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  2. Hi Small modification: In Blender ver 2.83, bpy.context.object.modifiers["Shrinkwrap"].use_keep_above_surface = True should be changed to: bpy.context.object.modifiers["Shrinkwrap"].wrap_mode = 'ABOVE_SURFACE'
  3. Dental technology and treatment techniques have changed a lot of things. It can be seen that now people can get better treatments through 3d printing and detailed pictures of the dental issues. Thanks for explaining the importance of 3d printing and teeth implants here. It is going to be very helpful for everyone. <a href="https://crestwooddentalky.com/oral-surgery/">Dentist La Grange KY</a>
  4. i can not get my dcm files imported in the latest slicer
  5. Amazing to see how many people have shown the intent to help in this difficult time. As a small effort from our side we are providing free 3d segmented model of COVID-19 for researchers . Please find link below https://www.mysegmenter.com/order/images?link=M7430vYEbn Also people can download the entire datasets from our site: http://covidctscans.org/
  6. In recent weeks we have seen that the spread of the Coronavirus has increased. However, on the good note, we have also seen an increasing number of people willing to help. Thousands of people from around the world who have 3d printers have share their contact information, creating a large database, offering their knowledge in 3d technology (mostly non-profit) to help in this fight against coronavirus. In Spain, for example, thanks to the biomedical3d company, some hospitals such as the University Hospital of Virgen del Rocio and Hospital Puerta del Mar, have been testing the 3D printed hands-free door openers that help in preventing the transmission of the covid19 as the staff don’t need to touch the doors to open them. Other organizations such as Ayudame3D, have printed face shields. Currently, each Ayudame3D volunteer has the ability to create one every 3/4 hours. They are part of a group called "Coronavirus makers", a group of people from different fields (medicine, biotechnology, 3D printing, industrial design, among others) that decided to share their knowledge and experience in a Telegram group and at their website to co-create artificial respirators and other solutions by using 3D technology. Since the onset of the COVID19 crisis, Coronavirus Makers volunteers have delivered more than 350,000 face shields using more than 9 tons of material. Isn't that amazing? Another Spanish company that is joining these initiatives is Leitat Technological Center. They have used 3D printing to make an emergency ventilator, costing less than EUR 500. It's in testing now. Their goal is to share the files for free, so the 3D printing community around the world can contribute to saving lives. There is now a large network of 3D printing against coronavirus in Spain, which currently has more than 1,000 printers and more than 300 professionals, and they are still looking for more volunteers to join the initiative. Those with a 3D printer and interested in join this team can register at 3dcovid19.tech. Files availables Take a look at some of the files that are available now and that can help protect you from COVID-19. Respirator Adapter for Decathlon Mask – These files allow you to convert a recreational mask into a respirator. Hands-Free Door Openers – These can go a long way in reducing the spread of infection in businesses and offices that must remain open. They can fit on a variety of doors and allow users to open doors with their forearm rather than their hand. Bonus: Leave them on after the crisis and people can open doors while carrying coffee and documents. ‘Savegrabber’ Door Opener – While the previous door opener mounts to the door handle, this one is portable and can be used on most lever door handles. Reusable Filter Mask – This simple mask allows users to change the filter material out regularly and it works with HEPA filters, coffee filters, and paper towels. Face Shield – This was designed by Canadian ER worker Dr. Tarek Loubani. All that’s needed is some elastic strap and Mylar sheet. Those with more complex materials and equipment available can take a look at the most complex files designed by the Isinnova team: The Venturi valve – The original that started it all. Protective face shields by prusa3d in Czech republic. There are more organizations that have recruited volunteers to join forces and fight COVID-19. Fathom is working to design printable nasopharyngeal swabs for COVID-19 test kits as well as ventilators. You can also be part of the CoVent-19 Challenge. It was founded by residents at Massachusetts General Hospital as “An Open Innovation Effort to Design a Rapidly Deployable Mechanical Ventilator” using additive manufacturing. Participants will be allowed to submit multiple designs during Round 1, and participants may choose to submit full system designs and/or modules/parts for other teams to integrate into their design. Do you know any other initiative? leave us your comments!
  7. LIVERPOOL, N.Y. - A couple of entrepreneurs Isaac Budmen and Stephanie Keefe are making 300 face shields to help help workers at a coronavirus testing site in Syracuse County. They make and sell 3D printers in their house by the name of Budmen Industries. Last Saturday they produced 50 shields using seven 3D printers, they are now using 16 printers to produce 250 before the end of this week. "It just sort of felt right to us to do what we could to help the situation," Budmen said. They started their business in 2017, they spent most of Sunday trying to translate their idea that the protective shields were easy and comfortable to use. Since then they have not stopped producing the shields requested by the county. This is an example of solidarity in these times of crisis due to the pandemic. The couple has not set a price for the prints and they have focused on producing them to help their community. This is how Budmen put it "I just said we'll get it done," “We're really not looking to make money off the county in this crisis. Onondaga County Executive Ryan McMahon gave the couple a big shout-out during his daily update on the coronavirus pandemic on Tuesday. Budmen said he and Keefe got to work designing the shields as soon as soon as they heard the county was planning to open a site in the city where people could go to be tested for the coronavirus. They figured the county would need face shields for the safety for workers performing the tests, he said. However, the county has agreed to pay for the shields for what is estimated to be an approximate price of $ 8 for the expenses for the materials used. This is another story worth sharing with you. REFERENCES 1. Budmen Industries. https://budmen.com/ 2. CNY couple, using 3D printers, makes 100s of face shields for coronavirus clinic. https://www.syracuse.com/coronavirus/2020/03/cny-couple-using-3d-printers-makes-100s-of-face-shields-for-coronavirus-testing-clinic.html
  8. The Empire strikes back. The company, which produced the original valves, is going to sue those guys for "patent violation", because the original valve cost 11000$ and the copy - few bucks. In my opinion, we deserve to extinct...
  9. In Italy, young entrepreneurs used their engineering skills with high precision combined with their passion for 3D printing to create 3D printed valves that can be connected to machines to help coronavirus (COVID-19) infected patients breathe. Chiari Hospital General Manager Mauro Borelli on the phone confirms that not only are the 3D-printed "life-saving" valves working properly, even a second improved model from the first version has been developed, "which generates less friction." This is a beautiful story during the coronavirus season that fills us with hope. The idea arose due to the need for valves to connect the breathing helmets to the oxygen cylinders, not available in the market because the manufacturing company was saturated by the number of orders. How to do it "Why not try recreating them with a 3D printer?" It was intuition. In a round of calls, the SOS del Mellini di Chiari recovers in the editorial office, at the hours when the solidarity of AiutiAMObrescia runs fast, to reach Massimo Temporelli, a physicist, entrepreneur and scientific disseminator, who among the fablabs finds the immediate availability of Cristian Fracassi and Alessandro Ramaioli, young engineers from Brescia who get to work. In a few hours they print 3D prototypes. Then Mellini is presented with the first fifty valves ("It's actually a Venturi tube, a hydraulic invention that dates back to the 18th century," says Borelli, an engineer himself). Ready it is, everything works. A small miracle in which Brescia's technology, heart, competence and determination made the difference. For many as for Antonio, 60 yo, he admitted Mellini by covid-19, among the first to benefit from the "valve that saves lives." Without which he would now struggle to breathe. Instead, his course is progressing well. For the two young engineers, hours of unremitting work to produce a hundred of these valves, but the smile behind the masks also outweighs signs of fatigue on the face. And their commitment is reflected in the immediate availability gathered by many other companies in the medical and 3D printing sectors, such as Invatec-Medtronic, Only 3D, Fabula 3D. Digit of the generosity of Brescia. REFERENCES 1. Valvole salvavita con la stampante 3D, già una decina in funzione - Giornale di Brescia. https://www.giornaledibrescia.it/sebino-e-franciacorta/valvole-salvavita-con-la-stampante-3d-già-una-decina-in-funzione-1.3467083 2. Coronavirus: 3D printers save hospital with valves. https://www.bbc.com/news/technology-51911070 3. Italian hospital saves Covid-19 patients lives by 3D printing valves for reanimation devices. https://www.3dprintingmedia.network/covid-19-3d-printed-valve-for-reanimation-
  10. In 2019, 1482 articles about 3D printing were published, there have been important advances in all areas of medicine, mainly in surgery where implants and tissue reconstruction are used. For an optimal search we recommend using https://pubmed.ncbi.nlm.nih.gov/. We share with you the articles that are among the 10 most read today. These collections reflect the most important 3d printing research topics of current scientific interest and are designed for experienced investigators and educators alike. 1. The Role of 3D Printing in Medical Applications: A State of the Art. Aimar A, et al. J Healthc Eng 2019 - Review. PMID 31019667 Free PMC article. 2. Medical 3D Printing. Is This Just The Beginning? El Gamel A. Heart Lung Circ 2019. PMID 31495503 3. 3D Printing of Pharmaceutical and Medical Applications: a New Era. Douroumis D. Pharm Res 2019. PMID 30684014 4. Perspectives of 3D printing technology in orthopaedic surgery. Zamborsky R, et al. Bratisl Lek Listy 2019. PMID 31602984 5. [Research Progress of 3D Printing Technology in Medical Field]. Zou Q, et al. Zhongguo Yi Liao Qi Xie Za Zhi 2019 - Review. PMID 31460721 Chinese. 6. Implementations of 3D printing in ophthalmology. Sommer AC and Blumenthal EZ. Graefes Arch Clin Exp Ophthalmol 2019 - Review. PMID 30993457 7. 3D printing for heart valve disease: a systematic review. Tuncay V and van Ooijen PMA. Eur Radiol Exp 2019 - Review. PMID 30771098 Free PMC article. 8. 3D printing and amputation: a scoping review. Ribeiro D, et al. Disabil Rehabil Assist Technol 2019. PMID 31418306 9. Medical 3D Printing Cost-Savings in Orthopedic and Maxillofacial Surgery: Cost Analysis of Operating Room Time Saved with 3D Printed Anatomic Models and Surgical Guides. Ballard DH, et al. Acad Radiol 2019. PMID 31542197 10. 3D and 4D Printing of Polymers for Tissue Engineering Applications. Tamay DG, et al. Front Bioeng Biotechnol 2019 - Review. PMID 31338366 Free PMC article.
