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  1. 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.
  2. 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!
  3. New embodi3d users have uploaded great 3d models with excellent details! Here are the best from this week, we invite you join our community and discover this cutting edge technology of today and the future in the medical field. Sign up it´s easy! 1. A stl file showing the normal kidney location AABERNETHY uploaded this excellent 3D model. The kidneys are paired retroperitoneal structures that are normally located between the transverse processes of T12-L3 vertebrae. 2. Lumbar spine with scoliosis from a stl file In complex spinal disorders as scoliosis, the correction procedure is often very challenging as unexpected pedicle absence and vertebral rotations can be discovered intraoperatively, posing great risk of neurovascular lesions during the operation. Apparently, current visualization modalities as planar radiographic image and CT scans are not qualified to provide necessary anatomic overview of the affected spinal segments, even the CT with 3D reconstruction can only provide the image without tactile feedback. Therefore, 3D printing is very promising in the personalized treatment of complex spinal disorders. 1 747Larry@gmail.com 3. A CT abdomen and pelvis showing muscle tissue The role of 3D-printed models from DICOM images continues to expand and is fueled by the growing realization that intraoperative utilization of 3D images is not as efficient as having a physical model identical to patient structures, particularly for highly complex interventions. Further reductions in morbidity, mortality, and operating room time are inevitable. Uploaded by Azeem 4. Maxillofacial CT scan Shin uploaded this maxillofacial ct scan with good detail. It shows the paranasal sinuses and teeth. 5. Head/Skull 3d model from a STL file processed Dr. Gutierrez uploaded this excellent skull 3D model with exquisite detail. 6. A CT scan of the skull Thank you ngadhoke for upload this skull CT scan in high quality. 7. A 3d model of a central giant cell granuloma of mandible This loculated and expansile mass with wavy septations located on anterior mandible. Presentation • Most common signs/symptoms: pain, swelling of mandible > maxilla Demographics • Age ○ Adolescence to 3rd decade; mean: 25 years • Gender ○ F:M = 2:1 TOP DIFFERENTIAL DIAGNOSES • Aneurysmal bone cyst (ABC) ~ 15% of central giant cell granulomas contain intralesional ABC • Cherubism • Ameloblastoma • Ossifying fibroma • Brown tumor of hyperparathyroidism References 1. Wang, Y. T., Yang, X. J., Yan, B., Zeng, T. H., Qiu, Y. Y., & Chen, S. J. (2016). Clinical application of three-dimensional printing in the personalized treatment of complex spinal disorders. Chinese Journal of Traumatology, 19(1), 31-34. 2. Mitsouras, D., Liacouras, P., Imanzadeh, A., Giannopoulos, A. A., Cai, T., Kumamaru, K. K., ... & Ho, V. B. (2015). Medical 3D printing for the radiologist. Radiographics, 35(7), 1965-1988. 3.Koch, B. L., Hamilton, B. E., Hudgins, P. A., & Harnsberger, H. R. (2016). Diagnostic Imaging: Head and Neck E-Book. Elsevier Health Sciences.
  4. 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.
  5. Exploring Teeth in a 3D Model Reveals More than You Think As with all medical fields, dentistry requires highly accurate modeling in order to create prosthetics and supporting oral health devices. While dentists have embraced digital 3D X-rays in completing diagnostic work, alginate-based dental molds are still the norm in the profession. The reason for this is simple: 3D-printed molds still weren't as accurate as 3D-printed models, therefore they were not useful in creating prosthetics, dentures, orthodontic devices, and veneers. But, the technology is quickly advancing and is now on-par with tray-and-alginate and plaster-modeling techniques. And, the cost of owning and operating high-resolution 3D printers is also falling each year, making them a practical consideration for most oral health professionals. Beyond creating molds, 3D printing is useful in diagnosing a range of oral health disorders that may not be so obvious in an X-ray. From the standpoint of radiologists, 3D printer-capable STL files created from multi=detector and cone-beam CT scans can alter the entire course of patient treatment. As recently reported by the medical journal Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, the first signs of many medical conditions may initially appear as oral health issues. These can include conditions such as periapical disease, pericoronitis, and hypogammaglobulinemia disorder. These are just a few of the many examples in which examining oral health and teeth in a 3D model is helping to transform the practice of dentistry. There are a 3D-printing technologies available to dentists and all have their own advantages and disadvantages. But, in the coming years, it is expected that additive manufacturing techniques in dentistry (like other areas of medical 3D printing) will become the norm, not the exception. As a registered member of embodi3D®, you can practice using this emerging technology by downloading the many ready-to-print STL files available on the website. You can even upload and convert your own CT scans into STL files and utilize the latest democratiz3D® algorithms. Become a registered embodi3D® member, today! #1. A Jaw from dental CT scan This 3D printable jaw and maxilla was created from a CT scan. #2 Creating 3D-Printable Teeth from a CT Scan This excellent 3D model uploaded by Precision shows the normal anatomy of the jaws. #3. Creating a 3D Model of the Upper Teeth with a CT Scan and democratiz3D® Rob LaRosa created this 3D model using the democratiz3D® service showing teeth. #4. 3D Printer-Ready STL Files of the Upper Jaw and Teeth Rob LaRosa created this 3D model using democratiz3D®. #5. Anatomy of a Human Molar Tooth This excellent 3d model shows the normal tooth anatomy. Enamel covers the crown, and a thin layer of cementum covers the roots. Dentin, a calcified matrix, lies between the enamel or cementum and the pulp chamber (P) or root canal. Cementum and dentin cannot be distinguished at imaging because they have similar mineralization. The pulp chamber and root canal contain neurovascular elements. Gingiva covers the maxillary and mandibular alveolar processes. In teeth with multiple roots, the space between the roots is called the furcation. Lamina dura, a thin layer of dense bone, lines the socket. The periodontal ligament (straight arrow) lies between the lamina dura and cementum. #6. 