-effective reality.”
4D Printing and Nanotechnology
With recent advances in ‘4D’ printed materials that can change depending on their temperature or other external factors, practical applications of nanotechnology are now the forefront for 3DPRG researchers. Future projects may allow them to develop 3D printed drugs customized to each individual. They also hope to create materials that can work as vehicles for vaccines.
The lab is equipped with word-first, state-of-the-art machines, including a bespoke PiXDRO JETx six head ink jetting system by Roth & Rau. This printer can create six materials, including metallic and ceramic ink as well as reactive polymers. This is useful for printing electronics all on one machine, but can also be used to develop drugs made with custom ingredients designed for individual patients.
The second machine of note is a two-photon lithography printer by Nanoscribe. This machine can print polymer-based objects from the nano to mesoscale, with future applications in electronics, science and medicine.
Karen Brakspear of EPSRC also said, “The EPSRC is dedicated to developing UK innovation by providing grants and funding for science and engineering research. 3DPRG’s work at The University of Nottingham continues to drive the capabilities additive manufacturing forward. We are pleased to be behind a team performing such ground-breaking research and look forward to its continued impact on not only the scientific community, but on the UK business, engineering and industrial communities.”
Photo Credits: 3DPRG
Type 1 diabetes is a condition wherein the pancreas does not produce insulin necessary for delivering sugar to the cells to be converted into energy. Most patients with Type 1 diabetes usually show signs of the disease when they are still in their youth.
To date, Type 1 diabetes patients use insulin therapy together with other treatments to manage their condition and live healthy and long lives. However, scientists may have the solution for Type 1 diabetes through 3D bioprinting.
Researchers from the University of Twente in the Netherlands were able to build scaffolds that will help improve the pancreatic islet transplantation through embedding the islets with a mixture of gelatin and alginate. This will serve as the material that will be implanted on the islets. The islets of Langerhans are part of the pancreas that is responsible for the production of insulin.
The new process developed was called bioplotting which allows the 3D structure optimum exchange of insulin and glucose. Dr. Aart an Apeldoorn – one of the co-authors of the study – noted that the scaffold can block antibodies that destroy the pancreas but it has a mesh large enough to allow the insulin molecules to diffuse through.
Laboratory results showed that the 3D printed islets as well as scaffolds are capable in performing the functions of the real islet cells. Moreover, they also provide protection against the response of the immune system considering that Type 1 diabetes is an autoimmune disease.
This research still has a long way to go but the researchers are really positive that it can help many people once they perfect the technology.
3D bioprinting is very significant in the field of medicine, industrial engineering, pharmacology and materials construction. This is the reason why researchers from the University of Nottingham created a bioprinted material that works seemingly like play dough. This material is capable of enabling protein and cell transfer.
Lead researcher of the study Professor Jing Yang said that 'bioprinting is a very hot topic in tissue engineering'. The problem is that the output requires a good printing environment and, currently, the bioprinted materials are not compatible with living cells; and if they are they don’t have enough properties for specific applications.
However, the new bioprinted material created by the researchers is a micro-particle paste that can be injected using the syringe. The new material can sustain strains and stress. Conventional bioprinting techniques involve the use of high heat or the use of strong organic solvents or ultraviolet light. The drawback to this technique is that it prevents the incorporation of the cells and other biomolecules during the fabrication process.
Since the new material was created using ambient temperature, it allows the materials to fuse together properly. Moreover, the cells and proteins can also work fast in fulfilling their specific functions. Currently, Yang and his research team are looking at the possibility of using the new material as an injectable bone defect filler. Aside from being a potential bone filler, the new material can also be used in creating biological scaffold to reconstruct larger defects such as nasal reconstruction. This new material looks very promising in medical reconstruction.
On my last post I gave an overview of the 3D printers I am currently using in our hospital program. Now I will be explaining the different software I have used from one time to another to go from 3D model to 3D print. The software I cover here is available as a free download or for under $500.
1. TinkerCAD: The first software I used was TinkerCAD. It is a web-based CAD design tool, Simply create a free account and start designing. The layout and menu's are simple and basic enough for beginners to naviagate. It offers many pre-made tools to use from adding letters to adding shapes. For creating designs in TinkerCAD it uses a combination of adding and subtracting shapes or using pre-made designs. The main tools I use are Align, Group, Ruler, and Cylinder. When finished you can download your designs for exporting to a 3D printer or use a 3rd party to print your design for you. For being a entry-level software I still use it to add connections between bones, and for simple movement between parts. Importing .stl files is an important function to use when creating files in other software and wanting to edit in TinkerCAD.
Use in Healthcare Applications: Adding custom connections between parts, creating simple frames and supports.
Pros: Simple design, easy to use, no software to download, free, always available online from any computer.
Cons: Pre-loaded shapes can be limiting for complex parts. Amazing results can be achieved with practice and time.
2. 123D Design: This software is part of the Autodesk family. This a free download, geared more towards users with some knowledge of CAD software. Where TinkerCAD requires the user to use shapes to make designs, in 123D you can create from scratch. This software is ideal for designing prototypes and those wanting to becoming more familiar with CAD software. I use 123D when I need more control than what is offered in TinkerCAD.
Use in Healthcare Applications: The software provides more customization than TinkerCAD. It allows for custom-made parts used in Rapid Prototyping Design.
Pros: Simple to use, free, great for learning CAD software.
Cons: Other software is capable of the same functions.
3. Autodesk Fusion360: I recently started using this software. As our 3D printing program grew I started to receive request to design prototypes based on drawings. Fusion360 has been my software of choice when creating prototypes. The software offers many tools from Sculpting, Combining, Importing Mesh, and Press & Pull, to name a few. I can spend countless post just discussing all the features available in Fusion360, best advice is to go use it. The online support is outstanding. Autodesk really has stood behind this product and helping the community, all my questions were answered within hours (during business hours) and customer support always provided screenshots or videos as well as the written steps. Fusion360 also has a new feature that will export directly to the printing software included or a 3rd party software, such as Preform, Simplify3d, Meshmixer, etc.
Use in Healthcare Applications: Designing prototypes, creating designs based off of patient scan data, creating a wide range of models from simple to complex, allows for online collaboration with your team.
Pros: Many features available, great online/community support, constant updates to software.