  11. This has been an amazing year for us at Embodi3d and we'd like to share with you the best 3d medical printing models of 2019 1. A great brain 3d model, the first place! uploaded by Osamanyuad. This example shows the cortex which is a thin layer of the brain that covers the outer portion (1.5mm to 5mm) of the cerebrum. 2. A heart 3D printed model uploaded by Tropmal. It shows the coronary arteries that supply oxygenated blood to the heart muscle, excellent for educational purposes. 3. Portal vessels anatomy uploaded by Platypus1221. The portal vein or hepatic portal vein is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. 4. A Dental Cone-beam Computed Tomography in an adult orthodontic patient uploaded by R Thomas. The cbct is an advanced imaging modality that has high clinical applications in the field of dentistry. 5. A kidney 3D .STL file uploaded by Shahriar The kidneys are a pair of organs found along the posterior muscular wall of the abdominal cavity. The left kidney is located slightly more superior than the right kidney due to the larger size of the liver on the right side of the body. This is an excellent example in .stl format. 6. 3D Printable Human Heart Model with stackable slices, short axis view uploaded by Dr. Mike. This 3D printable model of a normal human heart was generated from an ECG-gated contrast enhanced coronary CT scan. The slices are cut to illustrate the echocardiographic short-axis view. If you are interested in a 3D printable heart that shows slices in the anatomical transverse plane, 7. A bony hand in a .STL file processed uploaded by MABC The wrist has eight small bones called the carpal bones, or the carpus. These join the hand to the two long bones in the forearm (radius and ulna). The carpal bones are small square, oval, and triangular bones. The cluster of carpal bones in the wrist make it both strong and flexible. This incredible 3D medical printing model shows all the bones and joints for learning purposes! 8. 3D Prenatal Ultrasound uploaded by kevinvandeusen The 3D ultrasound images provide greater detail for prenatal diagnosis than the older 2D ultrasound technology. 9. A bony knee in a .STL file processed uploaded by Yousef97 In this example we can evaluate the knee joint in three parts: The thigh bone (the femur) meets the large shin bone (the tibia) to form the main knee joint. This joint has an inner (medial) and an outer (lateral) compartment. The kneecap (the patella) joins the femur to form a third joint, called the patellofemoral joint. 10. A lower extremity CT scan of a femoral fracture uploaded by Yondonjunai The femur is the largest bone in the body, and consequently it is often thought that high energy mechanisms are required to produce a femur fracture. You can see an example here: 11. An skull fracture example uploaded by Raspirate This example shows a fracture skull. The skull is a bony structure that supports the face and forms a protective cavity for the brain. 12. A CT chest scan with contrast upload by Nikluz This example shows the vascular structures and thorax muscles. 13. 3D-Print a Left Knee Joint Model with this Excellent STL Upload (Converted from CT Scan) by Niels96 A 3D model of left knee, we can see that is formed by three bones: the femur, the tibia and the patella. the knee joint is the largest synovial joint and provides the flexion and extension movements of the leg as well as relative medial and lateral rotations while in relative flexion. 14. A Huge thoraco-abdominal aneurysm (preoperative model) by Valchanov This is a difusse dilatation of aorta with a high risk for rupture. Most of the patients are asymptomatics and accidentally discovered on routine chest radiography. 15. A stl file showing the elbow´s bones by Pekka The elbow is a hinged joint made up of three bones, the humerus, ulna, and radius. The ends of the bones are covered with cartilage. 16. A CT scan of Left Knee Joint Model by Niels96 Computed tomography scan (CT or CAT scan) is a non-invasive diagnostic imaging procedure that uses a combination of special X-ray equipment and sophisticated computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. In this example we can evaluate the knee with detail. 17. A 3d model of a polytrauma pelvis in a .STL file by Narkos. This patient suffer a polytrauma right hemipelvis with fracture S1-S2 and fracture of the ischiopubial branch. 18. A full body CT scan by davidmorris80@oulook.com A whole body scanner images without injection with window function that allows the study of the soft tissues, including lymph node structures, mediastinum and abdomen. 19. A .STL file of a left temporal bone ready for 3d printing by Nicola Di Giuseppe. This shows the mastoid, malleus, incus, the bony canal of the facial nerve and the stylomastoid foramen excellent for learning purposes. 20. An Anatomical heart box 3d model by valchanov This was valchanov´s best selling model for 2019!
  12. The Biomedical 3d Printing Community Nov. 2019 | Vol. 1 | Issue 1 The Official Newsletter of the embodi3D Printing Community In This Issue: _________________________ How to sell your 3D Model Member Spotlight RSNA Conference What Are You Working On? How to Sell Your 3D Model Are you designing or creating 3D printable medical models? Do you have cool models you would like to share with the world? You can sell your models in the embodi3D model marketplace and make a tidy sum. Just ask embodi3D member Dr. Peter Valchanov. He recently made enough profits from model sales on embodi3D to purchase a new Prusa MK3S 3D printer.There is a need for high quality medical models. Help the community by selling your creations online. Learn More About Selling Member Spotlight Dr. Valchanov is an embodi3D Power Contributor and professor of anatomy at the Medical University of Varna in Bulgaria, where he runs a hospital-based 3D printing lab. His specialty model of the nasal cavity and paranasal sinuses is a top seller on embodi3D. Take a look at his full list of publicly available downloadable models, including many free models. You can read his blog, which includes great 3D printing tutorials such as Medical 3D Printing 101. Dr. Valchanov is also active in the forums, where he is involved in a variety of interesting 3D printing discussions. Thank you Dr. Valchanov for being a valuable embodi3D member! See Dr. Valchanov's Content RSNA Conference The annual Radiological Society of North America (RSNA) conference hosts an array of 3D printing events for over 50,000 attendees from December 1st through the 6th in Chicago, Illinois. Members, along with our very own Dr. Mike, founder of embodi3D, will be attending RSNA and he would like to meet YOU! Click the link below to meet up! Meet Dr. Mike at RSNA What are You Working On? Do you have a passion for 3D printing and want to show off your sweet new project? embodi3D is interested in your vascular, muscle, skin, bone and every model in between! Email us for a chance to feature your 3D projects in our upcoming newsletters! Email Us Your 3D Project Change to Terms of Use To more accurately keep up with our costs, the fixed transaction fee for model sales will increase from 10 cents to 30 cents on December 1, 2019. Learn More
  13. Brain Aneurysm is the abnormal bulging in the blood vessels of the artery wall which helps in supplying blood to the brain. Brain Aneurysm is also called as Berry Aneurysm as it appears in the size of a small berry. A brain aneurysm may leak or rupture, causing brain bleeding (hemorrhagic stroke) most commonly occurs in the space between the brain and the thin tissues that cover the brain however, Most brain aneurysms don't rupture but it create health problems or cause symptoms. These aneurysms are often detected for other conditions during screening. https://simshospitals.com/brain-aneurysm
  14. Top Orbital and Skull 3D Model STL Files on embodi3D® In our day-to-day lives, we rely on vision more than any of the other four senses, so it only makes sense that human anatomy has adapted to include several features which keep our eyes safe: tear ducts, eyelids, and of course the orbital bone. The orbit (also known as the "eye socket") provides a rigid form of support and protection for some of the most sensitive parts of the eye including the central retinal artery, maeula, retina, choroid, and sclera. The orbit has such complex anatomical features that modeling can prove difficult, and in many instances, the finer features of the orbital bone have been simply been averaged out. The orbital structure isn't one bone, but seven: the frontal, lacrimal, ethmoid, zygomatic, maxillary, and palatine, and sphenoid bones. Can you think of any part of the human body where seven bones converge to fulfill a singular purpose? In recognition of this phenomenal feature of the human anatomy (and one of the most recognizable parts of the human skull), this week's embodi3D® Top Uploads articles, we are featuring several standout uploads — all of which can be used to create an orbital and skull 3D model. As detailed in the scholarly article "Clinical application of three-dimensional printing technology in craniofacial plastic surgery" 3D printing techniques are being used in craniofacial surgeries and especially in reconstruction procedures the require complex modeling. Using the latest 3D printing technology and the STL files converted using democratiz3D®, the contralateral orbit can serve as a point of reference for those in the medical field since the ipsilateral structures taken with a CT scan can be easily converted into an STL file and then fed to a 3D printer. These technologies improve patient consultations, increase the quality of diagnostic information while also helping to improve the planning stage of the surgical process. During surgery, a 3D-printed model of the orbital can be used to orient surgical staff and serve as a guide for surgical resectioning procedures. While these files are available for free on the website, you must register with embodi3D® before you can begin uploading and converting your own CT scans into STL files as well as downloading and 3D printing anatomical models from other users. Every day the collection of anatomical models grows on the embodi3D® website. This is but one of the many ways embodi3D® is seeking to revolutionize medical practices. #1. An Awesome Model of the Orbit's Acute Anatomy The orbits are conical structures dividing the upper facial skeleton from the middle face and surround the organs of vision. Seven bones conjoin to form the orbital structure as we can see in the example below. #2. A 3D Model of the Orbit's Surface in STL Format This excellent 3D model of embodi3D® shows the superficial bony margin of the orbit, which is rectangular with rounded corners. The margin is discontinuous at the lacrimal fossa. The supraorbital notch (seen in the image below) is within the supraorbital rim and is closed to form the supraorbital foramen in 25% of individuals. The supratrochlear notch is medial to the supraorbital notch. #3. A CT Scan of an Orbital Floor Fracture Hisham published this excellent ct scan on embodi3D®. Direct fractures of the orbital floor can extend from fractures of the inferior orbital rim. Indications for repair of the orbital floor in these cases are the same as those for indirect (blowout) fractures. Indirect fractures of the orbital floor are not associated with fracture of the inferior orbital rim. #4. A 3D Model of an Orbital Fracture CT scans with coronal or sagittal views and 3D models help guide treatment. They allow evaluation of fracture size and extraocular muscle relationships, providing information that can be used to help predict enophthalmos and muscle entrapment. #5. 