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Musings about biomedical 3D printing

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Invasive Heart Surgery Avoided as Advances in 3D Printing Improve Safety of Transcatheter Aortic Valve Replacement (TAVR)

3D printing is revolutionizing the treatment of aortic stenosis, as reported by researchers from St. Joseph's Hospital in Phoenix, Arizona and presented at the 2014 Radiological Society of North American (RSNA) meeting. Aortic stenosis is a deadly condition where the valve that connects the heart to the aorta does not open properly. The aortic valve, as it is called, is designed to open freely to allow blood pumped from the heart to move in a forward direction into the aorta, the main artery of the body. At the end of a heart contraction, the valve closes to prevent the blood from flowing backwards. In patients with aortic stenosis, the valve fails to open during contraction, thus preventing blood from flowing forward during cardiac contraction (systole). The heart compensates by squeezing harder and harder to maintain adequate forward flow. Eventually, the heart becomes too strained and a variety of severe complications can ensure, including heart attack, heart failure, syncope (fainting), and sudden death. In patients with severe aortic stenosis there is a 50% chance of dying within two years if untreated. Traditional treatment of aortic stenosis involved open heart surgery to replace the valve. This is a major operation and involves sawing through the breast bone to open the chest and gain access to the heart. As one can imagine, the procedure is risky and recovery takes a long time. Many patients who are too ill or weak and are not eligible for the surgery. Fortunately, there is a new procedure where a prosthetic aortic valve can be implanted by navigating a plastic tube, or catheter, to the heart through a puncture in the artery of the hip or sometimes via a direct puncture through the apex of the heart. This procedure, called a Transcatheter Aortic Valve Replacement, or TAVR, promises to make aortic valve replacement minimally invasive, that is doable through a small hole instead of requiring open surgery. Recovery time is significantly less and patients who are ineligible for conventional surgery can often get TAVR. The major problem with TAVR is that it can be very difficult to accurately place the prosthetic valve through the catheter, and poor placement can result in devastating consequences. Unlike open surgery, where the surgeon has direct access to the diseased heart valve, with TAVR the physician must work through the catheter. The valve is loaded on a collapsed metal mesh called a stent. The stent is then inched forward through the catheter into the proper position. The position is checked with x-ray and then the stent is expanded -- hopefully in the correct position relative to the diseased aortic valve, pushing it aside and replacing it with the new prosthetic valve. Once the prosthetic valve is expanded it cannot be retrieved or repositioned, and millimeters matter. Valves come in different sizes. If the valve is the wrong size or malpositioned by even a few millimeters it can cover the coronary arteries and lead to heart attack, cause blood clots to form leading to stroke, or even come free and cause tearing of the aorta. Different sized TAVR aortic valves This is where 3D printing comes in. The Arizona researchers used contrast enhanced computed tomography (CT) scans to gather precise data on the anatomical structure of the heart, aorta, and aortic valve from three patients with severe aortic stenosis, and manufactured precise 3D printed replicas of the aortas. Then they tested various valve sizes and position to see what had the best anatomic fit. They then did CT scans of the prosthetic valves within the 3D models and compared those to postoperative CT scans of the actual patients after TAVR, and found that the pre-surgical test fitting in the 3D printed models accurately predicted how the valves would perform in real patients. Use of the 3D printed models helped the surgeons choose the correct size valve and positioning prior to the surgery, thus reducing the risk of he TAVR procedure. Digital rendering of the aorta Testing the implantable valve in the 3D printed model by deploying it through a catheter (blue) I have personally used customized 3D printed models I designed to test wires and catheters prior to complex mesenteric artery aneurysm treatments (publication forthcoming), and I can tell you that knowing your wires and catheters will work before the procedure is far better than figuring it out with trial and error during the procedure. Presurgical testing with 3D printed models is here to stay. If you are interested in learning more about applications of 3D printing in medicine or how to make your own 3D models, please register as a member (it's free and only takes a minute!) and join the community of medical professionals who are all trying to build the future of 3D printing in medicine. Ask a question, start a discussion, or download free 3D printable models to make on your own. I will put some links to a few of the free downloadable models related to this article below. FREE 3D PRINTABLE DOWNLOADS Heart and pulmonary artery tree http://www.embodi3d.com/files/file/59-heart-and-pulmonary-artery-tree-from-ct-angiogram/ Human heart http://www.embodi3d.com/files/file/27-human-heart/ Human heart #2 http://www.embodi3d.com/files/file/35-3d-printable-human-heart/