3D Model of the Bony Maxilla, Mandible, and Teeth Manufacturers have used 3D printing technology to create novel dental implants with a porous or rough surface. However, as a method for producing batches of complex dental implants, 3D printing has the ability to produce complex geometries, such as a bone-like morphology, which may not be produced by milling alone – although milling/machining may also be used to refine the printed form – for example, the implant platform. #7. A 3D Model of the Upper Teeth in STL Format JAWSDOC uploaded this 3d model that shows the permanent teeth. #8. A CT Scan of the Teeth in STL Format When interpreting multi-detector computed tomographic (MDCT) images, the radiologist may provide added value by identifying definite or possible dental lesions and referring the patient to a dental specialist for clinical evaluation and dedicated radiography or cone-beam CT, as necessary. #9. A Craniofacial Model, Female 57 yo Great model and print turned out great! This dual material craniofacial model was 3D printed for a customer. The print uses detailed white to represent the bones and detailed clear polished to represent the skin surface. #10. A great set of 3d printing teeth This example was created with democratiz3D. Automatically create 3D printable models from CT scans showing the teeth ideal for maxillofacial pre-surgery. Finally, we recommend some radiology articles about this topic: 1. Scheinfeld MH, Shifteh K, Avery LL, Dym H, Dym RJ. Teeth: what radiologists should know. Radiographics. 2012 Nov 1;32(7):1927-44. 2. Loureiro RM, Naves EA, Zanello RF, Sumi DV, Gomes RL, Daniel MM. Dental Emergencies: A Practical Guide. RadioGraphics. 2019 Oct 7;39(6):1782-95.
  6. 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.
  7. 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.
  8. 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).
  9. Happy International Day of Radiology! Create a Pelvis 3D Model Using STL Files For the better part of history, human anatomy has been taught by using human cadavers. While the practice has become much more ethical over the past century (grave-robbing is a rarity), there has been a push among the medical community to transition from human cadavers to 3D-printed anatomical models. Recently, the Anatomical Sciences Education released a report that may be of interest to those in the medical community: The Production of Anatomical Teaching Resources Using Three-Dimensional (3D) Printing Technology. This report details how 3D printing can provide the most important aspects of the prosection experience for medical students, yet without the ethical or hygienic issues often associated with using cadavers. Since Charles W. Hull first described the concept of 3D printing back in 1986, the field has now grown to encompass nearly every aspect of society — everything from do-it-yourself toys to life-saving implants, and even a pelvis 3D model as is the case in this week's featured article. Many of these uses would likely even be somewhat of a surprise to Mr. Hull. The embodi3D® community is helping the medical field to become less reliant on human cadavers while also creating opportunities to share 3D-printed anatomical models via STL files — something that is especially useful for medical students wishing to practice procedures in the treatment of rare conditions. Medical 3D printing offers a range of opportunities for medical students to study the bones, tissues, and muscles of the human anatomy. 3D printing also helps create understanding between physician and patient; patients are more apt to agree to a medical procedure when the condition can be seen as a lifelike 3D-printed model. In this week's hip, spine, and pelvis-themed post, embodi3D® will share with you some of the best 3D pelvis models. Many of these are available in ready-to-print STL format. You can create your own 3D printer-ready STL files by using embodi3D® software to convert CT scans. To get started, all you have to do is register with embodi3D®. It's quick, easy, and costs absolutely nothing to join. #1. An Anatomically Precise 3D-Printed Spine and Pelvis (Available for Free in STL Format) Embodi3D uploaded this excellent example of the pelvis anatomy. The pelvis is a complex structure composed of an osseous ring formed by the ischia, ilii, and sacrum, with numerous muscles and fascial condensations attached for support of the pelvis viscera and to enable ambulation. Within the pelvis reside the organs of reproduction, urination, and evacuation, in addition to major blood vessels, lymphatics, and nerves. #2. An Incredible 3D Model of an Acetabular Fracture of the Pelvis valchanov upload an incredible 3D model showing us acetabular fracture of the pelvis. Acute pelvic injuries can be divided into three major categories: Disruptions of the pelvic ring, fractures of the acetabulum, and isolated pelvic fractures which do not involve the acetabulum or disrupt the pelvic ring. Radiologists should be able to categorize the injury into one of these patterns based on an AP radiograph of the pelvis obtained as part of the routine trauma evaluation. Additional views, or more often today, CT scans, are used to further categorize the injury pattern and direct treatment. Hip injuries can be divided into two major categories: Dislocations and fractures. Fractures are further subdivided into femoral head, femoral neck, intertrochanteric, subtrochanteric, or isolated trochanteric fractures. Dislocations are most commonly posterior, but may be anterior or central. Sports injuries of the pelvis can be divided into intraarticular injuries, impingement syndromes, bursitis, fatigue fractures, and muscle/tendon injuries. The older population may present with insufficiency fractures of the pelvis, bursitis, or tendinopathy and tears of the pelvic musculature. TERMINOLOGY • Fracture involving articular surface of acetabulum. • Anterior column: Portion of innominate bone extending from anterior superior iliac spine to pubic symphysis and inferior pubic ramus. ○ Delimited on radiographs by iliopubic (a.k.a. iliopectineal) line. • Posterior column: Portion of innominate bone extending from posterior superior iliac spine to