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Found 224 results

  1. Stratasys is helping to sponsor a randomized clinical trial to determine the effectiveness of 3d printed heart models for pediatric congenital heart surgery. Read the full story here.
  2. 3D printing technologies have opened up the capabilities for customization in a wide variety of applications in the medical field. Using bio-compatible and drug-contact materials, medical devices can be produced that are perfectly suited for a particular individual. Another trend enabled by 3D printing is mass customization, in that multiple individualized items can be produced simultaneously, saving time and energy while improving manufacturing efficiency. 3D printers are used to manufacture a variety of medical devices, including those with complex geometry or features that match a patient’s unique anatomy. Some devices are printed from a standard design to make multiple identical copies of the same device. Other devices, called patient-matched or patient-specific devices, are created from a specific patient’s imaging data. Commercially available 3D printed medical devices include: Instrumentation (e.g., guides to assist with proper surgical placement of a device) Implants (e.g., cranial plates or hip joints) External prostheses (e.g., hands) Prescription Glasses Hearing Aids In summary, the 3D Printing medical device market looks exciting and promising, Various Reports and surveys suggest the unexpected growth and demand for 3D Printing in medical device industry and it is expected to blossom more but a number of existing application areas for 3D printing in healthcare sector require specialized materials that meet rigid and stringent bio-compatibility standards, Future 3D printing applications for the medical device field will certainly emerge with the development of suitable additional materials for diagnostic and therapeutic use that meet CE and FDA guidelines.
  3. Cardiologists in Aalst, Belgium, 3D printed the hearts of two patients for preprocedural planning in the treatment of arrhythmia (irregular heartbeat). There are different types of arrhythmia and treatment thereof varies. Some conditions don’t require any treatment, while others call for medication or surgical procedures. One minimally invasive procedure is catheter ablation. During this procedure, a catheter delivers high-frequency electrical energy to a small area of tissue inside the heart that causes the abnormal heart rhythm. This energy scars the tissue, thus destroying the electrical pathway that causes the abnormality. Typically, each pathway needs to be disabled individually. Drs. Tom De Potter and Peter Geelen developed a new, more efficient ablation technique to treat arrhythmia. They now can treat the affected tissue in its entirety, rather than pathway by pathway. Given that everyone’s heart anatomy is different and the risks involved in using a new technique, they had their patients’ hearts 3D printed from a CT scan to practice, customize and perfect their technique. For updates on news and new blog entries, follow us on Twitter at @Embodi3D. Photo credit: http://www.hartcentrumaalst.be/nieuws
  4. The 3D printing technology has proven its benefits to the field of medicine. Recently, researchers from the Japanese company Fasotec created realistic 3D printed models of lungs based on the patented technology called Biotexture Wet Models. This particular technology allows surgeons as well as medical students to practice surgical training on almost realistic lungs that do not only have textures similar to real lungs but also comes complete with blood vessels. The reason for the development of realistic 3D printed lungs is to allow students to practice for real life surgical experience. Currently, the 3D printed realistic lungs are used at Jikei University Hospital in Tokyo. The lungs are made by creating the 3D-printed model shells. The shells are hard and empty and then are filled with gel to make up the synthetic replica of human lungs. The doctors then make the final touches to make the model look as real as a human organ as possible. Tomohiro Kinoshita, one of the researchers who developed the Biotexture Wet Models, said that this new innovation in 3D printing lets doctors and students experience the softness of real organs and see them bleed. With the almost realistic experience provided by such a 3D printed organ, both doctors and students will be able to improve their skills even before they go to the operating room. This futuristic technology provided by 3D printing looks very promising and Fasotec is not only geared towards developing realistic lung models but also other organs such as the heart, kidney and liver.
  5. Very few infectious diseases in recent years have commanded the kind of attention and concern that Zika Virus has. Although Zika outbreaks have been reported in Africa, Southeast Asia and other parts of the world since the 1952, recent announcement by the Center for Disease Control and Prevention (CDC) confirming its link with microcephaly has forced everyone to sit up and take notice. The CDC estimates that the current pandemic is widespread with at least 50 countries reporting active Zika transmissions at this time. Most people with Zika virus infection will not have any symptoms though some may experience mild fever, conjunctivitis, muscle and joint pain, and headaches. The virus is primarily transmitted by the Aedes mosquito. However, pregnant women may pass the infection to their babies, which may lead to microcephaly, a neurological condition associated with an abnormally small brain in the infant. The condition can lead to birth defects ranging from hearing loss to poor vision and impaired growth. Prompt diagnosis and treatment of Zika virus infections in pregnant women can, nonetheless, lower the risk of microcephaly to a great extent. Researchers have, therefore, put in a lot of time, money and effort to find a solution, and as always, three-dimensional (3D) medical printing and bioprinting technologies are leading the way. Understanding the Disease To begin with, 3D printing has played a crucial role in conclusively establishing the link between Zika virus and microcephaly. Researchers at John Hopkins Medicine used 3D bioprinting technology to develop realistic models of brain that revealed how the virus infects specialized stem cells in the outer layers of the organ, also known as the cortex. The bioprinted models allowed researchers to study the effects of Zika exposure on fetal brain during different stages of pregnancy. The models are also helping the scientists with drug testing, which is the obvious next stage of their research. Zika Test Kit Engineers at Penn’s School of Engineering and Applied Science, under the leadership of Professor Changchun Liu and Professor Haim Bau, have developed a simple genetic testing device that helps detect Zika virus in saliva samples. It consists of an embedded genetic assay chip that identifies the virus and turns the color of the paper in the 3D printed lid of the device to blue. This can prompt healthcare professionals to send the patient for further testing and to initiate treatment. Unlike other Zika testing techniques, this screening method does not require complex lab equipment. Each device costs about $2, making Zika screening accessible to pregnant women from the poorest parts of the world. Treating Microcephaly The scientists at the Autonomous University of the State of Morelos (UAEM) in Mexico are relying on the additive printing technology to create a microvalve that may help treat microcephaly in infants. The valve reduces the impact of the neurological disease and slows its progression by draining out excessive cerebrospinal fluid associated with this disorder. It can be inserted into the infant brain through a small incision to relieve fluid pressure and provide space for normal development. Researchers estimate the device will be available for patient use by 2017. These examples clearly demonstrate the impact of 3D printing on every aspect of the fight against Zika virus from diagnosing the disease to treating it. The results have been extremely promising, and both researchers and healthcare professionals are immensely hopeful that additive printing technology will help them overcome the infection quickly and effectively.