Cons: Cost associated with purchasing software (minimal)
4. Meshmixer: Another software from the Autodesk family that I use. This is a very powerful & valuable piece of free software to have when 3D printing. Meshmixer gives you control over many different aspects of your model, including Transform, Plane Cut, Sculpt, Analysis, and adding Supports. The Analysis function provides Slicing of your model, it will correct errors and prepare the model for 3D Printing. Meshmixer allows direct exporting to certain printers (*listed in Meshmixer). Using the Support feature allows you to define how supports will be generated. This software also allows you to add or remove supports that are generated by the software, a very useful feature when printing a patient specific model that is dependent on accuracy.
Use in Healthcare Applications: This software is a must-have. I use it to double-check for any slicing errors prior to printing. You can also sculpt organic models from scratch (see uterus)
Pros: Free. Many editing options available. Will help ensure more successful prints.
Cons: Although there are training guides and a community forum. The software can be overwhelming to a first time user. The best recommendation is to search forums and spend time using the software to become familiar with the available features.
There are many options available when choosing software to use. It is important to evaluate cost, ease of use, available functions, and capability with the 3D printers you will be using. Evaluate the goals of your 3D Printing Program to choose what combination of software you will need and use. Remember as most of the software featured here is free, spend time working with each one.
Links to software websites found Here
An added extra. Download a 3D Skull ready for Print Click Here
Written by David Escobar
Check out my site for more information 3DAdvantage.org
The 3D bioprinting company Organovo started mass producing functioning miniature models of the human liver more than a year ago. (Did you miss that news?) Pharmaceutical companies are all over the product and demand is high.
Each liver Organovo prints is about the size of the tip of a ball point pin. While they wouldn’t be much use for transplants, the livers are a great facsimile of the real deal, even taking on the roughly hexagonal shape that the cells in our livers also create.
But what could the world do with a bunch of tiny, functioning models of the human liver? Apparently, a whole lot.
A Boon for the Pharmaceutical Industry
Pharmaceutical companies have long been looking for ways to test experimental drugs on human tissue without accidentally killing anyone. With these new livers, they have the perfect opportunity.
Most often when drugs are recalled by the US Food and Drug Administration, it’s because they cause some kind of liver damage that was previously unknown to pharmacologists. Companies try to prevent these hiccups with thorough testing. In addition to testing drugs on animal tissue, they also traditionally test them with samples of living human hepatocyte cells, which are found in the liver and give an approximation of how the liver will react to the drugs. The only problem is that the cells only live for about 48 hours, so tests of the long-term effects of liver exposure to the drugs are impossible.
Organovo’s tiny livers solve that problem. These hexagonal structures can live for more than 42 days, functioning and producing proteins like a real liver. Suddenly, the most common reason for recalling drugs has a testable solution. Indeed, Organovo has already been able to detect the negative effects of a certain recalled drug with their liver models, something the hepatocyte cells alone never detected. If the livers had been available before, the drug would have never made it to market.
Organ Patches of the Future
The next step for Organovo is to figure out how to print out larger pieces of liver tissue, as well as for other organs. Their hope is that doctors will be able to graft their products onto the organs of sick patients. Animal tests are already in the works.
"If you could get to something large enough to get to, for example, 10 percent of an organ's function, it can significantly benefit the patient," says CEO Keith Murphy.
How It All Works
So what exactly goes into printing livers at Organovo? (That’s a sentence I never thought I’d type.) Well, the printer uses two bio-ink syringes, one filled with thousands of parenchymal liver cells and the other filled with non-parenchymal liver cells that promote cellular growth. Then computer software instructs the robotic arm of the printer to print the mold with intense precision. Sensors near the printer ensure that the cells are taking on the appropriate hexagonal shape. Once three hexagons are arranged on the printing tray like a honeycomb, the first syringe fills them with parenchymal cells. The printer is finished when 24 microtissues are created, each of them about 250 microns thick. Engineers then put the livers in an incubator, where the cells fuse into the complex structure of liver tissue. Voila! Tiny livers.
The burning question is, when are we going to start seeing full organs printed out?
“I believe that could happen in my life time,” said chief technology officer Sharon Presnell.
Photo Credits: PopularScience
Orbital hypertelorism is a disorder where there is an abnormal distance between the eyes. This is caused by the abnormal development of the bones in the forehead during infancy stage. This condition is often a syndrome of many diseases like Edwards disease and Loeys-Dietz syndrome.
Recently, an Indian-based company called Osteo3D created a solution for people suffering from this condition. Dr. Sathish Vasishta and Dr. Derick Mendonca from Sakra Hospital in Bangalore used a 3D printed model to plan a surgical procedure to treat this condition.
To correct the condition, it is important for doctors to remove the bone in the midline of the skull. To help doctors plan their next step, they created a 3D printed model of the patient’s skull. It helped the surgical team visualize the possible results in the operation.
The surgical team used the models to help them correct the anomaly of the orbital hypertelorism. The medical model allowed the doctors to practice the procedure before the operation thus they were able to reduce the risk of any possible infection to the patient and lessen the operating time. In fact, this difficult operation only took 7.5 hours for the doctors to complete.
The use of 3D printers is common in first world countries and what makes it exciting is that in an emerging nation such as India, this technology is already made available for doctors to use. With the success of the operation, it is no wonder why doctors and medical researchers are taking advantage of the vast potential of 3D printing.
3D printing is used in bioengineering patient compatible organs and cell structures but it is also used in the side of the pharmaceutical industry. A group of researchers from the University College London’s School of Pharmacy used 3D printing to explore the effects of geometry on the characteristics of drug release on pills and tablets. Their study aims to produce differently-shaped tablets that are difficult to create using traditional methods.
Traditional methods in creating tablets is fabrication. Researchers in this study indicated the importance of 3D printing in the mass production of tablets. A few months after publishing the findings, scientists were able to venture into making liquid-based tablets because they used 3D printers to create the tablets.
They hope that one day, doctors will be able to email their patients their medicine dosage that can be 3D printed using their home printers into a specific tablet right at the comforts of their home. Currently, they were able to print water-soluble form of plastic similar to dishwashing pods. In order to create the 3D printed tablets, the liquid drug is loaded into the plastic material which subsequently self absorbs to create the tablet with the predetermined shape.
Dr. Simon Gaisford, head of the School of Pharmaceutics at UCL, noted that it is possible in the future for patients to print their own medication using emailed prescriptions from their doctors as long as they have a 3D printer at home. With this technology, patients suffering from debilitating conditions don’t need to travel to get to a pharmacy in order to get their medications.
China has about 1.5 million patients who suffer from organ failure every year and only 10,000 of these patients get organ transplantation due to shortage of donor organs. According to Shanghai’s National Business Daily, 3D printing is a very promising technology that may help the organ transplantation shortage in China.