Dr. Mike

Dr. Mike

 

Amazing 3D Printed Models on Display at RSNA 2014

3D printing is a hot topic at this year's Radiological Society of North America (RSNA) meeting in Chicago. I've been involved in medical 3D printing for the past two years, and every month there seems to be more interest. At this year's RSNA meeting, the level of interest is higher than I have ever seen before. There are literally dozens of sessions related to 3D printing in radiology, and they all seem to be very well attended. The Sunday session on "Fundamentals of 3D Printing" had a line out the door and down the hall as shown by the picture below. So many people were standing in the room that they had to close the session due to fire safety limits.   Perhaps one of the biggest draws is the vast array of striking 3D printed models on display from a variety of vendors that offer 3D printing and consulting services. 3D printer manufacturers have been working hard on new and exciting 3D printing materials. As a result, there is now a large selection of materials to choose from, each with a unique set of properties. When the right anatomy, materials, and printers are combined effectively, the models can truly become things of beauty. While you can't get your hands on the individual models shown here, Embodi3D does maintain a growing library of 3D printable models for you to download and 3D print yourself. I will put links to some of my favorite downloadable files at the end of this article.             Long lines were seen outside of most 3D printing sessions, including this one on Sunday morning. In this hands-on session which teaches 3D printing software, each of 50 workstations was occupied. There was standing room only in the back of the room. 3D printed model of a kidney with a tumor and blood vessels (pink). This model uses two colors to highlight anatomy. 3D Systems Medical Modeling 3D printed model using colored gypsum powder shows the various structures of the heart. 3D Systems Medical Modeling A human brain. 3D Systems Medical Modeling 3D model of a spine with severe deformity. 3D Systems Medical Modeling Multicolor 3D model of the skull, with cut away that shows the cerebral arteries (red) and veins (blue). 3D Systems Medical Modeling Hollow model of an abdominal aortic aneurysm using two colors. The atherosclerotic calcium is shown in pink. 3D Systems Medical Modeling This large model of a skull and mandible was designed to demonstrate jaw alignment. 3D Systems Medical Modeling This transparent brain shows various white matter fiber tracks in different colors, an amazing property of newer 3D printing materials. Stratasys. Multicolor 3D print of a heart. Stratasys 3D print of heart with detailed pulmonary arteries and veins. Stratasys 3D print of a skull using transparent material. Materialise Example of 3D printed orthopedic surgery cutting guides used for knee replacement surgery. Materialise Glass-like 3D print of a pediatric heart. Materialise. Select 3D Printable files available for free download on Embodi3D.com. Must register to download. Registration is free and only takes a minute. Human brain Human heart #1     Human heart #2 Half skull, sagittal cut Skull base "Lace" skull     Lumbar vertebra

Dr. Mike

Dr. Mike

 