  6. Version 1.0.0

    305 downloads

    These congenital heart defect STL files demonstrate Partial Anomalous Pulmonary Venous Return (PAPVR). In PAPVR, one or two of the pulmonary veins returns blood to the right atrium instead of the left atrium. This causes oxygen-rich blood to flow back to the lungs instead of on to the rest of the body. Because some oxygen-rich blood is continually flowing between the lungs and the right atrium, the right chambers of the heart may become dilated. Over time, this may cause an abnormal heart rhythm (arrhythmia). In addition, too much blood flow to the lungs may increase the pressure in the lung's blood vessels, leading to a condition called pulmonary hypertension. If only one of the pulmonary veins is affected by the disorder, there may not be any symptoms. If two of the veins are affected, there may be shortness of breath during heavy exercise. Aortic coarctation is also present. Coarctation of the aorta is a narrowing of the aorta, the main blood vessel carrying oxygen-rich blood from the left ventricle of the heart to all of the organs of the body. Coarctation occurs most commonly in a short segment of the aorta just beyond where the arteries to the head and arms take off, as the aorta arches inferiorly toward the chest and abdomen. There are three STL files for 3D printing this model in slices. A whole model STL file is also available for 3D printing. Demonstrated is a bicuspid aortic valve and history of coarctation repair within the first week of life by end to end anastomosis. MRI obtained for evaluation of distal arch. MRI findings: • PAPVR of left upper lobe to innominate vein: Qp:Qs of 1.4:1 • Mild residual narrowing of second transverse segment of the aortic arch. • Moderate post-stenotic dilation of aorta MRI images obtained at end-systole due to tachycardic heart rate during exam. RV End-systolic volume is 36.3 ml. LV End-systolic volume is 30.06 ml. MRI methods: A GE 1.5T HDxt system was used for the 3D HEART sequence which used a 3D respiratory-navigated balanced SSFP (steady state free precession) multi-slab sequence with T2 preparation that provides whole heart coverage with high contrast-to-noise ratio between vessels and myocardium. Due to the relatively fast heart rate of 122 bpm, the fat saturation was turned off to decrease the time needed for the prepatory pulse brining the acquisition window earlier into the cardiac cycle so that it could be centered on the quiescent stage of end systole. The sequence was run with the following parameters: TR 3.4, TE 1.4, Freq 224, Phase 160, RR 8, and fat sat off. Learning: The MRI identified previously un-diagnosed partial anomalous pulmonary venous return. However, the Qp:Qs fell within acceptable left to right shunting of < 1.5:1 and there was insignificant RV, RA enlargement. The MRI evaluation of the coarctation repair revealed a good repair with only mild narrowing, which appeared more severe by echo due to the post-stenotic dilation. Disclaimer: The available model has been validated to demonstrate the case’s pathologic features on a Z450 3D printer, (3DSystems, Circle Rock Hill, South Carolina)(or other printer as appropriate). While the mask applied to the original DICOM images accurately represents the anatomic features, some anatomic detail may be lost due to thin walled structures or inadequate supporting architecture; while other anatomic detail may be added due to similar limitations resulting in bleeding of modeling materials into small negative spaces. However, intracardiac structures, relationships, and pathologic features represent anatomic findings to scale and in high detail. Credit: The model is provided for distribution on Embodi3D with the permission of the author, pediatric cardiologist Dr. Matthew Bramlet, MD, and is part of the Congenital Heart Defects library. We thank Dr. Bramlet and all others who are working to help children with congenital heart problems lead normal and happy lives. It is distributed by Dr. Bramlet under the Creative Commons license Attribution-NonCommercial-NoDerivs. Please respect the terms of the licensing agreement.

    Free

  7. Physicians across the globe have relied on surgical interventions for centuries to treat complex illnesses and injuries. High quality surgical instruments have played an important role in their success. Nonetheless, healthcare professionals are constantly looking for tools that would improve patient outcomes and minimize the risk of unwanted complications. In recent times, three-dimensional (3D) medical printing and bioprinting technologies have allowed doctors and engineers to develop innovative tools that help perform invasive procedures with greater ease. Robotic Surgical Tools Mechanical engineering students at Brigham Young University (BYU), under the guidance of their professors Barry Howell, Spencer Magleby, and Brian Jensen, combined additive printing technology and the ancient art of Origami to create surgical tools that can fit through 3mm wide incisions. Inside the body, the tools can unfold and expand into complex devices such as D-core tools. Minute incisions allow for quick healing eliminating the need for sutures and scars. The tools are highly precise and effective as well. Researchers at BYU are now collaborating with California-based Intuitive Surgicals to manufacture their products. The company is using 3D printing to develop both the prototypes and the actual tools. The 3D printing technology is also helping Intuitive Surgicals to create instruments with fewer parts making the entire process more cost-effective and stable. The Pathfinder ACL Guide Orthopedic surgeon Dr. Dana Piasecki of the OrthoCarolina Sports Medicine has developed a 3D printed surgical tool to conduct ACL surgeries with improved success. Currently, most surgeons drill a hole in the patient’s tibia to remove the torn anterior cruciate ligament and replace it with a graft. The procedure is painful, and the graft often fails to anchor properly. The Pathfinder ACL Guide, created by Dr. Piasecki in collaboration with Strasys Direct Manufacturing, has a 95 percent chance of placing the graft at the right position and helping it withstand the stress associated with extensive movement. The surgical tool is made from a biocompatible and flexible metal and is significantly cheaper than the existing devices. The Pathfinder ACL Guide has been registered with the FDA as a class I medical device and can now help thousands of amateur and professional athletes to continue playing their game in spite of an ACL tear. Eyelid Wands and Forceps Similarly, Dr. Bret Kotlus, a New York-based cosmetic surgeon, has used 3D printing technology to create customized tools for eyelid surgeries. His stainless steel Eyelid Wand helps surgeons lift excess eyelid skin and point it to various facial structures as per the needs of the patient. The handle of the tool consists of a ruler for accurate measurements. Dr. Kotlus has also developed 3D printed Pinch Blepharoplasty Marking Forceps that allow surgeons to mark excessive skin with a gentle ink. It comes with a round tip and a built-in ruler handle for additional patient comfort. These tools also add some sophistication to the doctor’s office at an affordable price. Close to 50 million surgical inpatient procedures are performed across the United States each year. While recent times have seen a significant improvement in the way these interventions are carried out, a lot can be done to make the process more efficient and safe. This is where 3D printing is bound to make a huge impact in the near future. Sources: Johnson & Johnson Adopts Cutting Edge 3D Printing for the Future of Medical Devices 3d printed eyelid instrument designed by Dr. Kotlus 3D Printed Tool Offers New Option for ACL Surgery Researchers Combine Origami, 3D Printing in Quest for Smaller Surgical Tools