inferior pubic ramus. ○ Delimited on radiographs by ilioischial line. • Anterior, posterior walls: Create cup surrounding superior portion of femoral head. • Sciatic buttress: Bony continuity from sacroiliac junction (SIJ) to acetabulum. ○ Lost in both-column fracture, preserved in other types. PATHOLOGY • High-energy trauma most common. • Fall in elderly osteoporotic patient.. • 5 simple fracture types: Anterior column, posterior column, posterior wall, anterior wall, transverse • 5 associated fracture types: Transverse with posterior wall, posterior column with posterior wall, T-shaped, both column, anterior column with posterior hemi-transverse. #3. A Anatomical 3D-Printed Pelvis Bone (Available in STL Format) Dr. Mike makes this 3D model of the pelvis bone showing the bony pelvis. This forms a ring which can be conceptually subdivided in several ways. In the adult, it is formed of three bones and three articulations. The sacrum articulates via the paired sacroiliac joints with the innominate bones on either side, which articulate with each other via the pubic symphysis. The sacroiliac joints and pubic symphysis are synovial joints, but allow very limited motion. The bony pelvis can also be divided into the anterior portion of the ring, including the innominate bones from the ischial spine to the pubic symphysis, and the posterior ring, including the sacrum and the posterior portion of the innominate bones. Alternatively, the pelvis can be divided into the false pelvis above the iliopectineal line and part of the abdominal cavity, and the true pelvis which lies between the iliopectineal line and the ischial tuberosities. #4. A Muscle Model STL File Converted from a CT Scan This 3D printable of the pelvis was generated from real CT scan data and is thus anatomically accurate as it comes from a real person. It shows the detailed anatomy of the muscles. Muscle Groups • Hip adductors ○ Pectineus, adductors brevis, longus and magnus, obturator externus, quadratus femoris. • Hip flexors ○ Iliopsoas, rectus femoris, sartorius. • Hip abductors ○ Gluteus medius, gluteus minimus, tensor fascia lata, sartorius, tensor fascia lata. • Hip external rotators ○ Piriformis, gemelli, quadratus femoris, obturator internus, obturator externus • Hip internal rotators ○ Piriformis (when hip flexed) • Hip extensors ○ Gluteus maximus, long head biceps femoris, semimembranosus, semitendinosus. #5. 3D-Printable Model of the Bony Pelvis (from a CT Scan) 3D printed bone anatomy facilitate pelvis education, especially in assisting structure recognition, compared with cadaveric pelvis and atlas. Other advantages over cadavers relate to ethics, cost, hygiene and repaired fragile structures. #6. A 3D-Printable Medical File of the Bony Pelvis (Converted from a CT Scan DICOM) Anatomic Spaces in Pelvis • Horizontal division into true and false pelvis • False pelvis: Iliac crest to pelvic brim ○ Part of abdominal cavity. • True pelvis: Pelvic brim to ischial tuberosity • Greater sciatic notch ○ Concavity along inferior border of ilium between posteroinferior margin of ilium and ischial spine . ○ Sacrospinous ligament along inferior border of notch converts notch to greater sciatic foramen. ○ Much of foramen is occupied by piriformis muscle. ○ Superior to piriformis muscle: Superior gluteal vessels and nerve. ○ Inferior to piriformis muscle: Inferior gluteal vessels, internal pudendal vessels, sciatic nerve, posterior femoral cutaneous nerve, nerve to obturator internus, nerve to quadratus femoris muscle. • Lesser sciatic notch ○ Small notch anterior to ischial spine. ○ Sacrospinous and sacrotuberous ligaments convert notch to lesser sciatic foramen. ○ Contains obturator internus, nerve to obturator internus, internal pudendal vessels and nerve. • Obturator ring/foramen ○ Bony ring formed from pubic body, superior and inferior pubic rami, and ischium. ○ Majority of foramen is covered by obturator membrane. ○ Superior portion of foramen not covered by obturator membrane. – Designated obturator canal – Obturator artery, vein, and nerve pass out of pelvis through obturator canal. ○ Obturator internus muscle arises from internal margin of obturator ring and obturator membrane. ○ Obturator externus muscle arises from external margin of obturator ring and obturator membrane. #7. 3D Pelvis Model from 62-Year-Old Patient with OA and Fracture (from CT Scan Data) An incredible 3D model showing degeneratives changes and fracture of the pelvis. PATHOLOGY General Features • Etiology ○ OA pathogenesis not fully understood; heterogeneous risk factors ○ Microtrauma applied to cartilage with biochemical changes of aging – ↓ water content, ↓ proteoglycans, ↓ number of chondrocytes □ Leads to brittle or soft cartilage, at risk for fissuring, ulceration, and delamination ○ Trauma – Acetabular or femoral head fracture, generally related to hip dislocation – Abnormal weight bearing due to trauma or degenerative change in other joints □ Limb-length discrepancy with pelvic tilt □ Scoliosis with pelvic tilt □ Knee arthritis with malalignment and relative limb shortening ○ Developmental abnormalities – Legg-Calvé-Perthes (ON in childhood) – Slipped capital femoral epiphysis ○ Abnormal morphology (developmental) – DDH □ Acetabular dysplasia (most common) □ Rotational malalignment of femoral neck – Femoral acetabular impingement morphology □ Cam type: Anterolateral femoral neck bump □ Pincer type: Overcoverage of head by acetabulum □ Cam and pincer types often coexist □ Several etiologies for each of these types ○ Abnormal morphology (congenital) – Epiphyseal abnormalities, such as spondyloepiphyseal dysplasia ○ Low levels of estrogen have been associated with ↑ risk of OA • Genetics ○ Twin and familial studies suggest OA is multigenic trait #8. Free Downloadable 3D Printing Model of the Pelvis and its relation with vascular vessels This incredible 3d model uploaded by vishnuk shows the pelvis and its relation with vascular vessels with great detail. #9. 3D model of the pelvis showing ureter passing down along the sides of the pelvis and get inside the bladder This excellent example was uploaded by Siewerts showing us the urinary pelvic organs and the relations with the pelvis bones. #10. Skin model STL file from converted CT scan This 57 years old female pelvis shows the shape and surface of this anatomical region, also you can access to all the series including bone, muscle and ct.