Chen Jiming, an engineering professor from Beijing University of Technology, noted that using 3D printing technology in the field of medicine is a long process thus the medical industry might need to wait for at least five years before 3D printing makes any significant progress. Problems like finding appropriate materials and developing printing equipment are one of the dilemmas that this technology is facing.
While it is too far to see 3D printer being used to create compatible organs for patients, 3D printers are widely used in China to create models of the affected body parts of patients so that doctors can observe as well as decide on how to deal with their patients’ condition. Although this may be the case, doctors and researchers are working non-stop to develop ways to use 3D printing in making organs for transplants.
In April of this year, Nepal suffered its worst natural disaster in more than 80 years. Two major earthquakes rocked the nation, leaving a death toll of more than 8,000 people and 15,000 injured. Nine out of every 10 schools were destroyed and countless homes and businesses were lost. Now, as the country attempts to restore what it can of people’s lives and livelihoods, the 3D printing community is taking unique and inspiring steps to help those who were injured by the devastation.
Arms for Amputees
Case-in-point is University of Victoria engineer Pranav Shrestha. A Nepalese citizen, he and his brother designed a prosthetic hand with a 3D printer, and have plans to distribute them out of an orthopedic hospital in Kathmandu, that their father co-founded.
Shrestha sees a considerable need globally, as 80% of amputees live in poor countries, and merely 2% of them are able to afford prosthetic devices.
Dr. Nikolai Dechev, who runs the project at the University of Victoria, hopes to make the prosthetics open source. Soon, the group will launch a crowdfunding campaign to help create printing stations in Nepal, as well as at sites in Guatemala.
Medical Supplies for Remote and Impoverished Areas
Field Ready is an organization with the goal of solving the difficulties of aid efforts in remote and impoverished areas. Their work was most recently a success in Haiti, using MakerBot 3D printers to create a range of medical supplies for when disaster strikes—such as umbilical cord clamps and prosthetic arms. Their efforts can be the next vital resource for relief in Nepal. With the help of Bold Machines, Field Ready has been looking for solutions for people who lose limbs in disasters. e-Nable is also a popular group of volunteers printing prosthetics, but they still face the issue of getting the limbs to the areas where they’re needed.
In an interview with 3DPrint.com, Robert Steiner, the General Manager of Bold Machines, said, “The primary goal was to have a fully 3D printed prosthetic hand that did not require any screws, nuts/bolts or tools to assemble (as those items could be impossible to source in remote areas). We used fabric strips and elastic bands cut from shorts for the testing. The secondary goal was to make the files accessible for development/design changes by others – so it could be improved and modified for specific needs.”
Fundraising and 3D Recreations
NEPAL: 3D RELIEF is another organization led by leading researchers in 3D printing technology, that has raised funds in support of on the ground NGOs working to provide food, shelter, and water to displaced people. In an innovate approach to relief effort, they are also recreated affected areas as 3D models, providing valuable information about which ares were most affected by the earthquake.
“Specifically, we are building 3D recreations of Kathmandu, the earthquake and its aftermath, as well as generating 3D models of the most affected areas, the people, and debris,” wrote NEPAL: 3D RELIEF leader Jang Hee I.
While these examples only scrape the surface of how the 3D printing community is pioneering relief effort methods, they demonstrate a wide range of strategies aimed at using a fast, cheap and precise technology to improve lives after devastation.
The medical application of 3D printing has been profound over the years. One of the breakthroughs involving this technology was the successful skull transplantation conducted by doctors from the Universidade Estadual de Campinas in Brazil.
The first ever surgical procedure involving 3D printing technology, doctors transplanted a 3D printed titanium skull on a 23-year old patient suffering from a horrible head fracture that left a 12 cm hole across her skull. Without this medical intervention, the patient suffered from aches as well as pains throughout her body.
The patient’s family couldn’t afford conventional face prosthetics. Thus the researchers, led by Professor Paul Kharmandayan, worked on developing the prosthetics using 3D printer. He mentioned that while 3D printing has been phenomenal in other countries, it is not yet a popular option in Brazil. This first skull implant is a breakthrough because the researchers used domestic resources to create the implant.
Doctors used imaging scans of the patient’s head to study her condition. Moreover, they used the images created from CT scan, MRI and X-ray to fashion a skull transplant specific to the dimensions and morphology of the patient’s skull. The artificial skull was printed using both resin and titanium. The titanium implant was used to cover the hole on the patient’s head while the resin implant was used by doctors as a model to help them prepare for the surgery. The operation was a complete success and the patient showed signs of recovery after a week.
In order to help with choosing a 3D Printer for use in a Hospital 3d Printing Program i will be discussing the printers i currently use and how i use each one. All of the printers cost less then $5,000, which makes them affordable and avoids becoming a capital purchase.
Makerbot Replicator 2
Skull on Makerbot Replicator 2
This printer was our first purchase when starting a 3D program. Overall the Replicator 2 is a very reliable and low cost option for beginning users. The printer only prints PLA out of the box, but can be modified to use other materials such as flexible filament. PLA comes in many different colors. The PLA is very affordable, which makes this printer for printing prototypes and supports are simple to remove. The printer does require user maintenance periodically. The printer also requires manual calibration and build plate leveling.
Our primary use for this printer has been for rapid prototyping and presentations. For pre-surgical planning our Physicians requested clear printed models. The Replicator 2 can print in a Natural filament, however it did not meet the needs of the physicians.
My only issues using this printer has been filament spool jams and occasional leveling. Makerbot desktop provides many customization options for infill, speed, temp, resolution, to name a few.
Build Volume: 11.2 L x 6.0 W x 6.1 H in
Materials: PLA, *other materials available with modification to the printer
Best Uses: Rapid Prototyping, Color Models, Bones (Infill % can be customized)
Makerbot Replicator 2x
Makerbot Replicator 2X
The 2x was the second printer we added. I wanted a duel nozzle printer with the added benefits of new materials. With the addition of this printer we added ABS, Flexible, and Dissolvable filaments. This printer was my first experience with using a heated build plate and the new materials. Adding a printer with dual nozzles can add some challenges to overcome such as leveling the nozzles. Since this printer has been around for several years, there are many great tips & tricks available to someone just starting. I also increase successful prints by adding glue to the build plate. We use this printer for the same purposes as the Replicator 2, but with greater flexibility in materials and multiple colors.
Just like the Replicator 2, the same maintenance and setup applies.
We have added Simplify3d software to our library which has added greater function and customization to our Makerbot printers.