  8. Since the 1980s, three-dimensional (3D) medical printing and bioprinting technologies have been influencing almost every aspect of the human life. Most people are, however, surprised at the kind of impact additive printing is having in the field of medicine. The technology is helping diagnose and treat complex illnesses ranging from cancer and heart disease to arthritis and infections. In recent months, several innovative 3D tools have also been created to overcome obesity. More than two-thirds of adults in the United States are obese or overweight. The prevalence of obesity has doubled in children and quadrupled in adolescents in the last 30 years. This has increased the risk of Type II diabetes, cancer and other serious conditions in men and women of all ages and abilities. Both government agencies and nonprofit organizations have spent millions of dollars creating awareness about the issue. Consequently, many people now understand the importance of healthy diet and exercise. They, however, lack resources that will help them accomplish such goals. Physicians are also looking for tools that will assist them in treating morbid obesity more effectively. Thankfully, 3D printing technology is offering some novel solutions to everyone, and researchers believe that it will ultimately bolster the efforts aimed at reducing weight and enhancing fitness levels. Liposuction Tools BioSculpture Technology, under the leadership of New York Downtown Hospitals and the Presbyterian New York affiliated plastic surgeon Robert Cucin, is relying on 3D printing to develop an innovative line of surgical instruments to perform liposuction. The technology is also allowing surgeons to create exact replicas of the patient’s organs and practice the procedure before the actual intervention. Together, these products are making liposuction more accessible and safe. Liposuction is an invasive procedure that involves removal of excess fat from various parts of the body and is commonly used treat obesity. Close to 400,000 people underwent this surgery in 2015, as per the American Society of Aesthetic Plastic Surgery. Tracking Devices Exertion Games Lab in Melbourne, Australia, has created a simple device that can print 3D models of the user’s physical activity time, sleep time, and heart rate during the week to motivate and encourage them to set new challenges. Unlike smartphones and pedometers, the Exertion Games Lab device caters to the needs of children as it helps them grasp complex fitness-related information with ease. Children can also hold these models in their hands and share their enthusiasm with their peers. The Potential These examples just form the tip of the iceberg. The impact of 3D printing on the fight against obesity is expected to go beyond creating mechanical devices and surgical instruments. Tamara Nair, a Research Fellow at the Centre for Non-traditional Security (NTS) Studies in the S. Rajaratnam School of International Studies (RSIS), believes that the technology can also be used to create food products with higher nutritional value. Such foods may help obese and overweight individuals manage calorie intake according to their activity level. The 3D printing technology can also make nutritious foods more palatable, says Nair. These potential benefits may appear like science fiction to some readers. Nonetheless, if the recent advances in the 3D printing and bioprinting technologies are anything to go by, they may turn into reality very soon.
  9. Examples of historical medical 3D printing on display at RSNA. The green skull is from 1985! We've come a long way since then.
  10. What kind of 3D printers work best for printing from CT scans? In terms of resolution, what have others experienced and what sort of resolutions are needed for the models to actually be used for surgical planning?
  11. I was wondering if anybody has found a 3D printing material that works well for fracture studies. I am aware of Sawbones, but would like to explore the possibility of using CT scans to generate 3D printed bones of different size/age/sex for fracture/trauma studies. Thanks! Terrie
  12. Version 1.0.0

    13 downloads

    This 3D printable STL file contains a model of the torso and arms was derived from a real medical CT scan in high detail. This model was created using the embodi3D free online 3D model creation service. QIN-HN-01-0003

    Free

  13. Hello, Just found this website today and wanted to mention my related business: http://www.med-mod.com/ I have years of experience in both medical imaging and 3D printing. Check out some projects on my website or contact me directly with any projects you you would like help with. MikeF@med-mod.com Mike
  14. Significant thinning or loss of hair can have a detrimental impact on the individual’s overall quality of life. Men and women with unhealthy hair often suffer from emotional issues and low self-esteem. The condition may also be indicative of an underlying medical problem. As per the American Hair Loss Association, two-thirds of American men experience some hair loss by the age of 35 and about 80 percent of them have significant thinning of hair by the age of 50. Approximately half of women over the age of 50 also suffer from serious hair loss. Apart from genetics and lifestyle, certain medications and infections can also contribute to the condition. You will find a variety of hair loss treatments in the market today ranging from herbal products to surgical interventions. However, none of these solutions have succeeded in producing dramatic results in a consistent manner. Researchers are, therefore, looking at three-dimensional (3D) medical printing and bioprinting to find products that really work, and their efforts seem to be paying off. 3D Printing Technology to Create Cranial and Hair Implants AdviHair, a subsidiary of London-based AdviCorp PlC, has developed a unique set of cranial prosthetics known as the CNC Hair Replacement System. The company uses 3D printing technology to create implants that conform to the patient’s scalp measurement and skin color. The product can help conceal partial or full scalp baldness associated with Alopecia. Once the prosthetic scalp is placed in position, it behaves like regular hair. You can swim, wash and style it the way you want. The product is expected to benefit more than 6.8 million Americans suffering from Alopecia, an autoimmune disorder that occurs when the patient’s immune system destroys his own hair follicles. The prosthetics are ideal for individuals who cannot undergo transplantation or other Alopecia treatments. Cosmetic giant L’ Oreal has collaborated with French bioprinting company Poietis to print hair follicles that will enhance their understanding of hair biology. The process involves creation of a digital map that indicates the exact position of the living cells and other tissue fragments. The digital map is used to generate instructions for the printing process. A pulsing laser bounces off a mirror through a lens and knocks one micro-droplet of the bio-ink into its position. Approximately 10,000 such droplets are deposited each second. L’Oreal is hoping to use this technology to create products that will treat and prevent hair loss at a realistic price. Improved 3D Printing Software for Hair Implants Although 3D printed cranial prosthetics and hair implants are gaining popularity, many of them take several hours to print. Researchers at Massachusetts Institute of Technology’s Media Lab are, therefore, working on a software platform called Cilllia that allows users to print hair-like structures within minutes. Additionally, researchers at the institute are looking beyond the aesthetics to explore other major functions of the follicles including adhesion, sensing, thermal protection and actuation. Hair loss can be stressful and overwhelming, and the treatments can be expensive. Many patients experience poor results in spite of their best efforts. Scientists are now using 3D printing to overcome the drawbacks associated with conventional treatments, and their recent success is offering hope to the millions of hair loss sufferers across the globe.