3D Model Showing an Orbital Fracture Dropbear upload this excellent example of a right orbit fracture. #6. An Orbit 3D Model (Printable) Showing Fibrous Dysplasia (FD) for Surgical Demonstration The FD is a benign slowly progressive disorder of bone, where normal cancellous bone is replaced by fibrous tissue and immature woven bone. This entity constitutes about 2.5 % of all bone tumors. #7. An Orbit tumor 57-year-old male patient with increase in left orbital volume and proptosis for 6 months related to headache. No relevant personal medical history. #8. Complex right facial bone fractures In this example we can evaluate a rotated tripod, orbital roof and floor, maxillary sinus, nasoorbitalethmoidal. References Choi, J. W., & Kim, N. (2015). Clinical application of three-dimensional printing technology in craniofacial plastic surgery. Archives of plastic surgery, 42(3), 267. Bibby, K., & McFadzean, R. (1994). Fibrous dysplasia of the orbit. British journal of ophthalmology, 78(4), 266-270.
  15. In the last few decades, the 4th industrial revolution began - a significant advance in the 3D technology and an emerging of a brand new production method - the computer-controlled additive/subtractive manufacturing. It is considered "the new wheel" and it gives the ability to generate a detailed three dimensional object with complicated geometry from various materials (metals, polymers, clay, biological macro molecules) with a robot, controlled by a computer. The size of the object don't really matters - it's possible to construct structures on micron level or entire buildings. The thing, which really matters, is the geometry of the model. The specialists in the 3D technology are able to bend the very fabric of the world in every shape, which is needed. In the medical field, this advancement of the 3D technology was combined with the rise of the computer-assisted imaging and the histological imaging techniques , visualizing the living (or already death) organisms in details, never seen before. This is how the profession of the medical 3D artist emerged, giving new hope and amazing possibilities for the presentation, diagnostics and treatment of the human body. It's a hybrid profession, which requires vast knowledge and experience in the medical, engineering and computer science. If you want to become one and you're wondering can you actually sell your work, this guide will be quite helpful for you. As any other type of scientists, medical 3D artists have to choose his career path. It can lead to a career as academical professor, teaching students and performing theoretical experiments at a university or a science institute or as a industrial R&D specialist, creating practical products for the biomedical corporations. Both career options have their pros and cons, bot of them are saving lives. The difference is in the way of thinking. And the salary. For both of them the entrance requirement is a PhD in the field life or engineering science. So, in order to become a medical 3D artist, you need to go in the academy for a while, to endure the hell of the dissertation/thesis and to keep your sanity at the end. Once achieved, it's really hard to stay unemployed for long, those pesky talent seekers will jump on you like flies on manure. 1. Academical: The academical lives and thrives in his/hers institution. An office, a laboratory, some teaching obligations and the ability to work in the most cutting-edge fields of science and technology. More flexibility/freedom: the academical have a lot of free time, as long as the basic obligations towards the institution are satisfied. Intellectual autonomy: the academical can follow whatever idea he/she wants, as long as it's supported by the institution. Long term results: the academical things and acts in long period of time - one project can take an year, several year or the entire lifespan, depending on the project. Funding/salary issues: the academical is always underfunded and the salary sucks (unless he/she is well quoted, successful professor). This is why the problem-solving abilities and the high IQ are required for this career path. Strong ego and self-confidence: the academical things for themselves as geniuses, much smarter than the rest of the population (and in most cases they are right). Always “speaks theoretically”: the question "what if" is the breath and butter of the academia and it's really hard for the academical to be practical. 2. Industrial R&D specialist: the industrial scientist works in a office or a warehouse, with a team of other specialists, under the supervision of a project manager. He/she develops practical products, which have to be sellable and they have to be developed fast. More constrained (deadlines): the usual industrial project takes several months, under strict supervision and have to satisfy the needs of the marketing department. The deadlines are an issue here. Produces a practical product: the product have a practical, well defined application, shape, quality requirements and price. Pays a lot more: the salaries of the industrial R&D have an additional zero at the end. No funding issues: the industrial projects have more than adequate budget and they can receive an additional funding, if needed. No ego issues – “it’s just a job” - for the industrial specialist, the work is just a meaning for living. A job, as good as any other job. No "special missions" here. Literally “saves the world”: the products of the industry are used as practical applications and are used for diagnostics and treatment on everyday basis. Professional levels: As any other profession, the medical 3D artist goes through several stages, each one with higher requirements and possibilities. Jobber: the lowest level of them all. A sporadic odd jobs, for a low salary, for whoever is willing to pay. This is the first level, which a wannabe medical 3d artist reach and the level, on which most of them stay. Only those, who can achieve the necessary discipline, business ethics and quality can reach the next level. The jobbers are unpredictable, chaotic, they can hardly satisfy the deadlines and they offer the lowest quality possible. Every medical 3D artist in training is also a jobber. Freelancer: the selective few, who are talented and discipline enough to be able to offer NDA, contract, quote statement, production method description and industrial quality control. Those are the medical 3D artists, who doesn't suck, but wants to be free and flexible enough to follow their other interests. The freelancer is hired from companies and institution, which can't support a full-job 3d artist or their specialist are not competent enough to make the job done. A proud, well-respected person, working under strict business ethics, for fixed pay rate, usually calculated per hour or per item. The freelancer works on small projects, for a limited period of time and under well-defined condition, written on an official contract. Every professional medical 3D artist is also a freelancers. The reputation have a big importance in this group, which is why the freelancers are considered predictable, disciplined and competent to do any task, thrown at them. The salary here depends on the negotiating skills of the freelancer. Contractor: Those freelancers, who have the necessary business talent and are willing to take some risks, can make a company with several employees, several 3d printers, a convenient website with good portfolio and a variety of services. Such a company can take bigger orders from large institutions (hospitals or industrial companies), which requires a higher level of expertise, speed of service and quality control. Those contracts are for a longer period of time, under fixed condition, pricing and quality of the service. CEO: Those are the contractors, who are able to survive and to thrive, eventually can become big corporations, with hundreds of employees and millions dollars budgets. All of the current corporations started as small companies. Believe it or not, the biggest 3d printing companies (3D Systems, Stratasys. Ultimaker and many more) started as small, family-oriented companies, which became the gigantic corporations they are today. How they made it? I really want to know the answer of this question. So, most likely, you're a talented young (or not-so-young) individual with medical background, who watched some tutorials, made several models (most likely bones) and 3d printed them with a cheap 3d printer. Confident with your results, you think you can make a living with this amazing job and you're wondering how to start. My start was a bit rough, because I was trying to make a model of Pyramidal neuron in the Telencephalon for my department from a 10Gb Z-stack in Tif format with zero knowledge how to do it. This is how I found this website in first place. Few days later the model was done and when I tried to make my first bone models, it was way too easy, compared to the neuron. The rest is a lot of trails and errors, a lot of youtube tutorials, several kilograms of textbooks and the support of my colleagues. Here are some tips what you need to do in order to become a freelancer: Portfolio: If you want to sell your work, you have to present it first. Sketchfab.com is a very good way to do it, because it have an amazing 3d viewer with various awesome animation options. If you want to present your work, you just have to paste the link, because it's a zero-footrpint system - all you need to use it is a web browser. It's an excellent choice for 3d visualization and it's also free. The more models you're adding, the bigger audience you'll have and you don't have to worry what kind of 3d viewer your potential clients are using. Downloadable models: My personal choice is 30% paid models and 70% free ones. I'm a PhD student, I don't have some immediate need of money, so I can afford that. I'm dividing my models into regular and premium ones. In this way my models can be useful for everyone, both business parties or poor students around the world. It's really hard to find a good medical model for a presentation or a small university project and if you manage to find one, it's most likely from this website. Quote: When you're starting a job for someone, make sure that you have an accurate quote for your task in written format. Something like that: "I will generate ??? 