  10. 3D Free Scapula, Clavicle, and Humerus Models in 3D-Printable STL Format Shoulders are comprised of three main bones. These include humerus (bone in the upper arm), scapula (shoulder blade), and the clavicle, which we commonly refer to as the "collarbone." Bones of the shoulder work together with the transverse humeral ligament, synovial membrane of the bicep, bursa sac, and the superior transverse ligament to perform a complex range of motions. In fact, the shoulder has the most extended pivot range of any joint within the body. Your glenohumearal joint (shoulder) is a ball-and-socket joint that is able to move in so many positions due to the relatively small size of the glenoid fossa, as well as the laxity ("wiggle room") of the joint capsule. But, these features also make the shoulder prone to overuse injuries, subluxation, dislocation, and ligament tears. In this week's embodi3D® Top Ten, we are bringing you some of the best 3D scapula, clavicle, and humerus models which comprise the majority of the human shoulder joint. Before you dive into this week's Top 10 and start printing your own 3D anatomical models, you must first register with embodi3D®. It's absolutely free to sign up and you can take advantage of many of the features found on the embodi3D® website, including standard resolution democratiz3D® conversions. Register with embodi3D® today! Technologies like these were recently featured in the journal Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT), where models of a 3D scapula, humerus, and soft tissues are being used in preoperative planning. If you are interested in uploading your CT scans and converting these to 3D-printable STL format, the democratiz3D® Quick Start Guide will help you to quickly get up and running. How Shoulders Achieve Their Range of Motion Flexion, extension, abduction, adduction, circumduction, medial rotation, and lateral rotation. * Flexion: Pectoralis major, deltoid, coracobrachialis, & biceps muscles * Extension: Deltoid & teres major muscles. – If against resistance, also latissimus dorsi & pectoralis major. * Abduction: Deltoid & supraspinatus muscles. – Subscapularis, infraspinatus, & teres minor exert downward traction – Supraspinatus contribution controversial * Medial rotation: Pectoralis major, deltoid, latissimus dorsi, & teres major muscles. – Subscapularis when arm at side * Lateral rotation: Infraspinatus, deltoid, & teres minor muscles. #1. An Incredible 3D Model of the Shoulder in STL Format This articulation is maintained by overlying soft tissue structures. The posterosuperior acromion process of the scapula provides one half of the AC joint. It also forms most of the osseous portion of the coracoacromial arch, the roof over the rotator cuff. The acromion process is connected to the body of the scapula by the spine. The osseous structures of the shoulder girdle are the clavicle, scapula, and humerus. Medially, the clavicle articulates with the manubrium of the sternum at the sternoclavicular (SC) joint. This joint serves as the only true articulation between the shoulder girdle and the axial skeleton. Laterally, the clavicle articulates with the acromion process of the scapula at the acromioclavicular (AC) joint #2. STL File Showing Scapular Notch and Shoulder Variations in the shape of the clavicle are considered normal and are not usually pathologic. These variations may range from an almost straight bone to one with exaggerated curves. Another variation of the clavicle that is present in 6-10% of the population is termed the canalis nervi supraclavicularis. In this variation, a foramen forms through the clavicle, and the medial supraclavicular nerve passes through this accessory osseous canal. The scapular notch varies in size and shape. The notch is bridged by the superior transverse scapular ligament. This ligament ossifies in 10% of patients, producing a bony foramen for the suprascapular nerve. #3. A 3D Model of the Shoulders of the Muscle Rotator cuff: 4 muscles arising on scapula and inserting on humerus * Supraspinatus: From supraspinatus fossa of scapula to greater tuberosity – Abducts humerus, also depresses humeral head. * Infraspinatus: From posterior surface of scapula to greater tuberosity. – Externally rotates humerus * Teres minor: From lateral border of scapula to greater tuberosity – Externally rotates humerus * Subscapularis muscle: From anterior surface of scapula to lesser tuberosity – Superficial fibers extend across to anterior margin of greater tuberosity as part of transverse ligament – Internally rotates, adducts humerus #4. 3D Model (STL Format) of the Muscles Connecting the Arm to Axial Skeleton 4. Various muscles also serve to connect the arm to the axial skeleton. Anteriorly, the pectoralis major and minor muscles extend from the sternum and clavicle to the proximal humeral shaft. Posteriorly, the latissimus dorsi muscle arises from the thoracic cage to attach onto the proximal humeral shaft. The great range of motion provided for by the glenohumeral joint is executed in large part by the muscles of the rotator cuff. The supraspinatus muscle arises superior to the scapular spine and attaches to the superior facet of the greater tuberosity. The more posterior infraspinatus muscle arises below the spine and inserts onto the posterior facet of the greater tuberosity. The teres minor muscle originates and inserts just caudal to the infraspinatus. The subscapularis muscle arises from the anterior scapular body to insert onto the lesser tuberosity. The long head of the biceps originates at the superior glenoid rim, passes through the rotator cuff interval at the anterosuperior glenohumeral joint, and then follows the bicipital groove between the tuberosities into the upper arm. The deltoid muscle has a broad origination along the lateral aspect of the acromion from anterior to posterior. It covers the lateral portion of the upper arm before inserting on to the lateral proximal humeral shaft at the deltoid tuberosity. #5. 