  15. The three-dimensional (3D) medical printing and bioprinting industry is evolving at a rapid pace as 3D printers continue to move beyond research labs into commercial manufacturing facilities and hospitals. The printers are being used to create anatomical models, customized implants and even body parts that help treat, manage and prevent complex illnesses and injuries. The technology has contributed to the success several challenging surgical interventions in the recent times. Three-dimensional Printing Systems While scientists are using 3D printers for a variety of purposes, most physicians are relying on them to create patient-specific models of targeted organs and tissues. Healthcare professionals obtain accurate dimensions of the patient’s body parts from radiological images and feed the information into a computer to print exact replicas of the organs. These models help the surgeons assess the abnormality with precision and practice the surgery before the actual procedure. Several consumer-friendly 3D printing systems have been created to meet these needs. Belgium-based Materialise offers Mimics inPrint system that allows physicians to directly import patient images from hospital PACS and use them for 3D printing. The product comes with DICOM compatibility that supports all types of imaging machines. The semi-automated segmentation and editing tools within the printer’s software system ensure error-free printing and enhanced communication. Materialise sets up the entire system and trains the hospital staff to operate it efficiently. Stratasys Inc. also offers additive printing technology to hospitals across the globe. It has the widest variety of materials ranging from clear, rubberlike and biocompatible photopolymers to rigid and flexible composite materials in over 360,000 colors. The Medical Innovation Series from Stratsys has been created for physicians, medical device designers, clinical educators and other professionals in the healthcare industry. Success Stories Twelve National Health System (NHS) hospitals in the United Kingdom are relying on Stratsys printers to create models that allow surgeons to analyze patients’ condition, test implants and practice surgical interventions for better outcomes. Most popular 3D models at NHS hospitals include jaw bones for facial reconstruction surgeries, hip models for hip replacements, forearms for repairing deformed bones, and cranial plastics for fixing holes in a person’s skull. Doctors Without Borders, the Italian humanitarian organization, is also using 3D printed replicas of hospital models to setup new ventures in remote areas of the world. The technology allows physicians to have a realistic experience and thereby, improve patient care. Several other healthcare facilities are also using additive printing technology for increased efficiency. Physicians at Hong Kong’s Queen Elizabeth Hospital used 3D printing technology to help a 77-year-old woman suffering from two damaged valves. The patient had already undergone three open heart surgeries and needed a complex fourth intervention. The 3D printed model helped the doctors complete the surgery in just four hours. In another case, surgeons at Children’s Hospital in Colorado and engineers at Mighty Oak Medical created a 3D model of a patient’s spine to rehearse the surgery. The physicians also used additive printing technology to print customized brackets to treat the patient’s scoliosis. These success stories are inspiring other hospitals to install 3D printers at their facilities. They would, however, require expertise to handle the printer and tools to eventually use the 3D model for clinical purposes. Several facilities are incorporating 3D printing training programs to build knowledge within the institution and to lower the lead times for the actual procedure. While the initial investment may appear significant, most experts agree that 3D printing technology can be a game changer as it can help physicians improve clinical outcomes and reduce costs associated with complicated surgical interventions.