3D models of a ??? (system, organ, structure) from CT/MRI datasets, which will include the following structures (soft tissues, bones, arterial/venous vessels etc. etc.) in ??? days for a ??? USD per hour, ??? hours per model, ??? USD per model". The more accurate you are, the better. This gives you the framework, in which you're working. Everything outside this frameworks is an extra and it should be payed as well. Your clients will try to change the conditions of your quote, this is why you need something written to control this process. Make sure you specify the currency, $ can mean a US dollar or a Mexican peso! NDA: Some clients will requite a mutual non-disclosure agreement, which you have to print, sign, scan and send back to the client. If you don't have such a document signed, you can do whatever you want with the model and you don't have to explain yourself to your client. You can afford a lower price for a model without NDA, because you can sell it or upload it as free download anyway. If you have such a document, just forget about the model, don't share it, don't show it and don't print it - you don't want to be sued by a medical company, they are more powerful than you. Contract: You should have a standard freelancers contract, in which you should apply the quote statement. Most of the cases, the quote statement is enough. Production method: You have to specify your production parameters like software, methods and operations. Something like that: "Segmentation of the abdominal aorta with Slicer 3D, exporting of the model as stl file, modelling and sculpting (smoothing, remeshing, boolean operation etc etc) in Meshmixer, postprocessing (slicing, magnet sockets, hinges etc etc) in Fusion 360, importation of the model into Slicer 3D for subsequent quality control, including ??? measurements of the dataset, the model and generation of average deviation". Don't be too precise, just the basic operations you're using with the corresponding software. Make sure you're not using a cracked software in your production method, everything you're using should be owned by you! 3D printed models: It's a good idea to have a set of 3d printed models, which can be presented on conferences, exhibitions and your social media page. This is a good commercial for your work, which is also a way for popularisation of the medical 3D modelling. Deadlines: Be precise in your work and follow the deadlines! As an old proctologist from my med school used to say - it's better to mess your finger than your reputation. If you're good in your work, you'll be hired again. Invoice: As with the contract, you should have a standard freelancers invoice, which you should send to your client. All those documents increases your credibility and are considered as signs of professionalism. If you're keeping your professional level high, you'll have better clients and higher pay rate. Freelancers websites: It's a good idea to have profiles in several freelancers websites. Most of your clients will contact you in person, but most likely they'll find you on those websites. Linkedin is a must. Patreon and facebook are also a good bet. Pricing: The usual salary for 3d modelling is between 30 and 60$ per hour, depending on the complexity of the task and the presence of an NDA. The most useful pricing for 3d printing is 1,5-2$ per hour of 3d printing. The smaller slide thickness and the bigger models requires significantly more time and a bigger price. You should also include all the postprocessing you're using (sanding, airbrushing, magnets, varnishes etc etc). 3D printing: For small operations, two or three 3d printers are enough. Good budget options are Ender 3 (FDM) and Elegoo Mars (DLP). Prusa MK3 and Form 2 are better, more expensive options, which will make your life much easier. Keep your printers in good condition and provide a regular maintenance. Choose several brands of polymers and stick to them, you don't want surprises, why you're chasing a deadline. Have fun: It doesn't matter what you're doing and how much you're making by doing it. Just have some fun! 3D printing is amazing, highly contagious activity, but it can become a burden, if you're not enjoying it. And always remember - with your work you're developing the medical science and you're literally saving lives.
  16. Hmm its been a while since I did a registration. First thought is to try the reverse (register small to large). Another option would be to try to artificially make the smaller image larger by 'padding' it with black though that could throw off the registration.
  17. Hi Mike, Thanks for your video. I am working with a slightly different case from yours: I have two MRIs which represent the same patient (in the same position); however, one image is larger than the other (it represents a larger portion of the body). I follow the steps you suggested. The registration works fine, but the larger MRI is cropped to a smaller image which can overlap the other MRI. This is undesired for me since I would need the extra portion of the body originally provided by my larger image. Could you please help me with this? Just to help you understand, the image below shows the output of the initial (manual) alignment, where I still see the size difference between MRIs. The lower part will then be cropped when applying the General Registration (BRAIN). Thank you! Matteo
  18. If you are able to read this sentence, you not only have your English teacher to thank (as the popular bumper sticker suggests), but also your brain. The human brain — all of 3 pounds (1,350 grams) — consumes over 10% of the human body's total energy, yet most of its weight is water and makes up very little of the body's total mass. The recent explosion of 3D printing technologies in the field of neurosurgery has made creating a 3D brain model using CT-converted STL files easier than ever. This popularity has led to a number of medical authorities to further explore the technology's current utility and future potential. In a recent article titled "3D printing in neurosurgery: A systematic review," it was found that 3D printing techniques are not only practical, but also a viable means of creating anatomically correct models that can be applied to medical simulations, training, surgical planning, and secondary devices. 3D-printed models have also enabled neurosurgeons to explore structures in a way that is non-invasive. Amazingly, 3D models can be created using existing technologies, such as two-dimensional MRI, CT, and X-ray scans. These files are then converted into 3D printer-ready STL files using a program such as democratiz3D® from embodi3D®, a free tool that makes converting CT scans in 3D-printable files as easy as possible. Before you can make use the awesome medical 3D printing services offered by embodi3D®, you must become a registered embodi3D® member. It's absolutely free to join — sign up today! Once you've signed up, be sure to check out the tutorial demonstrating how easy it is to create your own 3D models. #1. 3D Printing a Brain Model with Stroke from an STL File This excellent 3D model of the brain circulation shows all the intracranial vessels. Stroke is a generic term that describes the clinical event of a sudden onset of neurologic deficit secondary to cerebrovascular disease. Stroke has 4 main etiologies, including cerebral infarction (80%), intraparenchymal hemorrhage (15%), nontraumatic subarachnoid hemorrhage (5%), and venous infarction (approximately 1%). Clinically, ischemic infarction is the most common etiology and will be the main topic of this introduction. The principal cause of cerebral infarction is atherosclerosis and its sequelae. Middle Cerebral Artery (MCA) distribution typically involves the majority of the lateral surface of the hemisphere, including the frontal, temporal, and parietal lobes. In addition, the majority of the lenticulostriate arteries arise from the M1 segment and supplies the basal ganglia. Anterior Cerebral Artery (ACA) supplies the medial anteroinferior frontal lobe, the anterior 2/3 of the medial hemisphere surface, and a variable amount of territory over the cerebral convexity. The corpus callosum is also typically supplied primarily by the ACA branches: Callosal perforating, pericallosal, and posterior splenial branches. Posterior Cerebral Artery (PCA) vascular territory, including the occipital lobes, inferior temporal lobes, and medial posterior 1/3 of the interhemispheric brain. Patients with PCA ischemia most commonly present with visual complaints. Large vessel/atherosclerotic strokes represent ~ 40% of strokes. The carotid bifurcation is the most common site of atherosclerotic plaque. Circle of Willis - A1-segment: Anterior cerebral artery from carotid bifurcation to anterior communicating artery gives rise to the medial lenticulostriate arteries. - A2-segment: Part of anterior cerebral artery distal to the anterior communicating artery. - P1-segment: Part of the posterior cerebral artery proximal to the posterior communicating artery. The posterior communicating artery is between the carotid bifurcation and the posterior cerebral artery) - P2-segment: Part of the posterior cerebral artery distal to the posterior communicating artery. - M1-segment: Horizontal part of the middle cerebral artery which gives rise to the lateral lenticulostriate arteries which supply most of the basal ganglia. - M2-segment: is the part in the sylvian fissure and the M3-segment is the cortical segment. - Horizontal M1-segment Gives rise to the lateral lenticulostriate arteries which supply part of head and body of caudate, globus pallidus, putamen and the posterior limb of the internal capsule. Notice that the medial lenticulostriate arteries arise from the A1-segment of the anterior cerebral artery. - Sylvian M2-segment Branches supply the temporal lobe and insular cortex (sensory language area of Wernicke), parietal lobe (sensory cortical areas) and inferolateral frontal lobe - Cortical M3-segment Branches supply the lateral cerebral cortex #2. A Brain Model Created from a High-Resolution MRI Scan This 3D model shows each of the cerebral hemispheres (the frontal lobe, the parietal lobe, the temporal lobe, and the occipital lobe, limbic lobe), sulcus, Silvian fissure and Rolandic fissure. Surgical education has undergone a recent paradigm shift toward simulation-based training as opposed to the traditional experience-based training program. This change reflects the need for a safe teaching environment separated from the risk-inherent operating room, thus enabling teaching faculty to focus on training during simulations and patient care during operations. Other factors have also contributed to the shift including instituted training restrictions that have limited patient interactions, which are essential for procedural learning. The capabilities of 3D printing are well suited for the development of these physical simulators, which is evident from the literature. #3. An MRI of the Brain This excellent MRI image of the brain shows all the anatomy structures with great detail. Current surgical planning for the resection of brain tumors involves using MRI technology to differentiate between tumor and surrounding brain tissue. Nonetheless, even when this distinction is clear, it can be difficult for surgeons to appreciate the relationships between adjacent anatomical landmarks during the procedure. 