Build Volume: 9.7 L x 6.0 W x 6.1 H in
Materials: ABS, PLA, Flexible, Dissolvable
Best Uses: Rapid Prototyping, Color Models, Bones (Infill % can be customized)
The Formlabs 1+ by far has been the strongest & most reliable printer we have purchased. It has help our program grow substantially, by allowing the prints to be clear, flexible and extremely durable, which has helped our research program use our models. This is the only SLA printer we have. The printer is simple to use and requires almost no setup, as no calibration is needed. I was printing within 15 minutes of turning the printer on for the first time. I use this printer for about 90% of the anatomical prints from patient CT/MRI data. The Preform software is easy to use and offers customization options, such as turning internal supports on or off. This is an important feature when printing accurate models of vessels or internal structures of the heart.
I have had a 99% success rate when using this printer. The main difference for use is using resin instead of spools of filament. The resin can be a bit messy but cleans with little effort.
Build Volume: 4.9 L x 4.9 W x 6.5 H in
Materials: Resin-White, Black, Grey, Clear, Flexible, Castable
Best Uses: Soft tissue and vessels, Heart values, Bones, Solid models, Clear models
Unboxing the CubePro Duo
Our newest addition to the center. We required a printer with a big build volume and offered multiple materials to be used. The printer can use PLA, ABS, and soon Nylon. The printer has a big build volume for the price range. The filament come in cartridges purchased from 3dSystems, so using 3rd party vendors for materials in not an option. The closed system does limit customization for pre-printing setup. It currently does not work directly with Simplify3d.
This printer has required more user maintenance and setup compared to the other printers i use. The Z-Gap calibration can be very confusing as well as the lack of a direct connection to the printer ( print files are transferred via USB or Wifi) The supports generated are very weak and tend to fail very often resulting in failed prints. Although the printer has some obstacles to overcome it is capable of producing great prints.
Build Volume: 11.2 L x 10.6 W x 9.06 H in
Materials: PLA, ABS, Nylon* (*coming soon)
Best Uses: Production quality prints. Multiple color & materials prints, Sterilizable prototypes
Written by David Escobar
Want to learn more, please visit my site 3dAdvantage.org
Follow me on twitter @descobar3d
In an Australia first, surgeons in Melbourne have successfully replaced a man’s lower jaw with a custom designed, 3D-printed prosthetic.
Thirty-two-year-old Richard Stratton was the self-named ‘patient X’ for an experimental joint design. Stratton had grown with an underdeveloped lower jaw, but it never caused any problems until the last few years. Pain while chewing, headaches and difficulty opening his mouth caused him to seek out a maxillofical surgeon to address the problem. At one point, he couldn’t even open his mouth wide enough to insert a fork.
A Custom Prosthesis for a Custom Problem
Oral surgeon Dr. George Dimitroulis was able to design and test a new prosthesis with the help of Melbourne University’s mechanical engineering department. While there have been a few successful 3D-printed jaw surgeries to date, this was the first one utilizing a titanium part. The part was a pivotal aspect of the design—protecting the cranial cavity from a joint that would wear on the skull.
The titanium joint was made with powder, which technicians heated and fused layer by layer as they printed it. The team at Melbourne also CT scanned Stratton’s skull and printed a model in order to adjust the titanium joint to perfection. Then to cover all their bases, they ran computer models of the type of movements Stratton would make while chewing to ensure the durability of the prosthesis.
Successful Surgery and Recovery
The customized joint was successfully attached to Stratton’s jaw during a five-hour surgery last month. Now, he can already open his mouth wider than before, and his physiotherapist believes his jaw articulation is better than that of similar patients who received a different type of surgery.
"They have a 3D model of my skull and the fact that they've made the joint to fit that perfectly, I feel a lot safer in knowing that it's not just a factory made, off-the-shelf joint,” said Stratton.
He also hopes that the precision and care that went into making the joint will result in a shorter recovery for him and greater longevity for the prosthetic.
Dr. Dimitroulis is proud of the care that went into designing and personalizing the joint to Stratton’s needs. "It really makes the fit truly patient-fitted, truly customized, as opposed to 'we're close enough' and it's something that I think will become the norm in the future…”
The accomplishment is also a boon for Australia and jaw prosthesis research in general. As the joint was designed in Australia and printed by Port Melbourne’s 3D Medical, an Australian 3D-printing firm, it’s a great example of “smart Australia,” according to Dr. Dimitroulis.
He also believes that the new technology will offer a lot to people in the rest of the world. ”We are at the crossroads of an exciting era, where an increased use of 3D technology will see customized medical devices become an integral part of healthcare," he said.
It would seem that an end to animal testing by cosmetic companies is in our sights, as French cosmetics giant L’Oreal announces plans to 3D Print human skin. What comes as news to many is that the company has actually been in the business of growing human skin since the early ’80s, and a new partnership with Organovo is only the latest step to fast-track the production of skin samples for cosmetic testing.
L’Oreal runs a lab out of Lyon, France where they currently grow human skin from incubated cells that were donated by surgical patients. Called Episkin, the skin ‘product’ is patented and often sold to other pharmacology and cosmetic companies. L’Oreal grows the skin cells in collagen, then artificially exposes them to air and UV light to replicate aging. The goal is to create unique samples to help the company accurately predict how different types of skin react to their products.
The process requires 60 scientists to develop 100,000 samples in a year. They cultivate them to mimic nine varieties of age and ethnicity so the company can optimize their products for specific skin types. It’s pretty expensive, costing around $70 per sample.
A Partnership on the Move
The new collaboration with Organovo, a bioprinting company based in San Diego, will hopefully help expedite the production of epidermis and eventually reduce cost. The 3D bioprinters will print small skin samples into nickel-sized petri dishes on an assembly line, allowing L’Oreal to do even more accurate testing with more ‘test subjects.’
"Some of the biggest potential advantages are the speed of production as well as the level of precision that 3-D printing can achieve," said Guive Balooch, global vice president of L'Oreal's technology incubator. "L’Oreal’s focus right now is not to increase the quantity of skin we produce but instead to continue to build on the accuracy and consistent replication of the skin engineering process."
The new technology will do more than improve cosmetic testing and all but eliminate the need for animal testing—it will also make strides in the medical field, such as burn care. Traditionally, skin grafts are made by applying a small section of healthy skin over the burn and letting it grow over the injury. For large burns, it’s not practical to take large amounts of skin from another part of the body to make a graft. If researchers at the Wake Forest Institute can accurately produce the cell structure of human skin, they could reproduce a patient’s skin using a sample 1/10th the size of the burn.