  16. Dear Embodi3D Members, We are excited today to announce Imag3D -- the world's first one-click CT scan-to-medical model creation service. No longer will you have to struggle with expensive or difficult to use software to make 3D printable models. With Imag3D, just upload your CT scan, fill out a few basic parameters, and click Submit. Within 10 or 15 minutes or so you should receive an email that your model is finished and ready to download. Your model will be manifold (error free) and ready for 3D printing. If you want to share your model with the community, you can do so with a click. Imag3D is free for Embodi3D members. Right now only the bone making module is active. Look for tutorials and additional information in the coming weeks. Imag3D takes medical 3D printing from something that was difficult, expensive, and time consuming and makes it quick, easy, and free. Click here to get started. Thank you for supporting us as we try to bring medical 3D printing to the masses! Sincerely, Dr. Mike and the Embodi3D team
  17. Dear Embodi3D Members, We are excited today to announce democratiz3D -- the world's first one-click CT scan-to-medical model creation service. No longer will you have to struggle with expensive or difficult to use software to make 3D printable models. With democratiz3D, just upload your CT scan, fill out a few basic parameters, and click Submit. Within 10 or 15 minutes or so you should receive an email that your model is finished and ready to download. Your model will be manifold (error free) and ready for 3D printing. If you want to share your model with the community, you can do so with a click. democratiz3D is free for Embodi3D members. Right now only the bone making module is active. Look for tutorials and additional information in the coming weeks. democratiz3D takes medical 3D printing from something that was difficult, expensive, and time consuming and makes it quick, easy, and free. Click here to get started. Thank you for supporting us as we try to bring medical 3D printing to the masses! Sincerely, Dr. Mike and the Embodi3D team
  18. Advances in science and technology are helping pharmaceutical companies and biotech giants to come up with novel molecules that may help treat serious and life-threatening conditions such as cancer, heart disease, and Alzheimer’s disease. However, bringing a new drug to the market can get complex and exhaustive. While most companies pass through the initial stages of drug development with ease, they face a lot of challenges during pre-clinical and clinical trials. Recent numbers reveal that only one in 5,000 drugs become accessible to patients. The biopharmaceutical industry spends over $31.3 billion on research and development each year. They also face a lot of ethical questions related to animal testing. Nonetheless, this scenario may soon change as additive printing technology becomes more accessible and dependable. Additive printing, also known as three-dimensional (3D) printing, involves deposition of desired materials on substrates to obtain 3D objects with specific dimensions and characteristics. Many different types of 3D printers are available in the market. Some machines help the user print mechanical and non-living objects. Others can print living tissues and cells when relevant biomaterials are added in controlled environments. Researchers across the globe have already succeeded in printing complex tissue fragments and even small organs such as ears using 3D printers. 3D Printed Systems for Drug Testing Organovo, a leader in 3D printing technology, has created multicellular, dynamic and functional 3D human tissue models for research and pre-clinical testing. As per the company’s website, the printed tissue will remain viable in vitro for a significant period of time while exhibiting all the structural and functional features of the actual tissue. Pharmaceutical companies can use these fragments to study the impact of new drugs on human cells and to predict the final outcome with greater accuracy. Organovo claims that its exVive3D will help researchers “assess biochemical, genomic, proteomic, and unique histologic endpoints.” Nano3D BioSciences, a Texas-based startup, has collaborated with AstraZeneca and LC Sciences to develop a cell-based assay system to assess the effects of a panel of vasodilating and vasoconstricting compounds. The company hopes that the assay will soon become a standard in toxicity testing and in the development of cardiovascular drugs. Similarly, a Canadian company, Aspect Biosystems, allows researchers to create customized tissue fragments for drug testing. The researchers will place specific cells in a hydrogel and print tissue fragments that are allowed to grow in an incubator until they achieve the desired dimensions. The components will resemble the target tissue in structure and function. Researchers at University of California, San Diego, have printed tissue fragments that closely mimic the human liver. According to Shaochen Chen, a NanoEngineering professor at the University, most companies spend 12 years and about $1.8 billion to create one FDA-approved drug. Their 3D printed liver tissue can help companies to perform pilot studies with minimal effort instead of waiting for animal testing or clinical trials, and thereby save millions of dollars. Benefits Apart from making pre-clinical trials more accessible and efficacious, 3D printed tissues also help drug companies overcome ethical issues associated with animal testing. Most researchers agree that animal testing is expensive, time-consuming and often inhumane. The animals require a lot of care, and this limits the number of tests that can be performed at a time. Additionally, results obtained from animal testing may not correlate with actual results in humans. The 3D printed tissue fragments help overcome such obstacles and may eventually allow drug companies to simplify research and development. In the long run, it may also help reduce costs and make therapeutics more accessible and effective for everyone. Sources: http://thenextweb.com/insider/2016/03/29/3d-printing-changes-pharmaceutical-world-forever/#gref http://eandt.theiet.org/news/2016/aug/3d-bioprinting.cfm
  19. Within the past few years, interest in 3D printing and its medical applications has been growing exponentially. 3D printed models have already been used to provide unparalleled pre-surgical planning in complex surgeries such as conjoined twin separation and face transplantation, as well as more common procedures such as fracture fixations and joint replacements. However, the majority of health care providers and recipients are still unaware of this technology and its utility. My hope with this blog is to provide a basic overview of 3D printing and its applications in medicine by answering some of the frequently raised questions. Stay tuned for future blogs where I will attempt to address specific topics in detail! What is 3D printing? 3D printing is a process of creating 3 dimensional objects from a digital file by using a 3D printer. In the field of medicine, the digital files are comprised of 2 dimensional CT or MR images. 3D printers do not directly recognize these digital files and post processing steps are required to convert these files into a format that is readable by 3D printers. The printer then deposits various materials layer by layer to build a 3 dimensional object. What are the applications of 3D printing in medicine? 3D models have already been used for presurgical planning in numerous subspecialties including maxillofacial and craniofacial surgery, orthopedic surgery, neurosurgery, cardiovascular surgery, pediatrics and dentistry. Models can also been used to design implants and prosthesis that are customized to each patient. In the field of radiation oncology, 3D models can be used for radiotherapy planning of optimal positioning of radiation beam and creation of personally designed radiation shields. 3D models are also proving to be superb educational tools for teaching anatomy, pathology and surgical techniques. Bioprinting, which involves printing of live cells and viable tissues that can potentially be implanted into human beings is currently an active filed of research. What are the benefits of 3D printed models that have already been reported? Currently, 3D printed models are predominantly utilized by surgeons. Preoperatively these models improve diagnosis and evaluation of the complexity of the procedure thereby allowing selection of optimal, patient-specific treatment strategy. The models can be used to plan every step of a complex procedure including surgical point of entry, incision size, precise screw length and trajectory. The models can also serve as a cutting guide for resection and as a template for preoperative bending of reconstruction hardware that would fit the specific patient anatomy perfectly. As a result of this accurate preoperative simulation and preparation, 3D models result in reduced actual operating time and cost associated with the use of surgical rooms. The time that the patient has to remain under general anesthesia, amount of blood loss and other potential complications are subsequently minimized. Shortened hospital stay and decreased need for follow up procedures have also been reported. 3D printed models allow patients who typically don’t have years of medical training, to visualize and better understand the planned procedure and make it easier for surgeons to obtain informed consents from their patients. What is the purpose of printing models if 3D images can be viewed on a computer screen? Although a 3 dimensional volume rendered digital models can be created, these digital models are still viewed on a 2 dimensional computer screen, which does not provide the same sensory input as holding a physical model in hand. Surgeons that have used the models report the additional tactile sensory input gained by holding the models and the ability to rotate and view the models from any direction in space greatly enhances their spatial perception of anatomic relationships between adjacent structures. Additionally the models provide the added benefits mentioned above such as serving as a cutting guide and template for pre-surgical bending of reconstruction plates, which cannot be achieved unless these models are printed into tangible objects. In summary, it is hard to imagine all the ways this technology will impact patient care, but judging from what has already been achieved within a very short period of time, 3D printing will certainly revolutionize the healthcare industry for the better. Leave a comment or question below regarding topics you would like addressed on the next blog! Tatiana Kelil, MD Image credit: Healio.com/orthopedics; John Robert Honiball (University of Stellenbosch).