3D Model of the Skin around the Shoulder, Arm, and Upper Chest A 3D model of the skin of the shoulder where the soft tissue of the shoulder and arm are shown. Trapezius: is responsible for the smooth contour of the lateral side of the neck and over the superior aspect of the shoulder. It can be seen and felt throughout its entirety when the shoulder girdles are retracted against resistance; the superior part can be palpated when the shoulders are elevated against resistance. Posterior axillary fold: is formed by the latissimus dorsi winding around the lateral border of the teres major muscle. Latissimus dorsi forms much of the muscle mass underlying the posterior axillary fold extending obliquely upward from the trunk to the arm. Teres major passes from the inferior angle of the scapula to the upper humerus and contributes to the fold laterally. Both muscles can be palpated on resisted shoulder adduction. Pectoralis major: can be seen and felt throughout its entire extent when it is contracted against resistance as in pressing the palm together in front of the body. Clavicular fibers can be felt if the shoulder is flexed against resistance to a position midway between flexion and extension, while the sternocostal fibers can be felt if the shoulder is extended against resistance starting in a flexed position. The inferior border of the pectoralis major muscle forms the anterior axillary fold. Deltoid: forms the muscular eminence inferior to the acromion and around the glenohumeral joint. The anterior, middle, and posterior fibers of the deltoid can be palpated. When the arm is abducted against resistance, the anterior border of the deltoid can be felt. The clavipectoral triangle (deltopectoral triangle) is the depressed area just inferior to the lateral part of the clavicle, bounded by the clavicle superiorly, the deltoid laterally, and the clavicular head of the pectoralis major medially. #6. CT Scan Showing a Fracture in the Proximal Humeral A computed tomography (CT) is recommended for complex fracture situations although those situations were not clearly defined. Therefore, precise indications for CT in proximal humeral fractures are not established. #7. Connection of Scapula, Humerus, and Clavicle Shown in 3D STL File The scapula is a spade-shaped bone comprised of a thin triangular body and a semi-ovoid cavity known as the glenoid fossa (glenoid cavity). The glenoid fossa faces lateral and slightly anterior and cranial. A bony spine runs across the dorsal surface of the scapular body and terminates in the acromion. The scapula articulates with two bones, the humerus and clavicle. The scapula does not directly contact the bony rib cage: the two structures are separated by muscle and other soft tissue. #8. Right Shoulder Injury Revealed by CT Scan On CT acute trauma may result of bony, labral, ligamentous or musculotendinous damage. The shoulder may be injured following repetitive injury or as part of systemic inflammatory conditions or infection. Moreover, the bones around the shoulder may be affected by benign or malignant bony lesions, and associated pathological fracture. #9. Right Shoulder with Pleomorphic Spindle Cell Sarcoma (3D-Printable STL File) Pleomorphic sarcoma composed of fibroblasts, myofibroblasts and histiocyte-like cells. Historically considered the most common adult soft tissue sarcoma. Usually older adults (age 50+ years) with slight male predominance; more common in lower extremities, rarely retroperitoneum, head and neck, breast. Large and deep-seated with progressive enlargement. Sarcomas adjacent to orthopedic implants or post-radiation are usually osteosarcoma or MFH. #10. 3D-Printable Model of Right Shoulder Bones The humerus is the large single bone of the upper arm. Proximally, it articulates with the glenoid fossa of the scapula forming the glenohumeral joint. The humeral head is large and globular. Just ventral to the articular surface is the lesser tubercle, where the subscapularis attaches. Lateral to the articular surface is the greater tubercle. The rotator cuff muscles of the shoulder insert on the proximal humerus. References 1. Manaster, B. J., & Crim, J. R. (2016). Imaging Anatomy: Musculoskeletal E-Book. Elsevier Health Sciences. 2. Bahrs, C., Rolauffs, B., Südkamp, N. P., Schmal, H., Eingartner, C., Dietz, K., ... & Helwig, P. (2009). Indications for computed tomography (CT-) diagnostics in proximal humeral fractures: a comparative study of plain radiography and computed tomography. BMC musculoskeletal disorders, 10(1), 33. 3. Duke University Medical School - Anatomy. (2018). Web.duke.edu. Retrieved 4 August 2018, from https://web.duke.edu/anatomy/ 4. Shoulder Joint Anatomy: Overview, Gross Anatomy, Microscopic Anatomy. (2018). Emedicine.medscape.com. Retrieved 4 August 2018, from https://emedicine.medscape.com/article/1899211-overview#a1 5. The Radiology Assistant : Shoulder MR - Anatomy. (2012). Radiologyassistant.nl. Retrieved 4 August 2018, from http://www.radiologyassistant.nl/en/p4f49ef79818c2/shoulder-mr-anatomy.html
  11. In this week's blog entry, we'd like to share the top ten of the best medical 3D printing models downloaded this month, as well as a few detailed examples that garnered the attention of embodi3D® users over the past month.
  12. As a complex joint and one of the largest joints in the body (one of my favorites), the knee joint is a fascinating feature of the human form. Check this incredible top 10!