Using 3D Printed Liver Models for Guidance During Liver Surgery

Researchers from Nagoya University in Japan are now using customized 3D printed liver models created from patient Computer Tomography (CT) scans for guidance during liver surgery, as reported at the 2014 Radiological Society of North America meeting. The human liver is a complex organ. Liver cells, called hepatocytes, do the work of cleaning the blood of toxins and waste -- the primary function of the liver. Hepatocytes are dependent on a complex network of vascular structures, including bile ducts, hepatic arteries, hepatic veins, and portal veins, which are organized into a complex branching network. This network is in turn organized into self contained units, each with its own bile ducts, arteries, and hepatic and portal veins, called segments, of which there are eight in the typical human liver.   When liver surgeons resect, or cut out, cancer from the liver, they remove the entire segment or segments that are involved, working hard to avoid any damage to segments that are uninvolved. The procedure is delicate, and there is no room for error. Cut out too little and there may be tumor left in the liver which can subsequently spread. Cut too much and a host of complications can arise, including bleeding, bile leak, liver failure, and potentially death. Furthermore, the surgeon must work under conditions where the tumor and vital structures may be poorly visualized or obscured by blood in the operative field.   This is where the 3D printed models come in. The Japanese researchers took CT scan data from the patient undergoing the liver cancer surgery and created a 3D printed model of the entire liver using a transparent material. They left the vascular structures hollow, and subsequently filled them with a colored material to color-code each type of vessel. The model was then vacuum sealed in a sterile pouch and brought unto the operating room during the surgery. The surgeon could handle the 3D model during the operation. Before making each cut, the surgeon could refer to the model and confirm where the tumor and each vital vessel was located, thus avoiding mistakes and reducing operating time.   Creating 3D printed models prior to surgery for preoperative planning and intraoperative guidance is something that I have done personally for endovascular procedures (a publication on my experience is forthcoming). I can tell you that the certainty of knowing what you are getting into, and avoiding nasty and unexpected surprises in the OR, is invaluable. Once surgeons experience the comfort of having an anatomically accurate intraoperative 3D printed reference model they will never want to go back. 3D printing in medicine is here to stay.             3D printed liver model showing the tumor to be resected. 3D printed liver model I will be publishing more blog articles about 3D printing at the 2014 RSNA meeting. Follow this blog or follow on Twitter @Embodi3D.

Dr. Mike

Dr. Mike

 

Revealing the Beauty of the Microscopic World Through 3D Printing

There is tremendous beauty and diversity in nature that goes unnoticed by humans because it is simply too small for us to see and appreciate. Embodi3D member Michael Holland hopes to change that. Via his eponymous company Michael Holland Productions, he has created a fascinating traveling museum exhibit called MacroMicro that reveals the striking complexity and beauty of the microscopic world through high-resolution micro-CT scanning and 3D printing. On the remote island of Iriomote-jima, part of the Okinawa Islands of southern Japan, beautiful white sand beaches can be found. Closer inspection of the sand reveals that each grain has a star-shaped appearance. These white sand grains are primarily the skeletons of Baculogypsina sphaerulata, tiny marine organisms that produce an intricately detailed star-shaped calcium carbonate shell. These beautifully complex structures go completely unnoticed by the average beachgoer. But through use of high-definition microscopic CT scanning and 3D printing, these sand-like shells, when enlarged as big as a dinner plate, come alive. Star sand The Humboldt squid, also known as jumbo squid, is a large squid with a mantle length that reaches up to 1.5 meters in length. Living in the eastern Pacific Ocean off the coasts of North and South America, these predatory invertebrates entrap their prey with tentacles that bear up to 200 suckers each. These predators have a devious secret. Within each sucker is a ring filled with serrated dagger-like spines. Once enveloped by the tentacles, hundreds of suckers attach to the helpless prey, and thousands of these tiny dagger-like structures penetrate it, ensuring that even the slipperiest of prey meets its inevitable doom. Enlarged to the size of a basketball and 3D printed (lead image, shown above), once can see how nasty this adaptation truly is. Everything we hear -- beautiful music, the rustling of leaves, a loved one's laughter -- is made possible by the incus, malleus, and stapes. These three tiny bones are the smallest in the human body and form the basis of the middle ear, without which human hearing would not be possible. Noise around us causes our tympanic membrane, or eardrum, to vibrate. But how are these vibrations transmitted to our brains where we process sound information? This is where the incus, malleus, and stapes come in. Attached to the inner surface of the eardrum, these bones form a chain that transmits the vibratory motion to the inner ear. There, tiny hairs are disturbed, which sends an impulse through the auditory nerve to the brain, which we interpret as sound. Everything we hear is transmitted as vibrations through these three tiny bones, called the auditory ossicles. In Latin, the malleus, incus, and stapes mean the hammer, anvil, and stirrup, respectively. When enlarged to the size of a real hammer through 3D printing, you can see how these tiny bones got their names. auditory ossicles of the ear The innocuous Townsend's mole, Scapanus townsendii, is commonly found in the moist soils of the Northwestern North American coastline. It's short and stubby arms are perfectly designed for digging, a fortunate thing as it spends most of its time searching for earthworms and other food in shallow burrows. However, when its small size is accounted for, the mole's arms are massively powerful. Click on the video link below to hear Michael talk about this small furry Hercules and how its secrets are revealed through 3D printing.   The Townsend's mole Through his MacroMicro exhibit and 3D printing, Michael is bringing the striking beauty of the microscopic world to us. Look for his MacroMicro exhibit in a museum near you beginning in 2016. The MacroMicro exhibit