Organovo appears to be a bioprinting company to watch, as it has also recently partnered with Merck to 3D print liver tissue to test drugs. Eventually, the company plans to develop fully functioning organs. If it works well, the technology may also herald an end to animal testing for pharmaceutical companies as well.
Balooch for one, is incredibly excited about the potential of the technology, calling it “boundless.”
Photo Credits: BBC and Wired
Summary: 3D printing is making rapid advances in many areas of medical treatment. In this article, I'll describe how I used recent advances in 3D printing to save a patient from having to have her spleen removed. In the process I broke some new ground in use of 3D printing in surgical planning. The clinical case and 3D printing advances are described in a recently published peer-reviewed paper in the medical journal Diagnostic and Interventional Radiology.
Intro image: The author using 3D printed vascular models in the OR.
A clinical conundrum I am a board-certified interventional radiologist, and specialize in the minimally-invasive treatment of vascular (involving blood vessels) disorders. My adventure in 3D printing started when a very nice 62-year-old lady was referred to me by another doctor. A CT scan done for another reason had incidentally detected aneurysms in her splenic artery. The splenic artery is the major artery going to the spleen. An aneurysm is a bulging of the artery wall. Aneurysms are dangerous because as they grow they stretch the artery wall, causing it to thin. Like a balloon, the more the aneurysm stretches, the thinner the artery wall becomes, until the wall is too thin to hold back the pressure of the blood and the aneurysm bursts. This can lead to sudden, acute, life-threatening internal bleeding.
Figure 1. Examples of aneurysms. The thin, stretched out walls of the aneurysm predispose it to rupture. The larger the aneurysm, the greater the risk of rupture and bleeding. Source Drugline.org.
Medical convention states that when a splenic artery aneurysm is 2 cm or larger, it is at risk for rupture and should be treated. My patient had two aneurysms in her splenic artery, each of which was 2 cm in size. Something needed to be done. A third, smaller aneurysm was also present but it didn't need to be treated at this time. The conventional treatment in this situation is a surgical splenectomy, in which a surgeon, either in an open fashion or laparoscopically, physically removes the splenic artery with its aneurysms. Because the spleen cannot survive without its artery, it must be taken out too. The spleen plays a critical role in the body's ability to fight infections, so after removal of the spleen, patients are at higher risk for certain infections.
Video 1. Digital rendering showing the two large splenic artery aneurysms arising from the splenic artery. The aneurysm are the sphere-like bulges arising from a small artery in the middle of the aorta. The large trunk is the abdominal aorta. Rendering done with Blender.
An alternative treatment to surgical removal is splenic artery embolization. In this procedure, a vascular surgeon or interventional radiologist, such as myself, will make a needle puncture in the artery of the hip and navigate a small plastic tube, called a catheter, into the splenic artery using x-ray guidance. A series of small metallic threads, called coils because they coil up once deployed, are then pushed through the catheter into the splenic artery, where they plug up the entire artery. In principle, the technique is similar to putting hair down your bathroom drain. The hair takes up space and eventually plugs the pipe. In the same way, fine thread-like platinum coils can be pushed into the artery one at a time until the artery is plugged up. Any blood in the artery clots, and without any blood flow there is no pressure on the aneurysm wall and thus no risk of the aneurysms rupturing. Unfortunately, the lack of blood flow also causes the spleen to die from insufficient oxygen. The process of the spleen dying from lack of blood flow results in pain for a day or two. Also, without a functional spleen, these patients also are at higher risk for infections.
My patient was a very intelligent and determined individual. I explained both options to her in detail, but she would not accept either of the conventional treatments. She did not want to lose her spleen and be at increased risk of future infections. She challenged me to find a way to treat her aneurysms while saving her spleen. I reviewed the case and imaging studies with several of my colleagues, all board-certified specialists in treating this type of problem. Everybody said the spleen couldn't be saved. It was "impossible." She either had to have her spleen removed or her splenic artery embolized. Do nothing and it was just a matter of time until an aneurysm ruptured, probably killing her. I was greatly moved by my patient's doggedness. She wasn't willing to accept the limits of conventional medical treatment, so I didn't think I should either. I kept searching for solutions.
I was aware of some specialized catheter equipment that had been specifically designed to treat aneurysms in the brain. Brain aneurysm treatments are very delicate affairs. If an aneurysm in the brain ruptures, it can result in intracranial bleeding, stroke, permanent disability, or death. Brain aneurysms can be treated with placement of metallic coils through a catheter, as long as the coils are only placed in the bulging, aneurysmal part of the artery. There, they cause blood to clot in the aneurysm, which reduces pressure on the aneurysm wall and prevents it from rupturing. These special coils and catheters are designed to treat the aneurysm while preserving blood flow in the parent artery. Because these aneurysms are in the brain, any disruption in the blood flow of the parent artery will result in stroke.
Figure 2: How coils can be used to treat aneurysms in the brain. Using specialized equipment designed for the brain, coils are used to pack the aneurysm while preserving blood flow in the parent artery. (Image source: wix.com)
Could the specialized coils and catheters designed to treat aneurysms in the brain work in the splenic artery? Nobody seemed to know. The patient's splenic artery had an unusually large number of loops, which would complicate any procedure. A search of the published medical literature did not produce any useful results. There were many variables that were different. I discussed my thoughts with the patient. I thought there might be a way to treat her aneurysms while sparing her spleen using this specialized brain aneurysm equipment. But the only way to know if the equipment would work would be to try it during an actual procedure. She gave me a puzzled look. "Well isn't there a way for you to practice?," she said.
For generations doctors faced with difficult and complex surgical procedures have really had only one true way to know if they will work: try it in a real surgery. We do everything possible to maximize our chance of success, such as ordering scans, consulting colleagues, reading research articles, and imagining the procedure over and over again in our heads. We try to know everything possible about the intended surgical procedure beforehand. But, the only way to truly know how things will go is to actually do it. There really wasn't any way to know how the brain catheter equipment would work in the spleen because nobody had ever done a procedure quite like this before. Yet, I kept thinking about my patient's statement. Why wasn't there a way for me to practice this beforehand?
Finding a solution with 3D printing At that point I had been looking into uses for 3D printing in medicine for about a year. There seemed to be great potential, but at the time few people were using 3D printing in real patient care. I had designed a few simple 3D printable body parts from medical imaging scans. Would it be possible to 3D print a replica of my patient's splenic artery, and practice doing this complex procedure in the 3D printed model? I had never 3D printed an arterial structure of such complexity. Another search of the medical literature revealed that nobody else had either. I was further hampered by the fact that as a private practice doctor, I don't have access to an expensive 3D printer or the costly proprietary software that is needed to create complex 3D printable anatomic models. Nobody was paying me for my time or expenses. I needed to find a solution that was practical but inexpensive.