  20. Purpose of this blog: To create a forum where members of the 3D medical printing community can share problems, solutions and practical advice pertaining to all aspects of the 3D printing pipeline. Featured problem: Setting up a new printer Featured printer: Printrbot Metal Plus Printing type: Fused deposition modeling Theme: Don’t put the cart in front of the horse Translation: don’t try to print before you’ve set up the printer If you are at all like me, you are impatient. When your new printer arrives, you want to rip open the packaging, set the printer on the counter, plug it in and hit “print”. If this sounds like you, keep reading. This first blog is a cautionary tale. Lesson 1: Make sure that your printer is properly calibrated. 1. Level, Level, Level While the printer may come “pre-calibrated,” it is always a safe bet to double-check that nothing untoward has happened during shipment. The printing bed needs to be level in relation to the path of the extruder, and therefore both the bed and the extruder railing should be checked and adjusted if not leveled. The more level you can get the print bed with respect to the extruder, the easier your life will be for all of the following steps. There are many reports of warped print beds on the internet; e.g. some of the printrbot simple models seem to have a dip in the center of the print bed. Using a straight edge rather than just a level may help you detect this type of issue. Getting that print bed straight by whatever means necessary is advised. 2. Determine your negative z-value, or get ready to throw out a lot of failed prints You need to determine the optimal distance that the hot end of the extruder should be from the print bed when printing. The number you are determining is the negative z value. Picking your negative z-value is sort of like Goldilocks and the 3 bears: If the negative Z value is too high, your print will look stringy. If the negative Z value is too low, your print will look smashed. So you want it Just Right. To set the negative z value, you need to modify the G-code. G-code? At this moment, let me digress for those not familiar with G-code. G-code is the language that the printing software uses to communicate with the printer. G-code is, in essence, directions given to the printer on how to drive the motors and turn the heaters on and off. This is akin to postscript for laser printers. Different slicing programs will create different g-code; some will do it better than others, depending on how optimized they are for a given printer, etc. This is also why some slicing programs may result in a faster print, based on more optimized/efficient g-code. tip: always enter G code in CAPITAL LETTERS For the Printrbot, you enter the G-code that assigns the negative z-value in Repetier. Go to the manual control tab on the right side of the screen, make sure your printer is connected and then type the following in the G-code line: M501 (shows you what the current X, Y and Z offsets are; output on the bottom of screen) M212 Z0 (The number you type after Z is the negative z value that you are assigning. Start with 0 and see where you land, then go negative in small increments e.g. -0.1 to move closer to the print bed, printing a simple object each time and seeing how it turns out. Positive numbers will move the extruder farther from the bed.) M500 (save) 3. Auto-level before every print. Your printing software should instruct the printer to auto-level before any print. In addition to the basic leveling described in 1., there is an “auto leveling” check designed to determine if the print bed is tilted in any direction. Also referred to as “z probing”, this step is necessary because the quality and success of your print depends on any discrepancies in the distance between the hot end of the extruder and the print bed at a given location being accounted for. This can be done by probing 3 locations on the print bed. Don’t believe leveling the bed matters? Well, here are some problems that can arise from a poorly leveled bed: -Initial print layer does not stick or parts are missing -The hot end of the extruder scrapes the bed -The extruder gathers up plastic from the first or second layer So how does auto-leveling work? -An auto-leveling probe (aka z end-stop sensor) defines the distance between the extruder hot end and the print bed at any given location. The auto-leveling probe is to the right of the extruder and has an orange tip in the picture below. The Printrbot Metal Plus has an “inductive sensor” that detects the print bed via conductivity from the aluminum bed. The theoretical beauty of this design is that the sensor tip can be positioned at a level higher than the tip of hot end of the extruder and thus will not drag through your printing surface the way a touch down sensor would. The potential pitfall is that things that change conductivity (i.e. adjacent metallic objects) may affect the sensor. It is possible that your z end-stop sensor is faulty- if you are the unlucky soul that receives a malfunctioning sensor, you may be in for some hurt if your printer tries to jam the extruder into the table. Even if your sensor works, you may misjudge the distance from the extruder to the bed- for these reasons, be very close to an off switch or the plug when you are calibrating your negative z value. If the extruder is being jammed into the table, by all means, turn the printer off! To auto-level before each print, you need to make sure that the printing software contains the autoleveling G-code and adds it to the beginning of any slicing G-code. You need to set up auto-leveling in each slicing/printing program you use. It does not translate between them. The G code you use in Repetier is: G28 X0 Y0 G29 Below are some links to setting up auto-leveling in Repetier and Cura. Setting up auto-leveling in Repetier on Mac: http://help.printrbot.com/Guide/Setting+Up+Your+Auto-Leveling+Probe+and+Your+First+Print+-+Mac/107 Setting up auto-leveling in Repetier on PC: http://www.repetier.com/documentation/repetier-firmware/z-probing/ Setting up auto-leveling with Cura: http://www.instructables.com/id/Use-Printrbots-Autoleveling-Probe-with-Cura/ Beware: Just because your printer auto-levels itself, it doesn’t necessarily mean it won’t plunge through the printer bed in a desperate attempt to follow your every command. In fact, the printrbot metal plus is NOT smart enough to know when to say no. When we accidentally told it to go down 10 mm in the z direction when it was at Z0, it did so, much to our horror (see picture below). In the background of this picture, a hole in the stage marks the scene of an unfortunate z-axis accident. In the foreground, the outline of an aorta that did not make it (foreshadowing for the next blog entry). 