Dr. Mike

Dr. Mike

 

Maker Profile: Dr. Marco Vettorello

Dr. Marco Vettorello is an anesthesiologist and intensive care physician in Italy. On the side he has been creating high quality anatomical models that are of great value for medical education. He has agreed to share his models with the Embodi3D community. All are available for free download. The models that he has shared include: Human heart Anatomic skull Maxillary bone Frontal bone Mandible Sphenoid bone             Thanks very much Dr. Vettorello! We appreciate you sharing with the Embodi3D community!        

Dr. Mike

Dr. Mike

 

3D Printable Human Heart Model

Lately I've been working on creating a 3D printed human heart from a CT scan. Printing cardiovascular structures like the heart is more difficult than bony structures since the blood vessels are usually not well visualized without a CT scan that uses intravenous contrast. Furthermore, the heart is always moving, and special techniques need to be performed during the scan to generate high-quality images that are free from motion artifact. This is one of several models I've been working on. I haven't yet tried 3D print this model, but I thought I would share it with the community to see what people think. The STL file can be downloaded here. If you 3D print this model, please share your results with the community. Post an update or upload pictures of your printed model. If you are creating your own 3D printable models, please consider sharing them with the community in the File Vault. On another note, I am considering putting together some video tutorials on how to create 3D printed anatomic models from CT scans using freeware. If you are interested in seeing tutorials like this, please leave a comment. Happy printing!            

Dr. Mike

Dr. Mike

 

Member success with 3D Printed Skull

Community member Mike Kessler has successfully printed a half skull available for download in the File Vault using a filament printer. He made the skull to help a family member who is learning skull anatomy in medical school. The skull looks great. Fantastic job Mike! Check out Mike's complete album here. If you have had success with printing one of the 3D anatomic models available for download on the site, please let us know how things went. If you are creating your own medical 3D models, please share them with the community in the File Vault.

Dr. Mike

Dr. Mike

 

3D Printable Lace Skull, Free for Download.

I've been working on ways to artistically expand on 3D printed anatomic models beyond an exact replica of the anatomy. My first project is this Lace Skull. The skull is based on an anatomically accurate skull generated from a CT scan. I have made several of the earlier skull models available for download on the Embodi3D website here and here. Using a variety of methods, I have transformed the skull and given it a unique lace-like appearance. The overall surface contours are still anatomically accurate. The lace-like texture gives the model its unique aesthetic but also cuts down on printing material while maintaining mechanical strength.   I have made the STL files available for FREE download in the File Vault section of the Embodi3D website. You can find the STL files here (HALF-SIZE | FULL-SIZE). If you 3D print this file, please report back regarding your outcome. I printed a half-size model using the "White, Strong & Flexible" nylon material on Shapeways.   If you would rather have Shapeways print the model and ship it to you for a fee, you can go Shapeways to directly order the models here (HALF-SIZE | FULL-SIZE).   I hope you enjoy this 3D printable model. Please report back on your experiences with printing the model. Also, please share your own 3D printable creations with the community in the File Vault section of the website.          