  13. Top 10 Free Downloadable CT Angiogram (CTA) 3D Printable Models on embodi3D.® For several years now, surgeons, radiologists, and others in the medical profession have used 3D-printed vascular simulation models from CT angiograms (CTAs) to practice complex procedures, as well as for research and educational purposes. The growth has been fueled by the development of high resolution imaging studies merging with the rapid development of 3D printing technologies, and the development of new printing materials. These advances have resulted in reductions in the costs associated with creating high resolution medical models. As noted in the journal RadioGraphics (Radiological Society of North America), CT angiogram-derived 3D-printed models are quickly being embraced by those in the medical field. The evolution of this disruptive technology is expected to revolutionize medical practices over the years to come. And, tools such as democratiz3D® are making it easy for medical professionals to create ultra-resolution 3D models. A human skull and collarbone, created by a CT Angiogram. Abdominal aortic aneurysms (AAA) are focal dilatations of the abdominal aorta that are 50% greater than the proximal normal segment or >3 cm in maximum diameter. The prevalence of AAAs increases with age. Males are much more commonly affected than females, with a ratio of 4:1. They are the tenth most common cause of death in the Western world. Approximately 10% of individuals older than 65 have an AAA. This week we would like to share the best 3d models of a CT angiogram (CTA). Don’t forget to register in order to download the images, you can do it clicking here: https://www.embodi3d.com/register/ 1. CTA of Aortic Abdominal Aneurysm (AAA) An excellent 3D model an abdominal CTA of Aortic Abdominal Aneurysm (AAA) showing the location infrarrenal. When issuing an MRI or CT report on a patient with an aortic aneurysm, whether it be thoracic or abdominal, a number of features should be mentioned to aid the referring clinician in managing the patient. Reporting tips for aortic aneurysms include : - size and shape - sac dimensions (outer surface to outer surface) - luminal diameter if mural thrombus is present - fusiform or saccular - size of vessel proximal and distal to aneurysm - characteristics of wall - mural calcification - presence of mural thrombus - location and relationship to involved branches/structurerenal arteries - involvement of the origins of the renal arteries - presence of accessory renal arteries and where they arise splanchnic arteries great vessels from the arch characterisation of possible aetiology - true or false - possibility of mycotic aetiology - complications: leak, rupture, proximity to bowel, aortocaval fistula, other relevant vesselsthoracic aortic aneurysms - the size and dominance of vertebral arteries should be included if the aneurysm is close to the left subclavian artery presence of carotid disease is important, as significant stenosis may predispose the patient to strokes during any period of reduced flow/hypotension AAA 2. Model of Abdominal Vessels Ready for 3D Printing A 3D model of the abdominal vessels with detail. In addition to great vessel pathology, 3D printing has also been used in the treatment of other visceral vessel diseases. 3D modeling was used to plan the optimal combination of guide catheter and microcatheter to successfully treat a patient with multiple splenic artery aneurysms. The team was able to preserve splenic function and minimize the need for repeat angiograms. 3D printing has also been described as an intraoperative reference for robotic resection of a celiac trunk aneurysm. Modeling other visceral vessel aneurysms has been described, including left gastric, right epigastric, gastroduodenal and posterior superior pancreaticoduodenal aneurysms. If this model is of particular interest, you may also want to check out a heart and pulmonary artery tree CT angiogram 3D model uploaded by health_physics, who used the democratiz3D® tool. 3. CT Angiogram of the Brain and Neck A brain and neck CTA example. 4. Vascular Simulation Model The use of 3D modeling for vascular simulations can provide training and education in either normal or complex anatomy. . It can also provide the haptic feedback which may be lacking in virtual reality simulations and has been shown to improve anatomical knowledge in students. In addition to provider education, 3D models have been demonstrated as a useful tool for preoperative patient education. 5. External Carotid Artery (ECA) CT Angiogram External Carotid artery ( ECA): arises from the CCA bifurcation and has 8 branches: 1) Superior thyroid artery- 1st branch of the ECA 2) Lingual artery- arises between the superior thyroid artery and facial artery; supplies tongue with blood supply 3) Facial artery- arises just above the lingual artery & courses along the lower mandible, across the cheek to the angle of the mouth. It continues to course superior along the side of the nose to the inner canthus of the eye; supplies tongue, lips, nose, and lachrymal sac with a blood supply; AKA- Angular artery 4) Occipital artery- arises from the posterior portion of the ECA opposite the facial artery and is an important communicating artery with the muscular branches of the vertebral artery 5) Posterior Auricle artery- arises from the ECA above the digastric & styo-hoid muscles opposite the apex of the styloid process. It has 3 branches which supply the membranous tympani, back of ear, and muscle 6) Ascending Pharyngeal artery- usually arises at the level of the carotid bifurcation and the smallest branch. It has 4 branches that supply the longus muscle, coli muscle, lymph glands, palate, typani, and dura matter 7) Superficial Temporal artery- arises between the neck, lower jaw, and external auditory meatus. It is the smaller of the 2 terminating branches of the ECA. It bifurcates into the anterior temporal and posterior temporal arteries providing a blood supply to the supraorbital rim and facial muscles. It is used to help identify the ICA from the ECA 8) Maxillary artery- arises at the level of the parotid gland opposite the neck of the condoyle of the lower jaw. It is the larger of the 2 terminating branches of the ECA. It is divided into 3 segments: 1st is the maxillary segment 2nd is the pterygoid segment 3rd is the spheno-maxillary segment One of its terminating branches is the infraorbital artery It anastomoses with the ophthalmic artery It is collateral for brain circulation (Pre-Willisian anastomosis) 6. CTA of Abdominal Aortic Aneurysms Abdominal aortic aneurysms probably represent the only surgical condition in which size is such a critical determinant of the need for intervention. Recent advances in imaging techniques have raised new possibilities in medical imaging regarding aneurysmal disease making size recordings more accurate and reproducible than ever. Here we show an excellent example of a AAA CTA. 7. Abdominal Aortic Aneurysm in a CT Angiogram-Created 3D Model A 3D reconstruction of an AAA. 3D printing has become a useful tool to many clinicians and researchers. A variety of applications currently employ 3D printing for the treatment of aortic vascular disease, including pre-procedural planning, training, and creation of personalized aortic grafts. Advances in the accessibility of 3D printing, as well as continued research in 3D-printed vascular networks, has the potential to revolutionize the treatment of aortic diseases. 