4. Just how accurate is your model? You can check to make sure that the printer motors are appropriately calibrated- i.e. they actually travel the correct distance when told to do so. As described above, the printing software communicates with the printer (and thus the motors) using G-code. To make sure nothing is “lost in translation”, you need to make sure that when the software tells the printer head to move, say, 10 mm in the x-direction and 25 mm in the y-direction, the printer head appropriately translates that g-code into the correct movement. There are 4 motors: -X motor -Y motor -Z motor -Extrusion motor To check the calibration of the x, y and z motors, tell the printer to move 40 mm in the x axis and then measure to determine whether it is accurate. If you measure 40 mm, you are done. If not, you need to do some recalibration (see below). Do the same with the y axis and the z axis. Appropriate calibration in the x, y and z axis matters a lot for medical modeling…you want to make sure you are creating accurate models! To check the calibration of the extrusion motor, heat up the extruder to the recommended temperature for the filament. Use tape to mark a few cm up the filament and then measure from the tape to the entrance into the extruder. Tell the printer to extrude 10 mm of filament and measure again. Rate of extrusion really matters: your printing software assumes it knows the accurate amount of material extruded per given time. If too much is extruded, your print will have globs; if too little is extruded, you have holes or poor matrix This is a great primer on motor calibration and how to fix errors: http://www.instructables.com/id/Calibrating-your-3D-printer-using-minimal-filament/ 5. More advanced calibration/ “tweaking” to optimize your prints: A 3D printing manufacturer who goes by “Ville” recently designed and published an STL test file that can be used to troubleshoot calibration issues with any printer. The print has several challenges, including various overhangs, small details, different sized holes and wall-thicknesses, bridging and different surfaces. The idea is that users can share problems and solutions with each other. Read more at: http://3dprint.com/48922/3d-printer-calibrating-test/ Download this STL test file at: https://www.thingiverse.com/thing:704409 The top picture is what the test model should look like. The bottom picture is what my printer produced. Guess I have some tweaking to do.... In the next post, we will tackle one of the most infamous struggles in 3D printing- getting your model to stick to the print bed. Until then, happy printing! -Beth Ripley
  21. Getting from DICOM to 3D printable STL file in 3D Slicer is totally doable...but it is important to learn some fundamental skills in Slicer first if you are not familiar with the program. This tutorial introduces the user to some basic concepts in 3D Slicer and demonstrates how to crop DICOM data in anticipation of segmentation and 3D model creation. (Segmentation and STL file creation are explored in a companion tutorial ) This tutorial is downloadable as a PDF file, 3D Slicer Tutorial.pdf or can be looked through in image/slide format here in the blog 3D Slicer Tutorial.pdf
  22. This is a time of rapid growth in medical 3D printing. The technology allows us to take an individual patient’s scan information and create physical models, which can be used in any number of clinical applications. The industry standard DICOM image files from CT and MRI scanners can be converted into 3D files, such as STL (for stereolithography) files. These digital models can then be uploaded to a 3D printing service bureau or printed on one of the currently available professional grade printers.The democratization of desktop 3D printers, however, now allows almost anyone with a serious interest in the technology to print models in their own office/workshop. These can be used for educational purposes and for prototyping, and represent an excellent entrée into the technology. Recently, I started printing 3D models of some of my own patient’s scans using a consumer grade desktop printer. The patient’s CTs were acquired on our Toshiba Aquillion 64 Slice CT scanner using our standard acquisition protocols. The DICOM volume data was then burned to a CD for processing. For my initial test prints, I used the Materialise Mimics and 3-matic software under their 30-day free trial period. The images from the appropriate volume were imported into the Mimics software. Thresholding is then performed to isolate the tissues in question, based on its Hounsfield units, a measurement of X-ray density. The particular anatomy of interest is then selected using “region growing” tools and a 3D model is generated. The model is then “wrapped”, to account for the individual CT slices, and to smooth any gaps in the 3D mesh. Choosing the degree of wrapping is where experience comes into play. Too little wrapping can cause gaps to be present on your final models. Too much, and detail can be lost. The 3D model is then exported into the 3-matic program for “local smoothing” of the model. The digital model is then hollowed, depending on the structure and its use. You then export it as a binary STL file. In all of the steps above, clinical knowledge of the anatomy is extremely helpful in creating the most accurate models possible. Understanding how the models will be used informs your decisions in their creation. The STL file is then imported into a slicing software to create the G-code files that instruct the printer how to actually create the physical model. I used the open source Cura software for the generation of the G-code for the printer. An image of the 3D model is seen superimposed in a representation of the build plate of the particular printer, in my case the Ultimaker 2 (Ultimaker B.V.). The model can be rotated to optimize the printing process. The highest resolution of current 3D prints from fused filament printers is in the z-direction: from the bottom on the build plate to the top of the object. The degree of overhang must also be taken into account. Since the filament cannot be deposited in thin air, the slicing software creates a scaffold to support the overhanging material. Keep in mind; this support structure must be physically removed in post-processing. The slicing software also creates a thin base layer of the material (called a brim or raft) that is deposited around the object to facilitate print adherence to the print platform. The generated G-code is saved to an SD card, which is then placed into the printer. In some cases, the files can be transferred wirelessly. I used 2.85 mm PLA filament to create the printed models. PLA is polylactic acid, a biodegradable material derived from cornstarch. PLA based material has been used in orthopedics for sutures, controlled release systems, scaffolding for cartilage regeneration, and fixation screws. The print time takes several hours, depending on the size and complexity of the model, as well as the amount of support structure used. Through trial and error, I found that careful positioning of the 3D model on the virtual build plate can potentially shorten the length of printing time. A full-scale hollow abdominal aortic aneurysm model took about 9 hours to print, while a full-scale scapula took 13 hours. A life-size pediatric skull will take approximately 23 hours to print! The use of 3D printing in medicine presents enormous potential. Exponential development of many new applications will occur if researchers, students and clinicians have access to small-scale 3D printers for prototyping new devices and procedures. The future is only limited by the imagination. A method of reimbursement wouldn’t hurt either. I would like to thank Frank Rybicki, MD, Professor and Chair of Radiology, University of Ottawa, and his team from the Applied Imaging Science Laboratory at Brigham and Women's Hospital for their great 3D Printing Hands-on courses at RSNA 2014. Copyright ©2015 Eric M. Baumel, MD