Dr. Mike

Dr. Mike

 

Dr. Mike's Interview on Radbuz

Today I was interviewed and featured on Radbuz. I spoke with Dr. Jenny Chen about my experiences with 3D printing in the biomedical space and where I think the field is going. Check it out! http://radbuz.com/2014/08/24/influencers-an-interview-with-dr-michael-itagaki-embodi3d-com-on-3dprinting-in-healthcare/

Dr. Mike

Dr. Mike

 

3D printing prosthetic arms for children who are missing theirs

E-Nabling the Future is a volunteer organization dedicated to creating inexpensive 3D printable prosthetic hands and arms for children around the globe who are missing limbs. The movement has grown from an informal collaboration to a veritable movement, and they are now producing functional and inexpensive prosthetic limbs. Traditionally designed arm and hand prostheses can cost up to $40,000. According to 3Dprint.com, it is now possible to create an entire functional my electric arm for $350. Their most recent innovation uses electrical impulses from the bicep muscle to open and close the hand. This enabled a six-year-old boy named Alex who is missing his right arm to give his mother a big hug.                           The picture of Alex's myoelectric prosthetic right hand gave me a sense of déjà vu -- I swear I had seen something like this before. Then it hit me. The prosthetic is eerily similar to Luke's prosthetic hand in The Empire Strikes Back. Thanks to the volunteers at E-Nabling the Future, science fiction is becoming science fact, and children are the beneficiaries of this amazing movement.     Please check out the E-Nabling the Future website, and if you are so inclined give a donation to this worthy cause. For updates on news and new blog entries, follow us on Twitter at @Embodi3D. Select images by Kt Crabb Photography

Dr. Mike

Dr. Mike

 

Capillaries in 3D printed organs - a big step towards 3D printable artificial organs.

There has been a lot of hype recently about 3D printed organs. There have been several instances in recent memory where somebody holds up a kidney or liver shaped 3D printed blob of jello-like cells and the press goes wild, as if the jello blob, because it is shaped like an organ, must be an organ and is ready to go directly into a patient. As someone who works with transplant patients all the time I can tell you it's not that simple. Real organs are incredibly complex. Take the liver for example. On the microscopic level there is a meshwork of cells comprised of reticuloendothelial cells. Hepatocytes live within this meshwork. Endothelial cells line small spaces called sinusoids. All these structures are connected to microscopic bile ducts, arterioles, and veins. The picture below demonstrates the microscopic architecture. The point is that an organ is more than a mass of cells. There is very, very complex microscopic and macroscopic architecture. That's why a recent research paper by a multinational team of investigators is so interesting. Reported in the journal Lab on a Chip, researchers from Australia, Italy, Korea, Saudi Arabia, and American teams at Harvard, Stanford, and MIT, report being able to 3D print capillaries. Additionally, they were able to grow "endothelial monolayers," which basically means a layer of cells that comprise the normal lining of capillaries in the body. An endothelium is important, because without it the blood within the capillaries will clot, leading to tissue death from lack of blood flow.   In theory this advance means that artificial organs with complex microscopic architecture, which is essential for a real organ to function, can be 3D printed. If the artificial organ is also manufactured using cells from the patient, this will eliminate the two greatest problems with modern organ transplantation. These are 1) insufficient number of transplantable organs (in the US they need to be harvested from recently deceased individuals who donate them, and there just aren't enough), and 2) immune rejection of the organ when the body inevitably realizes that the organ is from a different person. External video demonstrating advances in 3D Printing and bioprinting   This reminds me of an episode of Star Trek when Captain Picard is impaled through the heart and the laughs when he sees the dagger protruding from his chest. He is saved by a heart transplant. Perhaps he is laughing because in the Star Trek future an artificial heart with accurate microarchitecture is probably as close as the nearest replicator. Given this latest research, maybe someday soon we will all feel comfortable about rumbling with a gang of Nausicaans, knowing we can get spare organs whenever we need them.   For updates on news and new blog entries, follow us on Twitter at @Embodi3D.

Dr. Mike

Dr. Mike

 

3D printed white matter tracts illustrate the beauty and complexity of the human brain

Thanks to 3D printing understanding of the complex neural pathways of the human brain became a little bit easier. The Philadelphia-based Franklin Institute's new exhibit, Your Brain, features a striking 3D printed model of the white matter tracts of the human brain. White matter tracts are the pathways that nerve cells use to connect to each other inside the brain, and are incredibly complex.   Dr. Jayatri Das, chief bioscientist at The Franklin Institute, incorporated the displays in a new expansion. The model was built from an MRI scan of a real brain and was then printed using the SLS print method from 3D Systems. It shows approximately 2000 tracts. Printing such a delicate structure proved to be quite a challenge and the project was turned down by several 3D printing bureaus before it was accepted by an outfit in Oklahoma. The model was printed in 10 separate parts and then assembled.   This is truly an amazing advance in anatomic visualization. It's truly beautiful - a piece of art. For updates on news and new blog entries, follow us on Twitter at @Embodi3D. Source and images: 3D Systems