3D printing technology has enabled MRI data to be translated into patient-specific models depicting the associations between tumor, skull, vasculature, and surrounding nonpathologic brain tissue. Therefore, surgeons can recognize the location and extent of the tumor relative gyral/sulcal patterns and skull features. Models have then been further utilized to simulate realistic surgical approaches under microscopic observation. Spottiswoode et al. additionally included printed regions of functional MRI (fMRI) activation determined from presurgical mapping paradigms in the model to demarcate areas of eloquent cortex that should be avoided in resection. #4. A Brain CTA (nrrd file) This is an illustrative case of a normal CT angiography obtained with contrast administration. #5. A Fronto-Parietal Brain Tumor from an MRI Printed head models have also had a role in the planning and development of novel treatments for brain tumors. Phantoms that replicate the properties of the skull and cerebral tissue were produced to evaluate the potential for MRI-guided focused ultrasound to be used in the noninvasive thermocoagulation of brain tumors. #6. A 55-Year-Old Male's Brain (from an MRI Scan) The neocortex is the most phylogenetically developed structure of the human brain as compared with the brains of other species. The complex pattern of folding allows an increased cortical surface to occupy a smaller cranial volume. The pattern of folding that forms the sulcal and gyral patterns remains highly preserved across individuals. This enables a nomenclature for the cortical anatomy. #7. A Post-Traumatic Brain Injury Pneumocephalus refers to the presence of intracranial gas, and in the vast majority of cases the gas is air. The term encompasses gas in any of the intracranial compartments, and is most commonly encountered following trauma or surgery. Gas on CT will have a very low density (~ -1000HU) but care needs to be taken in ensuring that it is not fat which although of much higher density (-90HU) also appear completely black on routine brain windows. #8. A 3d printable model of the brain: An example This brain model was printed for a customer in white PLA. It turned out great! #9. Dilated Ventricles with Colpocephaly Colpocephaly is a congenital brain abnormality in which the occipital horns - the posterior or rear portion of the lateral ventricles (cavities) of the brain -- are larger than normal because white matter in the posterior cerebrum has failed to develop or thicken. #10. Full Sized Brain with marked cerebellar atrophy Diffuse atrophy of the cerebellum refers to a progressive and irreversible reduction in cerebellar volume. It is a relatively common finding and found in a wide variety of clinical scenarios. References 1. Randazzo, M., Pisapia, J. M., Singh, N., & Thawani, J. P. (2016). 3D printing in neurosurgery: a systematic review. Surgical neurology international, 7(Suppl 33), S801. 2. Radiology assistant web. 3 Radiopaedia.org 4. Osborn´s Brain Imaging. 5. Medscape
  19. 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.
  20. Creating a Kidney Free and Downloadable Models Using the Latest Medical 3D Printing Technologies At embodi3D®, we see the utility of creating a kidney model using 3D printing technologies as a way to better understand this complex and utterly vital organ. Through CT-converted STL files, researchers, students, and medical practitioners can examine the kidney in 3D form and in a state that is more natural. An average kidney has a peripheral cortex, central medulla, vessels, urothelial structures, and renal sinus fat. All of these features work together to properly eliminate toxins from the body, ensuring excess creatinine and urea are expelled and not concentrated in the bloodstream. The kidney is crucial to human health. Visualize, for a moment, the human body as a city; the veins, the highway transporting nutrients; the brain, the urban planners, and of course, the kidneys would be the waste management department. Kidneys don't have a glorious role, but like a city waste department, you quickly realize something is amiss when they aren't doing their official duties. Kidneys work by regulating the amount of water retained in the body. The amount of water retained is based on the body's hydration needs and the kidneys' need to expel toxins, namely urea and creatinine. When a kidney doesn't operate as it should, these toxins can build up in the bloodstream, leading to a range of health complications. A common blood test can reveal these byproducts. Currently, there is no cure for chronic kidney disease (CKD), only methods to slow its progression and provide some relief through dialysis and kidney transplants, respectively. A recent investigative inquiry into the impact of 3D-printed pelvicalyceal system models on patient information prior to surgeries related to percutaneous nephrolithotripsy found that it is highly feasible to generate models of the pelvicalyceal, and also helps patients to better understand the disease and the surgical process in treating it. Although 3D-printed models of the kidney continue to be used in patient education and as reference tools during complex surgical procedures. Although, more recently, a young patient in the United Kingdom received a kidney transplant during a procedure aided by a 3D-printed reference model. The last 5 to 10 years have seen dramatic changes in the ability of CT scanners to image faster with greater resolution. Using this new technology, CT has aided in the evaluation of urinary lithiasis, renal masses, and adrenal lesions. It's an exciting time in medical 3D printing and we would like you to be a part of it. Register on embodi3D® and take advantage of the many conversion algorithms registered users can utilize. #1. Left kidney in an STL (3D Printer-Ready File) Dr. Mike uploads this amazing 3d model of the left kidney. The kidneys are generally symmetric in size and appearance, but the left kidney may also be slightly longer than the right kidney. The kidneys are usually larger in male patients and should reach full size by the late teens. The normal range of the kidney size is variable based on patient height with median length 11 cm, and most are within a range of 9.8 to 12.3 cm. #2. 3D Model of a Right Renal Cortex (Kidney) Processed Using 3D Slicer The cortical thickness of the kidneys is usually symmetric. The mean thickness of the cortex is approximately 10 mm, based on sonographic studies #3. 3D Model of the Left Kidney with Hydronephrosis Hydronephrosis is a dilatation of collecting system. demonstrate the full length of the ureters and pyelocaliectasis. Grading: ○ Mild: Mild dilatation of renal pelvis ± dilatation of calyces. ○ Moderate: Moderate dilatation of renal pelvis and dilatation of calyces. ○ Severe: Severe dilatation of renal pelvis and calyces and parenchymal thinning. Thank you valchanov for this excellent example. #4. CT Angiogram of Normal Kidneys (from a Whole-Body CTA) When the cortex has enhanced but the medulla is nearly unenhanced, the nephrographic phase. We can see the renal vessels with exquisite detail. Beyond the renal capsule is the perinephric space, which contains fat and thin fibrous septations. The perinephric fat is contained within Gerota’s fascia. Gerota’s fascia also surrounds the adrenal, which is separated from the kidney by a transverse septum. The anterior and posterior renal fascias separate the kidney and adrenal from other adjacent spaces. If the fascia becomes thickened due to fluid or other causes, it may be visible. #5. Another CT Angiogram of Normal Kidneys (from a Whole-Body CTA) in a Coronal View This example of CTA shows normal kidneys. When the cortex and medulla are more similarly enhanced, and the urographic or excretory phase. Because of its high contrast sensitivity, CT allows differentiation of tissues with much less attenuation difference than can be identified with radiography; thus, there is greater sensitivity for detection of small or faint calcifications than is possible with radiography. #6. 3D Model of the Great Abdominal Vessels In this excellent 3D model we can see the great vessels of the abdomen. The kidneys are located within the retroperitoneal space to each side of the vertebral bodies at the level of T10-L2. The left kidney is often located slightly more cranial than the right kidney. Each kidney is supplied by one or more renal arteries, which originate from the aorta below the level of the superior mesenteric artery or rarely from the iliac arteries. Single bilateral renal arteries are the most common configuration and the renal arteries course anterior and medial to the kidney. However, in approximately 24% to 30% of kidneys, there will be multiple renal arteries. The right main renal artery typically passes posterior to the IVC, but precaval arteries are present in 5% of patients. The main renal artery typically divides at the renal hilum to form a dorsal and ventral branch. The dorsal and ventral branches subsequently divide into segmental renal arteries. In approximately one fifth of renal arteries, there may be early branching of the renal arteries within 2 cm of the origin of the main renal arteries. The renal arteries may also be in close association with the collecting system or proximal ureter. #7. CT Angiogram Showing Left Kidney with a Tumor In this CTA we can see a tumor localized in posterior pole of the left kidney. #8. T1-Weighted MRI Showing the Normal Anatomy of the Kidneys Normal T1-weighted MRI appearance of the kidney. The renal parenchyma is similar to other soft tissues and there is T1 bright fat in the renal hilum References 1. Atalay, H. A., Canat, H. L., Ülker, V., Alkan, İ., Özkuvanci, Ü., & Altunrende, F. (2017). Impact of personalized three-dimensional (3D) printed pelvicalyceal system models on patient information in percutaneous nephrolithotripsy surgery: a pilot study. International braz j urol, 43(3), 470-475. 2. Soliman, Y., Feibus, A. H., & Baum, N. (2015). 3D printing and its urologic applications. Reviews in urology, 17(1), 20. 3. Lee, J. K. (Ed.). (2006). Computed body tomography with MRI correlation (Vol. 1). Lippincott Williams & Wilkins.