  23. When a 77-year-old patient at Hong Kong’s Queen Elizabeth Hospital needed a complex heart surgery, the surgeons at the facility relied on three-dimensional (3D) medical printing for additional support. The patient was suffering from two damaged valves and had already undergone three open heart surgeries. Her body was not ready for a fourth intervention. The doctors decided to replace the damaged valves by making a small incision through her blood vessels. However, such an intervention had never been performed. A 3D printer helped the doctors create an exact replica of the patient’s heart and practice the intervention several times. They completed the actual procedure successfully in just four hours. 3D Printing Heart Helps with Cardiovascular Surgical Planning Surgeons at pediatric cardiac surgery center at the People’s Hospital in China also used a 3D printed model of the patient’s heart to analyze the anatomical abnormalities closely prior to the surgery. Their nine-month-old patient was born with malpositioned pulmonary veins and an atrial septal defect. The surgeons acknowledged that the anatomical model contributed significantly to the success of the intervention. Researchers in other parts of the world are also looking at additive printing or 3D printing technology to treat and manage cardiovascular illnesses more efficiently. The technique involves deposition of desired materials on a substrate in a predetermined manner to print an object of choice. Healthcare professionals believe that this revolutionary tool will help millions of patients suffering from heart disease and stroke. An estimated 17.5 million people died globally from such conditions in 2012, as per the World Health Organization. They were also responsible for one in four deaths across the United States, as per the Center for Disease Control and Prevention. 3D Printing Blood Vessels The use of 3D printing technology is not limited to the creation of anatomical models. Scientists at Saga University in Japan used the Kenzan method of 3D printing to develop 2mm by 5 mm blood vessels for patients with myocardial infarction. The researchers used tiny vertical spikes to position the cells and form tubular structures in a nutritious broth. Traditionally, cardiologists replaced the damaged blood vessels of the heart with healthy ones from other parts of the body. However, finding compatible replacements without impacting other physiological functions has been a challenge. The 3D printed implants can be customized as per the needs of the patient and can be used to replace the damaged veins and arteries with precision. Cyfuse Biomedical is employing tissue engineering techniques as they work to bring bioprinted nerves, blood vessels, cartilage, liver and heart muscle to the clinic. 3D Printing Heart Valves In another instance, scientists at Denver University custom printed heart valves that are the replicas of the original ones. Researchers obtained specific dimensions of the valves from CT and MRI scans and bioprinted them in just 22 minutes. Denver researchers are currently working to improve the biocompatibility of the 3D printed valves. The ultimate goal is to design patient-specific implants with a low risk of graft rejection. Given these developments, healthcare professionals and scientists are immensely hopeful about the development of a 3D printed heart. The biggest challenge, lies in creating a network of functional blood vessels that will allow the organ to survive in the body for a prolonged period of time. While the idea of printing a human heart may seem far-fetched, it is evident that 3D printing is influencing cardiovascular disease management in a big way. Sources: http://www.chinadaily.com.cn/china/2016-03/17/content_23921711.htm https://www.regmednet.com/users/3641-regmednet/posts/11230-nerve-and-blood-vessel-regeneration-using-3d-bioprinting-technologies http://www.thedenverchannel.com/money/science-and-tech/denver-university-researchers-use-3d-bioprinter-to-create-artificial-body-parts
  24. Three-dimensional bioprinting and medical printing technologies are influencing the field of ophthalmology in a big way. Quingdao Unique, a Chinese bioprinting company, had announced in 2015 that they will be able to print 3D corneal implants within a year. Their products will be available for animal testing initially, and if everything goes as per plan, their 3D printed human corneas could be ready for clinical trials in the next two to three years. The company’s third generation bioprinter provides optimal conditions for cell growth with a temperature range of 0 to 50 degrees Celsius, humidity regulation range of 80 to 98 percent, and pH of 7.0 to 7.5. Quingdao plans to overcome strength and flexibility issues associated with most human implants by using the patient’s own cells for printing. Ophthalmologists across the globe are very excited about this development. Corneal transplants help treat vision loss due to infections, congenital deformities and injuries. In fact, cornea is the most commonly transplanted organ in the United States with over 40,000 patients receiving a new one each year, as per the American Transplant Foundation. Yet, 53 percent of the world’s population does not have access to corneal transplantations, as per a global survey published in the February, 2016, edition of the journal JAMA Ophthalmology. Additionally, many patients experience complications when their immune systems reject the transplanted graft. Three-dimensional bioprinting is, however, expected to change all that. Scientists and healthcare professionals can rely on additive printing technology to deposit patient’s own cells and other compatible materials in a pre-determined manner on a desired substrate to create patient-specific implants with a lower rate of rejection. The 3D bioprinting technology also accounts for the natural anatomical variations that exist among humans. Doctors can refer to radiological images of the patients’ eyes to generate implants that have the same dimensions as the original one. 3D Printing Aids in the Diagnosis of Glaucoma and Other Eye Diseases Dr. Andrew Bastawrous, a Kenya-based eye surgeon, created a smart phone app to diagnose eye diseases such as glaucoma, macular degeneration and diabetic retinopathy. The app relies on the patient’s perception of the various orientations of the letter “E” to provide the diagnoses. A small 3D printed adapter can be added to the camera of the smartphone to obtain an image of the retina on the screen of the phone while administering the test. This technology is helping Dr. Bastawrous diagnose and treat thousands of patients with eye diseases in underprivileged areas of sub-Saharan Africa. Ophthamology Surgical Planning The use of 3D printing is not limited to corneal transplantations. Surgeons can use this technology to create models of the patient’s eyes and practice the procedure before the actual intervention. This preparation “would allow a full appreciation of the anatomic relationships between the lesions and the complicated surrounding structures,” as per an article published in the journal Investigative Ophthalmology and Visual Science. This invaluable tool has also transformed clinical practice and education. Researchers are using a 3D Systems Z650 printer to produce “highly realistic” 3D prints of orbits that offer enhanced visualization of the delicate nerves of the eye. The 3D models are made from non-human materials and thereby, help avoid the ethical questions associated with cadaver specimens. These recent developments only form the tip of the iceberg. Nonetheless, they clearly exemplify the limitless possibilities of 3D printing in ophthalmology. The technology is bound to simplify the treatment of eye diseases and improve patient outcomes dramatically.
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