Dr. Mike

Dr. Mike

 

Radbuz.com

I apologize for being slow with the posting recently. I was at a conference last week and this week I have been working on creating a 3D printable cardiac and arterial model (see image). More interesting blog articles will be coming shortly.   In the meantime, I encourage you to check out the blog of my friend, neuroradiologist, and 3D printing enthusiast Jenny Chen, MD., at Radbuz.com. You can follow her on twitter at @radbuzzz.

Dr. Mike

Dr. Mike

 

3D printed half-skull from CT scan shows detailed skull anatomy for students. Files available for free download.

This is the second in a series of articles about skull models created from CT scan data and designed to provide a low-cost means of anatomy teaching. To see my past article about the skull base model, click here. Learning detailed anatomy is a grueling process that doctors, nurses, and other health science students must go through. Traditionally, learning anatomy involved detailed study of textbooks, but learning 3D structures from 2D pages just doesn't work well. Dissecting cadavers is the traditional means of teaching doctors, but this process is tedious, messy, very expensive, and only available in select educational institutions (i.e. med schools). Most students of anatomy do not have access to these resources. 3D printing is putting the power of real 3D anatomy within reach of ordinary students at very low cost. These models are created from highly detailed CT scan data from real human bodies, not an artist's conceptualization. This half skull and cervical spine has been cut along median sagittal plane. This clearly shows the external bony anatomy (zygomatic arch, orbit, etc.) as well as intracranial anatomy (skull base formina, paranasal sinuses, etc.). Bony details of the cervical spine are also clearly shown.     You can 3D print your own model by downloading the free files. These files are available on this website in STL or COLLADA format, in full size and half-size versions. You can get them here: full size (STL, COLLADA), half-size (STL, COLLADA). Check out more downloadable files in the File Vault.   If you would rather have a high quality model made for you, you can buy one from Shapeways here (full-size, half-size). Feel free to modify the files as you would like, just please don't use them for commercial purposes. If you create something cool, please give back to the community by sharing it on the Embodi3d website in the File Vault.   For updates on news and new blog entries, follow us on Twitter at @Embodi3D

Dr. Mike

Dr. Mike

 

3D printed models help with surgery for complex congenital heart disease

Researchers at the Children's National Medical Center in Washington DC have used 3D printed heart models to aid repair of congenital heart defects. In the International Journal of Cardiology, the researchers report the case of a patient with transposition of the great arteries, a congenital heart defect in which the pulmonary artery and aorta are switched. Without treatment this condition is fatal in infancy. The man apparently had surgical treatment as a child, but as an adult began to have problems when the surgical conduit allowing his heart to function properly began to close.   A 3D printed replica of the heart was created with Mimics software from the Materialise. The heart was then printed using an Objet Polyjet printer. The investigators tested a variety of catheters and planned the procedure using the model before attempting the actual procedure on the patient. The investigators even deployed a stent within the model for practice. With the benefit of testing on the 3D model, the procedure went as planned. The narrowing was opened with a stent and the heart function returned to normal.   3D printed vascular models have been used recently to assist in planning complex and unusual procedures. They've been used for treating abdominal aortic aneurysms, and now for treating postoperative congenital heart disease. I have personally created a 3D model to help with treatment of a rare vascular anomaly (publication pending, stay tuned). When will 3D models be used for bread-and-butter procedures? What are the barriers to this happening? Please leave a comment.     For updates on news and new blog entries, follow us on Twitter at @Embodi3D Image source: International Journal of Cardiology

Dr. Mike

Dr. Mike

 

3D printed skull base generated from CT scan data accurately demonstrates complex skull base anatomy.