  21. Magnetic resonance imaging (MRI) allows for the delineation between normal and abnormal tissue on a macroscopic scale, sampling an entire tissue volume three-dimensionally. While MRI is an extremely sensitive tool for detecting tissue abnormalities, association of signal changes with an underlying pathological process is usually not straightforward. This digital model can then be used to create a 3D-printed custom holder for the brain. (1,2,3) An MRI sequence is a number of radiofrequency pulses and gradients that result in a set of images with a particular appearance. When describing most MRI sequences we refer to the shade of grey of tissues or fluid with the word intensity, leading to the following absolute terms: - high signal intensity = white - intermediate signal intensity = grey - low signal intensity = black Often we refer to the appearance by relative terms: - hyperintense = brighter than the thing we are comparing it to. - isointense = same brightness as the thing we are comparing it to. - hypointense = darker than the thing we are comparing it to. This week we´d like to share the best MRI images from embodi3d. Also, we invite you to become an embodi3D® member and get full access, it´s easy and free! 1. Aortic type III MRI 3D reconstruction This excellent 3D model was uploaded by valchanov. The aortic arch type III is described using as criterion the vertical distance from the origin of the brachiocephalic trunk (BT) to the top of the arch in the parasagittal ‘stretched-out’ projection. This distance is < 2 diameter of the left common carotid artery (LCA). This can influence the feasibility and difficulty of interventional and/or surgical maneuvers. 2. An head´s MRI pmcpartlan uploads this brain´s MRI, T1 sequence. In the context of neurosurgical planning, one can lay implantable devices on the skull or brain to see precise ultimate spatial fits, as well as anticipate surgical approaches such as any bone windows. The 3D models can also be excellent educational tools that are more robust and less toxic than fixed tissue. 3. An MRI of 25 year old male In this 3D model reconstruction we can see we exquisite detail all the structures of the face. Excellent for surgical planning. 4. A left knee MRI after an injury This MRI shows patella´s osteophytes. The cruciate ligaments and meniscus are normal. 5. Left hemisphere´s brain tumor. Contrast enhancement visualized. Homogeneous enhancement can be seen in: Metastases, Lymphoma, Germinoma and other pineal gland tumors Pituitary macroadenoma, Pilocytic astrocytoma and hemangioblastoma (only the solid component), Ganglioglioma, Meningioma and Schwannoma. Three-dimensional models and navigation systems for neurosurgery can be combined to improve surgical planning and surgeon training. An study titled: New Directions in 3D Medical Modeling: 3D-Printing Anatomy and Functions in Neurosurgical Planning reported herein demonstrates that preoperative planning using diffusion tensor imaging (DTI) tractography and 3D models is feasible and can be employed in the preparation of complex operations. Additionally, it is likely that this process can shorten operation times, contribute to better patient safety, and be used for training surgeons. 6. Right anterior cruciate ligament´s injury This knee MRI without contrast shows an anterior cruciate ligament´s injury. Most tears occur in proximal or mid portion of ligament. Staging, Grading, & Classification • Complete tear: Ligament functionally incompetent ○ Some fibers may remain morphologically intact • Partial tear ○ High grade (unstable): Abnormal Lachman but not completely disrupted – Usually ≥ 50% of ligamentous cross section disrupted. – Tears involving 50-75% of ligament → high likelihood of progression to complete tear. ○ Low grade (stable): Some laxity on exam but defined endpoint on anterior drawer test. Image Interpretation Pearls • Use axial MR images to determine partial vs. complete 7. Lumbar spine´s MRI In this MRI we can see L4-L5 bulging and osteodegenerative changes. Thanks Dr. Pablo Andres Rodriguez Covili, Medico Neurorradiólogo/Chile. 8. Normal hand finger anatomy by MRI Hand´s MRI can provide important information for diagnosis and evaluation of soft-tissue trauma in the fingers. An optimal imaging technique should include proper positioning, dedicated surface coils, and specific protocols for the suspected abnormalities. Familiarity with the fine anatomy of the normal finger is crucial for identifying pathologic entities. MR imaging is a powerful method for evaluating acute and chronic lesions of the stabilizing articular elements (volar plate and collateral ligaments) of the fingers and thumbs, particularly in the frequently affected proximal interphalangeal and metacarpophalangeal joints. In the palmar aspect of the hand, the flexor digitorum superficialis (FDS) tendons of the lesser (second-fifth) digits insert onto the palmar aspects of the bases of the middle phalanges. Prior to their insertion, they briefly split at the level of the proximal phalanges then reunite at the level of the proximal interphalangeal (PIP) joints to create ring apertures for passage of the flexor digitorum profundus (FDP) tendons. In the dorsal aspect of the hand, the digital branches of the extensor digitorum (ED) tendon trifurcate distal to the metacarpophalangeal (MCP) joint. A central band from each ED branch inserts on the dorsal aspects of the bases of the lesser middle phalanges. Radial and ulnar bands continue more distally to insert on the dorsal aspects of the bases of the distal phalanges. The MCP joint collateral ligaments of the thumb and lesser digits extend with slight obliquity from shallow depressions on the radial and ulnar aspects of the metacarpal heads to the bases of the proximal phalanges. 9. Left foot MRI An incredible foot´s MRI showing the normal anatomy with exquisite detail. Excellent for surgical assessment. 10. Another Lumbar spine´s MRI This MRI shows normal anatomy. References 1. Demertzis, S., Hurni, S., Stalder, M., Gahl, B., Herrmann, G., & Van den Berg, J. (2010). Aortic arch morphometry in living humans. Journal of anatomy, 217(5), 588-596. 2. Jones, J. (2018). MRI | Radiology Reference Article | Radiopaedia.org. Radiopaedia.org. 3. Luciano, N. J., Sati, P., Nair, G., Guy, J. R., Ha, S. K., Absinta, M., ... & Reich, D. S. (2016). Utilizing 3D printing technology to merge mri with histology: a protocol for brain sectioning. Journal of visualized experiments: JoVE, (118). 4. Naftulin, J. S., Kimchi, E. Y., & Cash, S. S. (2015). Streamlined, inexpensive 3D printing of the brain and skull. PLoS One, 10(8), e0136198. 5. Bahadure, N. B., Ray, A. K., & Thethi, H. P. (2017). Image analysis for MRI based brain tumor detection and feature extraction using biologically inspired BWT and SVM. International journal of biomedical imaging, 2017. 6. Mirvis, S. E. (2016). Diagnostic Imaging: Musculoskeletal: Trauma.