8. Stunning 3D Model of Human "Bovine Arch" Aorta The term “bovine arch” is widely used to describe a common anatomic variant of the human aortic arch branching. This so-called bovine aortic arch has no resemblance to the bovine aortic arch. A bovine arch is apparent in ~15% (range 8-25%) of the population and is more common in individuals of African descent. A related variant, also known as truncus bicaroticus, is the origin of the left common carotid artery from the brachiocephalic artery but not sharing a true common origin, which occurs in ~9% of the population. Sometimes this can be difficult to distinguish from a common origin because the left common carotid artery arises within 1cm of the origin of the brachiocephalic artery. Clinical presentation: This common variant is asymptomatic most of the time. In rare cases of head and neck surgery, e.g. tracheostomy, it can be a risk factor for injury and cause complications 4. In combination with an aberrant right subclavian artery it can cause a dysphagia lusoria. 9. CT Scan of Abdominal Aortic Aneurysm with Intraluminal Trombus A CT scan of an AAA with an intraluminal trombus. The pathogenesis of the abdominal aortic aneurysm (AAA) shows several hallmarks of atherosclerotic and atherothrombotic disease, but comprises an additional, predominant feature of proteolysis resulting in the degradation and destabilization of the aortic wall. 10. CTA of a Human Head and Neck An excellent example of a neck and head CTA showing the neck vessels. 3D model printing has the potential to become an essential preoperative investigation for surgery on arteriovenous malformations. References: 1. Collins J, Stern EJ. Chest radiology, the essentials. Lippincott Williams & Wilkins. (2007) ISBN:0781763142. Read it at Google Books - Find it at Amazon 2. Atar E, Belenky A, Hadad M et-al. MR angiography for abdominal and thoracic aortic aneurysms: assessment before endovascular repair in patients with impaired renal function. AJR Am J Roentgenol. 2006;186 (2): 386-93. doi:10.2214/AJR.04.0449 - Pubmed citation 3. Hangge, P., Pershad, Y., Witting, A. A., Albadawi, H., & Oklu, R. (2018). Three-dimensional (3D) printing and its applications for aortic diseases. Cardiovascular diagnosis and therapy, 8(Suppl 1), S19.
  14. In this week's blog entry, we'd like to share the top ten of the best medical 3D printing models downloaded this month, as well as a few detailed examples that garnered the attention of embodi3D® users over the past month. 3D printing is already being used to develop a broad range of medical devices with clinically effective results. The medical fields of oral and maxillofacial surgery and the musculoskeletal system are leading the way in validating the efficacy and effectiveness of 3D-printed devices and have found that 3D-printed anatomical models and surgical guides are reducing operating times and increasing surgical accuracy. 1 We invite you to register as a embodi3D member and take advantage of all the excellents resources available to you. Registering is free and allows you to upload, download, and share 3D-printable medical models with our diverse community. 3D-printed devices can play an important role in healthcare. Become a registered member of embodi3D and you can access the many free resources available. 1. 3D print of a cervical disk for segmented cervical spine This excellent 3d model uploaded by fbonel shows a cervical disk of the spine. The intervertebral disc is composed of three parts: The cartilaginous endplate, the anulus fibrosis, and the nucleus pulposus. The height of the lumbar disc space generally increases as one progresses caudally. The anulus consists of concentrically oriented collagenous fibers which serve to contain the central nucleus pulposus. These fibers insert into the vertebral cortex via Sharpey fibers and also attach to the anterior and posterior longitudinal ligaments. Type I collagen predominates at periphery of anulus, while type II collagen predominates in the inner anulus. The normal contour of the posterior aspect of the anulus is dependent upon the contour of its adjacent endplate. Typically, this is slightly concave in the axial plane; although, commonly at L4-L5 and L5-S1 these posterior margins will be flat or even convex. A convex shape on the axial images alone should not be interpreted as degenerative bulging. The nucleus pulposus is a remnant of the embryonal notochord and consists of a well-hydrated, noncompressible proteoglycan matrix with scattered chondrocytes. Proteoglycans form a major macromolecular component, including chondroitin 6-sulfate, keratan sulfate, and hyaluronic acid. Proteoglycans consist of protein core with multiple attached glycosaminoglycan chains. The nucleus occupies an eccentric position within the confines of anulus and is more dorsal with respect to the center of the vertebral body. At birth, approximately 85-90% of the nucleus is water. This water content gradually decreases with advancing age. Within the nucleus pulposus on T2-weighted sagittal images, there is often a linear hypointensity coursing in an anteroposterior direction, the intranuclear cleft. This region of more prominent fibrous tissue should not be interpreted as intradiscal air or calcification. 2 2. STL file of a human heart This 3D model from a STL file of a human heart shows with exquisite detail the vascular anatomy of this important organ. Cardiac 3D printed patient-specific models can be created for a number of different applications, including: creation of anatomic teaching tools, development of functional models to investigate intracardiac flow; creation of deformable blended material models for complex procedural planning, and increasingly, patient-specific models are being deployed to assist efforts to create or refine intra-cardiac devices. 