The base of the skull is one of the most complex and difficult parts of the body for doctors in training to master. And one of the most important. It is comprised of multiple bones (the ethmoid, sphenoid, occipital, frontal, parietal, and temporal, to be exact) and has numerous foramina (holes) through which arteries, veins, and the vital cranial nerves and spinal cord exit the skull on their way to and from the body.   These structures, although very small, are critically important clinically. Compromise of a tiny foramen (hole) can lead to deafness, blindness, paralysis, or even stroke or death. Because of the importance of this small space, medical students around the world struggle to learn the complexities and subtleties of skull base anatomy.   Unfortunately, pictures in an anatomy book just don't cut it. Real human skulls can demonstrate this anatomy well, but these are expensive and the skull has to be cut and opened in order to display the relevant anatomy. This is why I created a 3D printed skull base from real CT scan data.   Available in full size and half-size models, the skull base exhibits exquisite anatomical detail. Digital files of the skull base are available for free download in full size (STL, COLLADA) and half-size (STL, COLLADA) versions.   Very high resolution prints are available for a fee at Shapeways in both full-size and half-size. The half-size model is quite inexpensive so you don't have to worry if it is damaged by rough handling of multiple students.   In the near future I will be posting more anatomical digital models.   For updates on news and new blog entries, follow us on Twitter at @Embodi3D

Dr. Mike

Dr. Mike

 

3D Printing the Skull of Richard III

Researchers at the University of Leicester and Loughborough University have successfully 3D printed the skull of Richard III, the last Plantagenet King of England. For those of you rusty in your English history (as I am), Richard III was killed in battle at the Battle of Bosworth Field in 1485. This was the final major battle of the Wars of the Roses. The victor, Henry Tudor, went on to become King of England and founded the Tudor dynasty.   Richard III was buried in a nearby friary shortly after the battle, but the location of the friary was lost to antiquity. In 2012 the friary was discovered underneath a parking lot in Leicester, England and the subsequent excavation revealed the skeletal remains of the English King. The skeleton bore evidence of multiple traumatic injuries, especially to the skull, where there were multiple puncture and cleaving injuries. Additionally, there was significant scoliotic deformity of the spine, which is consistent with the famed hunchback appearance of the King. (Technically hunchbacks have kyphosis, not scoliosis, but close enough.)   To better illustrate the battle injuries and spinal deformities, and preserve the original bones, researchers performed CT scans of the bones and re-created them using 3D printing. They used the Mimics Innovation Suite from Materialise and printed the bones using laser sintering.     The Smithsonian Channel did a fascinating documentary about the excavation, including how they confirmed the identity of the skeleton using mitochondrial DNA via an unbroken line of maternal descendents (mitochondrial DNA is only passed from mother to child) to a Canadian furniture maker whose mitochondrial DNA exactly matched that extracted from the skeleton. Check out the Smithsonian Channel website for some additional details. Thumbnail photo credit: Andrew Weekes Photography

Dr. Mike

Dr. Mike

 

3D Printed Casts for Healing Fractures

Deniz Karasahin recently won a A'Design award for a 3-D printed medical cast that allows for improved ventilation and patient comfort when compared to traditional plaster or fiberglass casts. The organic 3-D printed structure has multiple ventilation holes which do not, presumably, compromise the mechanical integrity or strength of the cast.   The cast is created after scanning the patients target body area and importing the data into CAD software. The cast is printed with ABS plastic using a FDM process. Additionally, the inventor claims that Low Intensity Pulse Ultrasound (LIPUS) bone stimulators can be embedded into the cast material to improve healing. This promises to reduce the healing process by 38% and increase the here rate up to 80% in nonunion fractures.   This is very interesting. Of course, the cast itself looks very cool and I would definitely prefer a cast like this over a conventional plaster or fiberglass cast, as it seems like it would be much more comfortable.   I do have some questions about the LIPUS ultrasound treatment. A quick search of PubMed reveals that this technology has shown to help with tibial and radial fractures. Other studies show that it does not work for all bony fractures, for instance clavicle fractures. So it seems like the research is still out about exactly where this device might be used. Additionally, I can see practical problems with performing a 3-D surface scan on a swollen, mangled extremity in the ED, designing it using CAD software, and 3-D printing a cast on the spot. Right now there are barriers or practical implementation. Perhaps the cast could be more practically used as a replacement after a conventional cast has been placed in the acute setting. Should these casts become widely adopted, maybe someone will invent a 3-D printed cast of vending machine which will scan, design, and print your cast on the spot. Read the design proposal here.