  22. Explore the Neck Anatomy in a free and downloadable 3D Model The "neck"—colloquially speaking—is the section of human anatomy between the head and the rest of the body. The word "cervical" is derived from Latin and simply translates to "of the neck." The neck has a huge responsibility in supporting the head, while also allowing enough flexibility to change the position of the head—a full 60 to 80 degrees of rotation in most healthy adults. Because of its versatility and utility, the neck is simply one of the most fascinating parts of the human form. One of the best ways to explore neck anatomy is in a 3D model. In this week's post, the staff at embodi3D® have put together a number of exciting examples demonstrating the usefulness of 3D printing in modeling the head, neck, and upper torso. These days, physicians, radiologists, and those within the medical community are using DICOM CT scans converted into STL files in order to create 3D-printed models of this fascinating region of the human body. These 3D-printed models are then used in medical training, as references during patient consultations, as well as guides during complicated surgeries. In a recent issues of the Journal of Spine Surgery, they explored 3D-printed models' use in complex neck and spine surgeries, with a particular emphasis on how neurosurgeons are using the technology. The embodi3D® website hosts a section dedicated to CT scans of the head, neck, and spine, but this is the first blog post devoted to the neck. In this week's embodi3D® blog post, we will take a look at some of the most compelling files uploaded to the embodi3D® website. All of these can be used to explore the anatomy of the neck in a 3D model. Before you can begin printing your own 3D models, you must first become a registered member. It is absolutely free to join embodi3D® and take advantage of our many industry-leading tools and conversion algorithms. Register with embodi3D® today! #1. A CTA Scan of the Neck in NRRD Format Dr. Mike uploaded this excellent CT scan showing all the intricate structures of the neck in beautiful detail, including spaces of the infrahyoid neck. Spaces of the infrahyoid neck The infrahyoid neck is divided into 5 major anatomical compartments or spaces by the various layers of the cervical fascia. These spaces are well recognized in the axial plane and therefore suited for analysis on axial CT or MR. - Visceral space Central compartment containing several viscera like the larynx, thyroid, hypopharynx and cervical esophagus. - Carotid space Paired space just lateral to the visceral compartment which contains the internal carotid artery, internal jugular vein and several neural structures. - Retropharyngeal space A small virtual space containing only fat continuous with the suprahyoid space and the middle mediastinum. - Posterior Cervical Space Paired space posterolateral to the carotid space. It contains fat, lymph nodes and neural elements. - Perivertebral space This large space completely encircles the vertebral body including the pre- and paravertebral muscles. #2. A 3D Model Showing Skin of the Neck (in 3D-Printable STL Format) This awesome 3d model of the neck shows the surgical triangles. The infrahyoid neck is the region of the neck extending from the hyoid bone to the thoracic inlet. Traditionally the anatomy of the infrahyoid neck has been subdivided into a group of surgical triangles whose borders are readily palpable bones and muscles. These triangles have a cranial-caudal orientation and therefore are difficult to correlate with cross-sectional imaging. Another approach to the anatomy of the neck is the so-called 'spatial approach', which we shall use in this review. #3. MRI of the neck This dicom image shows the neck and head without contrast. T1 sequence allows evaluate the normal anatomy. #4. CT of the Neck in a Coronal View This model shows the muscles in the front of the neck are the suprahyoid and infrahyoid muscles and the anterior vertebral muscles (see the images below). The suprahyoid muscles are the digastrics, stylohyoid, mylohyoid, and geniohyoid. The infrahyoid muscles are the sternohyoid, sternothyroid, thyrohyoid, and omohyoid. #5. CT Scan of the Neck in a Patient with Craniotomy This ct scan shows the neck muscles and spaces. #6. 3D Model of the Cervical Spine from an STL File This 3d model shows all the bony structures of the neck with some important vessels. The cervical spine is made of 7 cervical vertebrae deemed C1 to C7. The cervical portion of the spine has a gentle forward curve called the cervical lordosis. Certain cervical vertebrae have atypical features and differ from the general form of a typical vertebra. C1 is also called the atlas because it bears the head, "the globe." It has 2 concave superior facets that articulate with the occipital condyles of the skull. This important articulation provides 50% of the flexion and extension of the neck. C1 has no vertebral body and no spinous process. #7. CT of the Neck in a Sagittal View In this ct scan we can evaluate all the lateral vertebral muscles, which are the scalenus anterior, scalenus medius, and scalenus posterior. Scalenus anterior lies at the side of the neck, behind the sternocleidomastoid. It arises from the anterior tubercles of the transverse processes of the third, fourth, fifth, and sixth cervical vertebrae, and descending, almost vertically, is inserted by a narrow, flat tendon into the scalene tubercle on the inner border of the first rib and into the ridge on the upper surface of the rib in front of the subclavian groove. Scalenus medius the largest and longest of the three scaleni, arises from the posterior tubercles of the transverse processes of the lower 6 cervical vertebrae, and descending along the side of the vertebral column, is inserted by a broad attachment into the upper surface of the first rib, between the tubercle and the subclavian groove. Scalenus posterior, the smallest and most deeply seated of the 3 scaleni, arises, by 2 or 3 separate tendons, from the posterior tubercles of the transverse processes of the lower 2 or 3 cervical vertebrae and is inserted by a thin tendon into the outer surface of the second rib, behind the attachment of the serratus anterior. It is occasionally blended with the scalenus medius. The scaleni are supplied by branches from the second to the seventh cervical nerves. When the scaleni act from above, they elevate the first and second ribs, and are, therefore, inspiratory muscles. Acting from below, they bend the vertebral column to one or other side; if the muscles of both sides act, the vertebral column is slightly flexed. #8. 3D model of the neck´s muscles This incredible 3d model shows all the muscles groups with detail. The muscles of the neck can be grouped according to their location. Those immediately in front and behind the spine are the prevertebral, postvertebral, and lateral vertebral muscles and on the side the neck are the lateral cervical muscles. In addition, a unique superficial muscle, the platysma, exists. The platysma muscles are paired broad muscles located on either side of the neck. The platysma arises from a subcutaneous layer and fascia covering the pectoralis major and deltoid at the level of the first or second rib and is inserted into the lower border of the mandible, the risorius, and the platysma of the opposite side. It is supplied by the cervical branch of the facial nerve. The platysma depresses the lower lip and forms ridges in the skin of the neck and upper chest when the jaws are "clenched" denoting stress or anger. It also serves to draw down the lower lip and angle of the mouth in the expression of melancholy. The sternocleidomastoid is the prominent muscle on the side of the neck. It arises from the sternum and clavicle by 2 heads. The medial or sternal head arises from the upper part of the anterior surface of the manubrium sterni and is directed upward, lateralward, and backward. #9. 3D model of the neck´s muscles You can see the supravicular fossa in this example and its relations. It´s limited anteromedially by the sternocleidomastoid muscle, posteromedially by the trapezius muscle and superiorly by the omohyoid muscle. Its pavement is formed by the middle scalene muscle and the first fasciculation of the anterior serratus muscle, involved by the deep layer of the deep cervical fascia. Its roof is formed by skin, superficial fascia and platysma muscle. Its content includes a series of structures that intersect this region, separated from each other by connective and adipose tissue, such as: the subclavian, suprascapular and transverse cervical arteries and veins; the terminal portions of internal and external jugular veins; lymph nodes; the thoracic duct on the left side; the lymphatic duct on the right side; the brachial plexus trunk; the phrenic nerve; and scalene muscles! #10. MRI of the skull and neck In this last example uploaded by Axel Foley you can evaluate with more detail the neck muscles. Tip: Nodes less than 1 cm in size can still be malignant and should be carefully evaluated for other abnormal features, particularly if in expected drainage sites of the primary tumor. References 1. The Radiology Assistant : Infrahyoid neck. (2009). Radiologyassistant.nl. Retrieved 23 September 2018, from http://www.radiologyassistant.nl/en/p49c603213caff/infrahyoid-neck.html 2. Li, H., Chen, R. K., Tang, Y., Meurer, W., & Shih, A. J. (2018). An experimental study and finite element modeling of head and neck cooling for brain hypothermia. Journal of thermal biology, 71, 99-111. 3. Kaye, R., Goldstein, T., Zeltsman, D., Grande, D. A., & Smith, L. P. (2016). Three dimensional printing: A review on the utility within medicine and otolaryngology. International Journal of Pediatric Otorhinolaryngology, 89, 145-148. 4. Neck Anatomy: Overview, Quadrangular Area, Osteology: The Cervical Spine. (2018). Reference.medscape.com. Retrieved 23 September 2018, from https://reference.medscape.com/article/1968303-overview#a5 5. Hoang JK, Vanka J, Ludwig BJ, Glastonbury CM. Evaluation of cervical lymph nodes in head and neck cancer with CT and MRI: tips, traps, and a systematic approach. American Journal of Roentgenology. 2013 Jan;200(1):W17-25.