I invested hundreds of hours testing free and open source software packages to see if they could be used to generate the detailed 3D printed splenic artery model I needed. I eventually found that a combination of the software packages Osirix and Blender, the latter of which is typically used for computer animation, would allow me to design a detailed anatomic model from my patient's CT scan. I could then use the low-cost online 3D printing services Shapeways and iMaterialise to actually print my models. I paid for everything out-of-pocket. When the models arrived in the mail I couldn't believe it. They were precise full-scale replicas of the patient's splenic artery.
Figure 3: A precise 3D printed replica of the patient's splenic artery. I contacted representatives from the companies that manufactured the brain aneurysm equipment. They had never heard of anybody testing their equipment in a 3D printed model before, but enthusiastically supported it. They donated real guidewires, catheters, stents, and coils for use in testing. Several came over to my house and we replicated the entire procedure inside the 3D model. During this testing I learned that some of catheters and wires would work well in the complex curves of the patient's splenic artery, and others would not. I was able to get all of the trial and error done in the model, something that otherwise would have taken place during the actual procedure. The model wasn't exactly the same as a real patient, but I was able to learn a lot about how the catheters and wires handled in the complex and unique geometry of the patient's splenic artery.
Video 2: Time-lapse footage of endovascular wire and catheter testing in the 3D printed model. Numerous problems were encountered with the difficult geometry of the splenic artery, but with trial-and-error a combination of wires and catheters was found that could handle the difficult geometry.
With the optimal set of catheters, wires, stents, and coils preselected, I subsequently did the real procedure on the patient. I completed all the necessary paperwork including getting approval from my hospital's research review board. I brought the 3D models into the operating room as a reference, and referred to them many times during the procedure. All of the preselected equipment worked beautifully, just as it had in testing. I was successful in putting coils in the aneurysms while preserving blood flow to the spleen. Even without having to try out different equipment combinations, the procedure was still very difficult and took five hours. If I hadn't had the ability to practice the procedure in the 3D printed model and preselect my equipment, it easily could have taken twice as long. That is, assuming I didn't collapse from exhaustion and dehydration before finishing it. More importantly, the opportunity to practice the procedure beforehand gave me confidence that I could be safe and successful in doing something that had never been done before. Nearly 2 years after the surgery, the aneurysms no longer a threat and the patient's spleen is fully functioning.
Figure 4: Referring to the 3D printed models in the OR during the surgical procedure to correct the splenic artery aneurysms.
Figure 5: positioning a small catheter into the splenic artery via a needle puncture in the arm.
3D Printing Lessons Learned This experience fundamentally changed my perception about the value of 3D printing in medicine. For safe, easy, and routine medical procedures, 3D printing will probably not have much of an impact in the foreseeable future. It's too time consuming and costly to make 3D printed models. For complicated or high risk procedures, however, it can be invaluable. No doctor wants to take unnecessary risks or have a bad outcome in surgery. Unfortunately, there are many, many unknowns in surgery, particularly with complex and unusual cases. 3D printing an anatomic model before surgery to study and practice reduces those unknown variables, making risky cases much safer. After my experience, I have no doubt that 3D printing will have a significant impact in improving patient care in all fields of medicine.
It is my belief in the potential of 3D printing to help doctors and patients that led me to the creation of this website, Embodi3D.com. Embodi3D is a place where 3D printing enthusiasts can help each other in all fields of biomedical sciences. Members can read medical 3D printing news, ask technical questions in the forums, and even download complete 3D printable medical models from the File Vault. There are several tutorials on how to start 3D printing medical models yourself. Everything on the website is free. I ask only that you give back to the community through comments, advice, and sharing of 3D models, if you are able.
Below are two 3D printable models used in actual testing. You can download the models yourself for free.
Download the FREE solid, splenic artery aneurysm lumen model. This is the solid model that shows the hollow space inside the artery (the lumen).
Download the FREE hollow splenic artery aneurysm model. This is the hollow model that the catheters and wires were tested in.
You can read the official peer-reviewed account of this 3D printing advance in the medical research journal Diagnostic and Interventional Radiology here.
If you liked this article, please share it with your friends! Tweet ⇒ https://goo.gl/cq1IQC ⇐ Post to FB⇒ https://goo.gl/VocYWp ⇐ Twitter: https://twitter.com/Embodi3D Facebook: https://www.facebook.com/embodi3d LinkedIn: https://www.linkedin...ompany/embodi3d YouTube: http://goo.gl/O7oZ2q
Other Free STL Downloads
A Collection of Free Downloadable STL Skulls for you to 3D print yourself.
3D printable human heart in stackable slices, shows amazing internal anatomy.
A Collection of Spine STL files to download and 3D print.
People with even a mild interest in 3D printing are aware of the benefits of technology for medical research and advancement. Though most people are less aware of the ever-increasing uses of 3D modeling and printing for scientific research as a whole. Sure, science stories don’t give you the same warm fuzzy feelings you get when you hear about how 3D printing has helped saved a baby’s life or gave a double amputee some new legs, but it is still exciting to learn how much the technology has contributed to the pursuit of knowledge.
One such example comes from Mark Hauber and colleagues of Hunter College in New York, who just this week published new findings of egg-rejection behavior with wild birds in PeerJ. The study uses a completely novel method for creating fake eggs for the experiments—3D printing.
The Research Question
In the natural world, birds have very unique reproductive behavior, which has drawn the interest of scientists since the 1960’s. Cowbirds, for example, are considered ‘brood parasites,’ because they lay their eggs in other birds’ nests in hopes they will take over responsibility for them. One of the common species that ends up with cowbird eggs in their nests are robins. Robin’s don’t want to waste energy caring for eggs that aren’t theirs, so when they’re able to recognize the speckled eggs of cowbirds in their nests, they chuck them out. What scientists want to know is how robins are sometimes able to identify the intruders, but at other times they go unnoticed.
Fake Eggs for Research
Scientists have been using artificial eggs to study the behavior of brood parasites for decades, but the quality of the impostor eggs have created some problems. For one, researchers most often have to make the eggs themselves from wood clay or some kind of plaster, and then spend hours hand-painting them to look as authentic as possible. This method causes researchers to create a lot of fake eggs that are unique from each other in terms of size, shape, color, and texture. The variety creates problems in replicating research.
