This week's embodi3D® blog post is inspired by a recently published article titled "Three-Dimensional Printing Surgical Applications". The scholarly article goes in depth on the current state of biomedical 3D-printing applications, with a special focus on how the technology may affect the ever-growing list of patients on the organ transplant waiting list, which numbers over 150,000 in the United States alone.

While medical 3D printing has been used to create 3D-printed models for training, educational, and inter-surgical reference applications, 3D-printed organs are still not viable in many types of procedures. This is especially true of organs found within the abdominal cavity (such as the gastric mucosa of the stomach lining), which rely on a mucous membrane layer in order to function properly. But, surgeons point to the progression of technology and see 3D-printed organs in the horizon.

For these reasons, the staff of embodi3D® remain relentless advocates of this technology; for the present applications and also where medical 3D printing from STL files will take the medical community as we head into a new age of less-invasive, more ethical surgery. For years, embodi3D® has provided a anatomically correct, 3D-printed organ models for the purpose of medical device testing and research. These models are made from CT scans, converted into STL files, with the final result being a highly detailed 3D-printed model. It is our hope that someday we can look back to the present era and wonder how we ever relied on human donations for organ transplantation. 

After you browse through this group of uploads, we encourage you to check out the Abdomen and Pelvis CTs forum for more great CT scans of the abdomen and pelvis. Also, we invite you to become an embodi3D® member. It's free and all you have to do is choose a screen name, enter your email address and preferred password, answer CAPTCHA, and you'll have access to a number of tissue conversion algorithms and other great democratiz3D® tools. 

#1. A Whole-Body CT Scan in DICOM and NRRD File Formats

First place: A Ridiculously Easily Way to Convert CT Scans to 3D Printable Bone STL Models for Free in Minutes which allows you to follow along with the tutorial. Included is an anonymized chest abdomen pelvis CT in both DICOM and NRRD formats. Take a look to this CT model of whole body.

#2. Pelvis CT scan Showing Osseous Disruption of the Right Posterior Portion of the Pelvic Ring

Pelvis forms ring surrounding and protecting pelvic organs. The anterior ring: Pubic bones, acetabula, ilium to level of ischial spines and posterior ring: Ilium from ischial spines posteriorly + sacrum
- Not all disruptions of pelvic ring are unstable.
- Integrity of ring dependent on ligaments; can infer ligament injury based on bone & joint displacement.

#3. A Contrast-Enhanced CT Scan of the Abdomen and Pelvis

This CT scan with contrast shows scoliosis of the lumbar spine, the intra abdominal organs are normal.

#4. Pelvis CT Scan Showing Postoperative Changes of the Osseous Disruption (#2)

Follow-up:

Staging, Grading, & Classification
• Young-Burgess classification:
Most widely used. Focuses on degree of injury and direction of force.  

APC: Symphyseal diastasis or sagittal pubic ramus fractures

– I: Symphyseal diastasis < 2.5 cm or bilateral pubic ramus fractures (superior and inferior); sacrotuberous and sacroiliac ligaments and SIJ intact (stable).
– II: Symphyseal diastasis > 2.5 cm, anterior SIJ diastasis; posterior SIJ normal width (partially stable).
– III: Symphyseal diastasis > 2.5 cm, anterior + posterior SIJ diastasis or separated sacral alar fracture (unstable).

LC: Oblique/coronal/transverse ramus fractures plus
–  I: Sacral impaction fracture on side of impact (stable).
– II: Iliac wing fracture extending through ring (crescent fracture) on side of impact with SIJ disruption (partially unstable).
 Ilium usually internally rotated with fulcrum in or adjacent to sacroiliac joint.
– III: Type I or II injury on side of impact with contralateral APC injury = windswept pelvis (unstable).

 VS: Symphyseal diastasis or sagittal ramus fractures with complete disruption of posterior arch and vertical displacement of hemipelvis (unstable)
– Highest mortality rate.  Combined mechanism

https://www.embodi3d.com/files/file/7142-pelvis-whitneys-project/ 

5. CT scan with contrast of thorax and abdomen.

A CT scan with contrast showing all the structures of the thorax and abdomen.

#6. CT Scan without Contrast of Thorax and Abdomen, Converted into 3D-Printable STL File

A whole body NRRD file converted from CT Scan for Medical 3D Printing includes the chest, abdomen and pelvis.

#7. CT Scan (with Contrast) Showing Postoperative Changes in a Segmentation and Fusion Anomaly (SFA) of Lumbar Spine

This ct scan also shows osteodegenerative changes and osteophytes. Coronal MR, AP radiography best for detecting and characterizing SFAs, "counting"  abnormal vertebral levels.

#8. A 3D printing model of the gastrointestinal tract from a CT Scan (with Oral Contrast)

In this example we can evaluate the stomach, small intestine and large intestine anatomy with exquisite detail.

#9. An skin 3D model of the surface anatomy of abdomen

The abdominal area is the region between the chest and the pelvis. Arterial supply of the abdominal wall comes from the following: Superior epigastric artery, a branch of the internal thoracic artery. Inferior epigastric artery, a branch of the external iliac artery. Superficial circumflex iliac and superficial epigastric arteries, the branches of the femoral artery.

The skin of the front of the abdomen is thin as we can see this great example. 

#10. Another 3D printing model of the gastrointestinal tract from a CT Scan (with Oral Contrast) showing the relations with vascular vessels

In this example we can evaluate some branches of the Abdominal Aorta.

References

1. AlAli, A. B., Griffin, M. F., & Butler, P. E. (2015). Three-dimensional printing surgical applications. Eplasty, 15.