  23. 3D-Printable Files of the Sinus Anatomy and Skull With hay fever season rapidly approaching in the northern hemisphere, embodi3D® is tackling the topic of the paranasal sinuses and portions of the upper skull. It's an autumnal celebration — embodi3D® style. Granted, we take on a number of arguably more interesting topics in our posts, and nasal and sinus anatomy should be fairly straightforward, right? After all, aren't these just openings and passageways in the skull that allow us to take in fresh air and exhale carbon dioxide? Not quite. This is human anatomy we're talking about, so nothing is ever as simple as one would assume, and the paranasal sinuses are certainly not an exception to this rule. The paranasal sinuses have six primary parts, including the frontal sinus, ethmoid sinus, nasal cavity, maxillary sinus, and mucus membrane. These features allow us to efficiently take in air from the environment. But, as outlined in in a study titled CT of Anatomic Variants of the Paranasal Sinuses and Nasal Cavity: Poor Correlation With Radiologically Significant Rhinosinusitis but Importance in Surgical Planning, there are certain conditions that complicate breathing and prevent the paranasal sinuses from operating efficiently. These include Agger nasi cells, nasal septal deviation (deviated septum), and a condition in which the sphenoid sinuses extend into the posterior nasal septum. As these conditions can have chronic and significant impacts on a patient's quality of life, it's no wonder that paranasal sinus CT scans are among the most-request scans ordered by ENT outpatient departments. The study's authors were unable to find a difference that was statistically different among variations of patients with nasal cavity disease of paranasal sinus disease. This means that all those CT scans being ordered for cases of rhinitis or sinusitis are lacking in value unless a surgery is being planned. Some incredible files of a CT scan following superior maxillary surgery have been uploaded in the past. Could 3D-printed models using CT scans converted in STL files provide better results than CT scans alone? We'll let you decide. But, we're certain you'll form an opinion after viewing these excellent uploads to embodi3D®. Don't forget: to get the most out of these files and to create your own 3D-printed models. Register with embodi3D® today! It's free and takes just a few short minutes of your time. #1. A Half-Skull Available for Download in STL Format An incredible 3D model of an half skull in half size uploaded by Dr. Mike. The paranasal sinuses (“the sinuses”) are air-filled cavities located within the bones of the face and around the nasal cavity and eyes. Each sinus is named for the bone in which it is located. This example it´s perfect for teaching and as a discussion piece. #2. Anatomy of the Paranasal Sinuses This excellent 3D model uploaded by valchanov shows: Maxillary sinus- one sinus located within the bone of each cheek. Ethmoid sinus- located under the bone of the inside corner of each eye, although this is often shown as a single sinus in diagrams, this is really a honeycomb-like structure of 6-12 small sinuses that is better appreciated on CT scan images through the face. Frontal- one sinus per side, located within the bone of the forehead above the level of the eyes and nasal bridge. Sphenoid- one sinus per side, located behind the ethmoid sinuses; the sphenoid is not seen in a head-on view but is better appreciated looking at a side view. #3. An Anatomically Precise 3D-Printed Nasal Cavity with Paranasal Sinuses The pink-hued membranes lining the sinuses make mucus that is cleared out of the sinus cavities and drains into the nasal passage. The right and left nasal passages are separated in the middle by a vertical plate of cartilage and bone called the nasal septum. The sidewall of each nasal passage is lined by three ridges of tissue, and each of these is called a turbinate or concha. Specifically they are designated as inferior, middle, or superior depending on whether one is referring to the lower, middle, or upper structure. Most of the sinuses drain from underneath the middle turbinate, into a region called the osteomeatal complex. When air flows through the nasal passage on each side, it streams through the crevices between the nasal septum and these turbinates. Both airflow and mucus ends up in a part of the throat called the nasopharynx (the very back of the nose, where it meets the rest of the mouth and throat). Air is then breathed into the windpipe and lungs, while the mucus is swallowed. #4. A CT Scan of Paranasal Sinuses Converted from a CT Scan DICOM Other interesting structures associated with the nasal and sinus tract: - Tear duct (called the nasolacrimal duct): drains tears from the inside corner of the eye into the nasal cavity. - Eustachian tube: this is the tube responsible for clearing air pressure in the ears; it opens into the back of the sidewall of the nasopharynx. - Adenoids: this is a collection of tonsil-like tissue that is found at the top of the nasopharynx beyond the very back of the nasal cavity. Although it can be large in children, this tissue usually goes away during puberty, although sometimes it does not and is then, at times, surgically removed for various reasons. #5. CT Scan of Chronic Sinusitis In this CT scan we can see maxillary sinuses with sclerotic thickened bone (hyperostosis) involving the sinus wall. Chronic sinusitis is one of the more prevalent chronic illnesses in the United States, affecting persons of all age groups. It is an inflammatory process that involves the paranasal sinuses and persists for 12 weeks or longer. The literature has supported that chronic sinusitis is almost always accompanied by concurrent nasal airway inflammation and is often preceded by rhinitis symptoms; thus, the term chronic rhinosinusitis (CRS) has evolved to more accurately describe this condition. Diagnostic Considerations - Problems to be considered include the following: - Temporomandibular joint syndrome - Asthma - Other chronic rhinitis - Nasal and sinus cavity tumors - Facial pain and headache attributable to other causes - Nasal polyp - Dental infection - Periodontal abscess - Antral-choanal polyp - Inverting papilloma - Aspirin/nonsteroidal anti-inflammatory drug sensitivity - Chronic headache of other etiology #6. A CT Scan of the Paranasal Sinuses In the article mentioned above the most common anatomic variant of the sinonasal cavities was deviation of the nasal septum, which was present in 98.4% of the patients but was considered to be more than minimal in 61.4%. The second most common variant was Agger nasi cells, which were present in 83.3% of patients, falling within the wide range of 3–100% reported in previous studies . Agger nasi cells were also the second most common variant that occurred bilaterally in our study. The third most common variant was extension of the sphenoid sinuses into the posterior nasal septum resulting in some degree of pneumatization of the posterior nasal septum (76.0%). The fourth most common variant was sphenoid sinus pneumatization extending posterior to the floor of the sella turcica (68.8%), which was defined as air extending more than halfway beyond the middle of the sellar floor toward the dorsum sella. The prevalence of pneumatization of the anterior clinoid process in our study was 16.7%, which is commensurate with the prevalence of 4–29.3% described in the literature . The prevalences of concha bullosa at 26.0% in our study (14–67.5% previously reported), pneumatized lamina of the middle turbinate at 37.0% (9.6–46.2% previously reported) #7. An Excellent 3D Model of the Skull in a Sagittal View Identification of some anatomic variants is crucial in the planning of functional endoscopic sinus or other skull base surgery, because the presence of these variants may influence the surgical approach. Most notably, the presence of sphenoethmoidal (Onodi) cells is associated with increased risk of injury to the optic nerves or carotid arteries during functional endoscopic sinus surgery and with other transsphenoidal and skull base procedures. Endoscopic sinus surgery (ESS) is one of the most common procedures done by otolaryngologists, so achieving a certain competency level in performing this procedure is crucial during the residency program. Moreover, ESS is considered a challenging procedure, especially surgery in the frontal sinus and the frontal recess, which remains the most challenging region of sinus surgery due to the variability and very complex nature of the cellular patterns. To overcome these challenges, simulation technology has emerged as a reasonable approach. A 3D-printed simulator currently developed in a work titled Development and validation of a 3D-printed model of the ostiomeatal complex and frontal sinus for endoscopic sinus surgery training proved to have realistic haptic feedback, especially for the bony dissection. As for the physical appearance, the realism of the anatomy scored high and this is correlated with the ability of the model to enhance 3D learning as was reported by the participants. References 1. Shpilberg, K. A., Daniel, S. C., Doshi, A. H., Lawson, W., & Som, P. M. (2015). CT of anatomic variants of the paranasal sinuses and nasal cavity: poor correlation with radiologically significant rhinosinusitis but importance in surgical planning. American Journal of Roentgenology, 204(6), 1255-1260. 2. Alrasheed, A. S., Nguyen, L. H., Mongeau, L., Funnell, W. R. J., & Tewfik, M. A. (2017, August). Development and validation of a 3D‐printed model of the ostiomeatal complex and frontal sinus for endoscopic sinus surgery training. In International forum of allergy & rhinology (Vol. 7, No. 8, pp. 837-841).
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