3D Printing the Perfect Egg
Hauber and his colleagues were able to design and print identical imitation eggs for their research using Blender Foundation’s open-source 3D graphics. This solved nearly all the issues described above, and makes it easy for them to share the exact egg specifications with other researchers who wish to replicate their study.
With the identical eggs, Hauber’s team was able to conclude that robins were more concerned with color than anything else when deciding whether or not to chuck an egg. The researchers still hand-painted the identical eggs (the 3D-printed coloring is not quite up to snuff yet), and they found that a blue egg stayed in the nest 100% of the time while beige eggs were often kicked out.
According to Christie Riehl, a Princeton biologist interested in the study, ”With 3-D printing, it's the possibility of being able to make exactly what you want. And not only that, but you can share those designs with other researchers so they can replicate your results with exactly the same methods."
Photo Credit: Mark Hauber via NPR
3D printing is very helpful in the field of medicine. In fact, many hospitals from different countries in Europe are now using 3D printing to create human bones used in bone surgery. The Japanese company, Next 21, is behind the endeavor of developing artificial bone graphs using 3D printing. It aims to replace the methods of traditional bone grafting that does not only take a lot of time but also effort and money.
The technology developed by Next 21 is called CT-Bone where the CT scans of the patient’s bones are taken in order to determine the size and shape of the bone that will be needed for the operation. The artificial human bones are printed using inkjet 3D printing process.
Researchers from the University of Tokyo originally developed this technology but has been licensed to next 21 since the 30th of April this year. So what makes the 3D printed bone better than traditional bone grafting? It does not use heat thus it promotes faster fusion to the patient’s bone thus healing time is cut in half. This technology is also less prone to infection and bodily rejections because it is made from inert materials, unlike conventional bone grafting.
The 3D printers used for this technology are able to print accurately thus making the synthetic bones fit on a patient to patient level. Currently, many European countries are using this innovation in their hospitals and it likely that it will reach the shores of other countries soon.
3D printing technology has made it possible for people to create human organs in reality. There are now many 3D printing companies that have invested in technology to improve the field of medical technology. One such company is CELLINK which created a universal bioink aimed at printing live and functional human tissue models.
Each day, more than 20 patients die while waiting for an organ transplant. With the revolutionary bioink from CELLINK, it is possible to manufacture “donor” organs artificially. However, in order to create functional organs, it is important for researchers to use a biocompatible substance to print successful organs.
The problem with most bioprinters is that they have different set-ups and configurations thus using a universal bioink can be a problem. Current bioprinters work in such a way that it needs two extruders for laying the bioink and laying the cells to the ink. Conventional bioinks serve as the substrates for the cells to grow onto.
However, the bioink developed by CELLINK is basically a special type of living ink that is made available for a wide range of 3D bioprinters. The cells and the bioink are mixed together thus only a single nozzle is required to create the organ. It is s a stand-alone product that can be used to revolutionize experimental cell culturing using 3D printing technology. To test the efficacy of the bioink, CELLINK first tested the new product by printing miniature ears. However, they are looking on ways to expand the technology to be able to print more organs.
Type 1 diabetes has long been considered a life-changing illness, with treatments geared towards detection and management. While a cure for the illness is still considered to be a long way off, the 3D printing method of bioplotting may offer patients a new treatment option that could ease diabetes management and improve the quality of life for many. Researchers have 3D printed a structure that helps protect insulin-generating cells that are implanted into the pancreas. Here’s why that's important.
For those of us who don’t have a type 1 diabetic among our friends and family, we might onlyy know to give someone who is hypoglycemic a glass of orange juice and then call someone who actually knows what’s going on. Hypoglycemia happens when a type 1 diabetic’s glucose levels get too low. It can cause dizziness and sweating in the beginning; if not addressed, it can lead to the person passing out or even dying. About one third of type 1 diabetics suffer from hypoglycemia.
One treatment option available to type 1 diabetics to reduce the instances of hypoglycemia is to undergo pancreatic islet transplantation. Clusters of cells are translated from the pancreas of a healthy volunteer into the person with diabetes. It’s an effective treatment, but a common and uncomfortable side effect is attack on the foreign cells by the patient’s immune system. Patients then must take consistent doses of immunosuppressant drugs to prevent the body from rejecting and attacking the donor cells. Now, a new option is available ti protect these cells, thanks to research in 3D printing.
3D Printed Scaffolding
Dr. AA van Apeidoorn and colleagues of the University of Twente just published groundbreaking research in the journal Institute of Physics. They developed a type of 3D printed scaffolding that can protect the cells from the body’s immune system, and giving them a better chance of functioning properly once in the body.
So far, the scaffolds haven’t made it out of the petri dish, but still the results are promising. Researchers tested the scaffolding around islet cells in the lab, and found that cells with the scaffolding were just as functional and able to do their job as those without it. Since the scaffolding doesn’t appear to affect how well the cells function, it may become a safe alternative to immunosuppressant drugs to protect these cells.
Co-author Dr. van Apeidoorn said in the paper, ”If we are to improve the success of this treatment for type 1 diabetes, we need to create an implant in which islets are embedded, or encapsulated, from a material that allows for very efficient oxygen and nutrient supply, and quick exchange of glucose and insulin, while keeping the host cells out.”
Although it’s too early to tell how or when type 1 diabetics might be able to benefit from the bioplotted scaffolding in clinical trials, the researchers are eager to take the research to the next stage.
"Our future research will look further into recreating an optimal islet microenvironment to provide the donor islets with the best transplantation start possible," said van Apeidoorn.
Photo Credits: 3ders.org
3D printing is no longer restricted to creating 3D surgical models. Recently, this technology is used to create helpful medical devices to alleviate patients suffering from different conditions. One of the recent innovations in 3D printing technology was spearheaded by researchers from the University of Michigan. The researchers were able to create customized CPAP or respiratory masks to help improve the condition of patients suffering from breathing inefficiency.
This 3D printed medical device is geared towards young patients suffering from craniofacial anomalies such as the Teacher Collins Syndrome wherein kids also likely suffer from sleep apnea. Traditional surgical solutions are not yet available to young patients thus they need to use a CPAP mask to help them breathe properly while sleeping. Unfortunately, conventional CPAP masks are geared towards adult patients thus leaks and discomfort often happen if young patients use them.
To create the 3D printed CPAP mask, researchers use 3D photography interfaces to create the 3D model of a patient’s face. The model is then used as a basis to create a mask that is appropriate for the contours of a patient’s face. The mask is created from silicon which is ejected by Stratasys 3D printers.
The new 3D printed CPAP masks improved the breathing of young patients. It is expected that young patients suffering from breathing problems will have better chances of improving their lives by using customized 3D printed CPAP masks. This innovation goes to show that 3D printing has a very promising role in the improvement of the medical industry.