Dr. Mike

Dr. Mike

 

3D Printed Lumbar Vertebra

Last year as part of my tests for creating bony anatomic models, I created a model of a lumbar vertebral body from a CT scan. The process was somewhat time-consuming as manual mesh editing was required to separate the vertebral body from its adjacent bony structures. I used Blender for this. Nonetheless, the end result looks good and accurately demonstrates the bony anatomy of a lumbar vertebra. I've created a YouTube video which briefly summarizes the steps of creation. Also, I've made the COLLADA file available for download for free to registered users, so you can 3D print it yourself. http://www.embodi3d.com/files/file/16-lumbar-vertebra/   If you wish to have the file printed and shipped to you, Shapeways can do it for a fee here: http://shpws.me/s5dU   Please share your thoughts and comments. Has anybody else had experience with creating bony models of this sort? Register and leave a comment or download the file.

Dr. Mike

Dr. Mike

 

3D Printing of a Cerebral Aneurysm

Researchers from Vanderbilt University Medical Center and Dartmouth-Hitchcock Medical Center recently reported use of 3-D printing techniques to create a vascular model of an intracranial aneurysm. I have also used 3-D printing to create vascular models. In the journal Surgical Neurology International, the authors described their technique. They used digital subtraction with a fluoro-CT system to capture the anatomic image and create a surface model. Mesh editing was then performed with MeshLab. The model was printed on a Stratasys Objet 500 printer using the Tango Plus material. Such models may be useful in patient education or determining the best surgical approach.   The authors state they used stereolithographic techniques to create the model, but the Objet 500 printer uses PolyJet technology. Stereolithography involves multiple layers of UV curing of a liquid resin and the material is usually quite rigid. I've used stereolithography to create vascular models (to be described in an upcoming paper) and I know it works. There is a spec sheet for the printer here, and a description of different 3-D printing techniques here. Nonetheless, this is interesting and impressive work. One problem that I have had with the Tango Plus material is the minimum wall thickness, and I wonder if this was an issue. A nice thing about Tango Plus is the quite rubbery and compliant feel.   What do you think about the potential of 3-D printing for vascular applications? Please leave a comment! The complete text of the article can be found here. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942610/ The digital model of the aneurysm The physical model of the aneurysm The Tango Plus material, showing its flexibility

Dr. Mike

Dr. Mike

 

3-D Printing of Dinosaur Bones

Researchers in Germany have successfully re-created dinosaur bones using 3-D printing from original bones still embedded in rock. As reported in the March 2014 issue of the journal Radiology, a fossil of a vertebral body of a Plateosaurus still embedded in the rock was found and was scanned using a CT scanner. The digital dinosaur vertebra was then digitally removed from its rocky surrounding shell. The dinosaur bone was then 3-D printed using a selective laser sintering machine to create an exact duplicate. The 3-D printed model can then be handled and used for research, while the original remains undisturbed and safe within its original rocky matrix.   What does this advance mean for the field of paleontology? Can delicate objects now be studied without having to disturb them? Can rare bones, previously paid away a museum vaults, now be digitally shared with the world? Please leave your comments.   The journal article is available here http://pubs.rsna.org/doi/abs/10.1148/radiol.13130666 A Plateosaurus skeleton  

Dr. Mike

Dr. Mike

 

Welcome to Embodi3D!

Welcome to Embodi3D! Embodi3D is the web's first online community dedicated to biomedical 3-D printing. Learn about the uses and potential of 3-D printing in biomedical sciences by reading the blogs or downloading a printable file. Contribute to the discussion by posting a comment in the blogs or forums. Upload your 3-D printing creations to the File Vault. If you have a lot to say, start your own blog. Help the world to realize the awesome potential of biomedical 3-D printing. Welcome to the community! Register now and join us!   Image: A human lumbar vertebral body, from digital representation to physical object created with 3D printing.

Dr. Mike

Dr. Mike

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