I have received several requests for spine STL files from CT scans and these files have been added to the file vault over time as more people are 3D printing vertebrae for medical moldeling. There was a really good response to my last article about the wonderful 3D printable skull models available for free download on the embodi3D.com website. So, I've decided to do another article about spine models.
Embodi3D.com contains a large collection of spine STL files within the Spine and Pelvis category of the Downloads area. These 3D printable files are available for download by registering an account. The vast majority of files are available for free download.
The spine is a very complicated anatomic structure. Some spinal bones, or vertebrae, are designed for flexibility, as in the cervical spine in the neck. Others are designed to support ribs, as in the thoracic spine in the chest. The lumbar spine, in the low back, has large, hearty vertebra that are designed to bear weight. The spine is the focus of many maladies, and a good anatomic understanding of the spine is needed before disease processes and their treatments can be fully understood.
I personally do many procedures on the spine. A few include lumbar punctures, epidural steroid injections, selective nerve root blocks, vertebroplasty, kyphoplasty, myelograms, lumbar drain placements, chemotherapy infusions, and biopsies of all kinds. Anatomy can be learned with books or pictures, but there is nothing quite like holding a 3D printed medical model in your hands to make that anatomy "click." 3D printed spine models can help teach spinal anatomy to all levels of students, from grade school to med school. To help others find the best medical models, I have put together a collection of the best 3D printable spine models available for free download on Embodi3D. I hope you find this collection useful and interesting.
Lumbar Spine STL Files from CT Scans
Whole lumbar spine and sacrum
L3 Lumbar vertebra
Another L3 Lumbar vertebra
L4 Lumbar vertebra
Lumbar spine wedge compression fracture
Thoracic Spine STL Files For 3D Printing
Whole thoracic spine
Cervical Spine STL Files For Medical Models
Whole cervical spine
Whole cervical spine with skull base
C1 (atlas) vertebra
A lot of remarkable applications of 3D printing are discovered each day, and one of the latest innovations were used by Chinese surgeons to conduct a delicate spinal surgery. Doctors from the Orthopaedic Hospital in Zhengzhou China treated a 28-year old patient suffering from a condition called atlantoaxial dislocation which causes the nerves near the end of her spinal cord to compress which leads to the inability of movement and lack of feeling on her extremities.
As the spinal cord is considered as the most delicate areas to operate on, a small mistake made by the surgeons could be catastrophic towards the patient. The patient can become quadriplegic (inability to move both hands and legs) or the patient may succumb to death in the middle of the operation.
However, the doctors ensured that the patient is in great hands by practicing first on a spinal model of the patient’s actual spine. Using the images obtained from the X-ray and CT scan data, the surgeons were able to print an accurate 3D model of the patient’s spine. This allowed the surgeons to practice on freeing the soft tissue from the affected area, reset the dislocation and also screw everything back without damaging the patient’s spinal cord.
Doctors were successful in conducting the surgery and the patient is reported to be recovering with significant improvement a few months after the operation. Thanks to 3D printing, surgeons are now able to perform difficult surgical procedures without putting their patient’s lives at risk. Hopefully, 3D printing will be used to create surgical models to treat diseases that are difficult to operate on.
3D bioprinting proves to be an indispensable technology in the field of medical research. Aside from creating precise medical models and prosthetics, it is now used to help improve the lives of patients suffering from different conditions.
Researchers from Michigan Technological University see the potential of using 3D bioprinters in synthesizing nerve tissues. Researchers are investigating the appropriate “bioink” to create printable tissues including nerve cells. The bioink is a nanotechnology material that can aid in the regeneration of damaged nerves for patients suffering from injuries in the spinal cord.
Professor Tolou Shokuhfar, a professor of mechanical and biomedical engineering at MTU, describes the new bioprinter as a small device that can change the image of medical science and research. The printer looks like an oven toaster with all of its sides removable. The metal frame is lit by ultraviolet light that can print bioinks at precise amounts.
Currently, the team of researchers were able to create nerve cells as their target specimen. The reason for this is that unlike conventional cells, nerve cells do not regenerate once they die or get damaged. Every year, people loose thousand or even millions or nerve cells until they get older. Creating synthetic nerve cells provide a promising future in neurosurgery. Aside from treating spinal cord injuries, it can also be used in treating brain anomalies like Alzheimer’s or Parkinson disease. Once this procedure is perfected, Professor Shokuhfar and his team are also looking into targeting bigger tissues like kidneys and the heart in the future.
The Coalition for Imaging and Bioengineering Research (CIBR) is a dedicated partnership of academic radiology departments, patient advocacy groups, and industry with the mission of enhancing patient care through advances in Biomedical Imaging. My good friend and colleague Dr. Beth Ripley and I recently participated in the sixth annual Medical Technology Showcase at Capitol Hill organized by CIBR, representing the Department of Radiology at the Brigham and Women’s Hospital (BWH) where we emphasized the importance of 3D printing in healthcare.
The annual Medical Technology showcase aims to bring examples of medical breakthroughs in imaging and bioengineering to members of congress and demonstrate how these advances are impacting patient care. In addition to educating policy makers and the public about innovative imaging technology, the event demonstrates the value of NIH funded academic research and the importance of collaborations between academia, industry and patient advocacy groups.
Our display booth comprised of the Department of Radiology at BWH, the Lung Cancer Alliance, and Fujifilm was a hit among attendees and we were pleased to see the level of interest in medical 3D printing. We displayed 3D printed models that have been used for different clinical applications and our booth partners from Fujifilm demonstrated Synapse 3D, a software that allows conversion of 2D image data from CT/MRI into 3D printable files.
Our goal was to demonstrate the importance of 3D printing in pre-surgical planning and how it can benefit patients by allowing surgeons to devise a patient specific treatment strategy and minimize post-surgical complications. Sheila Ross, a lung cancer survivor and patient advocate from the Lung Cancer Alliance emphasized how 3D printed models can give patients and their families a better understanding of the planned procedure.
A lung model from Fujifilm demonstrating a nodule (green) and surrounding bronchioles
The Lung & Brain cookies might have been slightly more popular than our 3D models
It is our hope that more funding and resources will be allocated to investigate innovative medical technologies such as 3D printing, which can then be translated to impact patient care. In order to transform 3D printing from being a fad, to a mainstream tool that fosters precision medicine, evidence based benefits of its different applications will need to be demonstrated in clinical trials which will require funding.
Tatiana Kelil, MD