3 3. Coronarygraphy showing the tipical configuration of the vascular anatomy The typical configuration consists of two coronary arteries, a left coronary artery (LMCA) and a right coronary artery (RCA), arising from the left and right aortic or coronary sinuses respectively, in the proximal ascending aorta. These are the only two branches of the ascending aorta. The right coronary artery courses in the right atrioventricular groove to the inferior surface of the heart, whereupon it turns anteriorly at the crux as the posterior descending artery (PDA) in right dominant circulation. The left coronary artery has a short common stem (and is hence often referred to as the left main coronary artery), that bifurcates into the left circumflex artery (LCx), which courses over the left atrioventricular groove, and the left anterior descending artery (LAD), which passes towards the apex in the anterior interventricular groove. Occasionally there is a trifurcation (in ~15%), with the third branch, the ramus intermedius, arising in between the LAD and LCx. In left dominant hearts, the LCx supplies the posterior descending artery (PDA). Branches - left coronary arteryleft anterior descending artery (LAD) - diagonal branches (D1, D2, etc) - septal perforators (S1, D2, etc) - circumflex artery (LCx) / ramus circumflex - obtuse marginal branches (OM1, OM2, etc) - ramus intermedius artery (RI) - right coronary artery (RCA) - conus artery - SA nodal artery - sinotubular artery - acute marginal branches (A1 or AM1, A2 or AM2, etc) - inferior interventricular artery (PDA) 4. A 3D model printing of legs from a CT This 3d model with educational purposes shows the bones of the pelvis and lower limb. 5. A lumbar spine 3d model from a CT This upload by ngadhoke to the Spine and Pelvis forum shows a 3D-printable model of a lumbar spine in exquisite detail. 6. A CT Scan Illustrating the head and neck normal anatomy assonuva uploaded a CT scan showing the normal anatomy to the Skull, Head, and Neck CTs section of the Medical CT Scan Files portion of the Downloads page. 7. A 3D model of the skull and maxilla from a STL file Micrive upload this 3d model of the skull and maxilla with exquisite detail. 8. A dog´s CT scan Hanus uploaded this excellent dog´s ct scan . 9. A forearm and wrist´s CT scan This awesome ct scan shows in good detail the bony anatomy of the upper extremity. 10. A jaw deformity´s 3D model from a STL file This excellent 3d model shows a jaw deformity. The last iteration of ICD-CM, version 10, sorts jaw deformities according to geometry, into 3 groups: anomalies of jaw size, anomalies of jaw-cranial base relationship, or unspecified. Yet these deformities can affect 6 different geometric attributes: size, position, orientation, shape, symmetry, and completeness. 4 References 1. Diment, L. E., Thompson, M. S., & Bergmann, J. H. (2017). Clinical efficacy and effectiveness of 3D printing: a systematic review. BMJ open, 7(12), e016891. 2. Ross, J. S., Moore, K. R., Bryson Borg, M. D., Julia Crim, M. D., & Shah, L. M. (2010). Diagnostic imaging: spine: published by Amirsys®. Lippincott Williams & Wilkins, Baltimore. 3. Vukicevic, M., Mosadegh, B., Min, J. K., & Little, S. H. (2017). Cardiac 3D printing and its future directions. JACC: Cardiovascular Imaging, 10(2), 171-184. 4. Gateno, J., Alfi, D., Xia, J. J., & Teichgraeber, J. F. (2015). A Geometric Classification of Jaw Deformities. Journal of Oral and Maxillofacial Surgery, 73(12), S26-S31.
  15. The upper extremity is connected to the axial skeleton and thoracic cage by the shoulder girdle. The unique arrangement of the skeletal and soft tissue structures of the shoulder allows for the greatest range of motion of any joint in the human body. For these same reasons, the shoulder joint is the least stable of all joints making it prone to dislocation and instability. The glenohumearal joint has a greater range of motion than any other joint in the body. The small size of the glenoid fossa and the relative laxity of the joint capsule renders the joint relatively unstable and prone to subluxation and dislocation. Range of motion: Flexion, extension, abduction, adduction, circumduction, medial rotation, and lateral rotation. * Flexion: Pectoralis major, deltoid, coracobrachialis, & biceps muscles * Extension: Deltoid & teres major muscles. – If against resistance, also latissimus dorsi & pectoralis major. * Abduction: Deltoid & supraspinatus muscles. – Subscapularis, infraspinatus, & teres minor exert downward traction – Supraspinatus contribution controversial * Medial rotation: Pectoralis major, deltoid, latissimus dorsi, & teres major muscles. – Subscapularis when arm at side * Lateral rotation: Infraspinatus, deltoid, & teres minor muscles. 1. 2. The osseous structures of the shoulder girdle are the clavicle, scapula, and humerus. Medially, the clavicle articulates with the manubrium of the sternum at the sternoclavicular (SC) joint. This joint serves as the only true articulation between the shoulder girdle and the axial skeleton. Laterally, the clavicle articulates with the acromion process of the scapula at the acromioclavicular (AC) joint 3. 4. 5. 6. 7. 8. 9. 10.
  16. 3D Printed Skull and the embodi3D® Top 10 Skull and Head Anatomy This week, embodi3D® brings you the best 3D anatomical models of the skull and head region, including several fascinating files that you can use to create a 3D printed skull. For medical professionals, students, and researchers, understanding the structure of the human skull is an important part of delivering an accurate diagnosis. Using tools such as democratiz3D® also helps medical professionals such as radiologists and surgeons to prepare for unique operations. Recently, a team of surgeons at at Boston Children's Hospital used 3D printing to plan for a young patient's surgery with great success. Citing this case, the Bulletin of the American College of Surgeons praised the training and surgical education benefits of 3D printing. After checking out this week's Top 10 list, you may also find Dr. Mike's entires on "Creating a 3D Printable Skull from a CT Scan in 5 Minutes Using Freeware" and "A Ridiculously Easy Way to Convert CT Scans to 3D Printable Bone STL Models for Free in Minutes." A 3D-printed skull shown with prominent fracture to the forehead. If you haven't already, be sure to register with embodi3D® to take advantage of all of the tools and conversion algorithms available to embodi3D® and democratiz3D® users. Registering is absolutely free and we have a number of tutorials available to help you get up and running as quickly as possible. 1. Excellent 3D-Printed Model of the Frontal Bone Colloquially known as the "forehead," the frontal bone comprises the squamus, orbital, and nasal parts of the skull. It is one of eight bones that form the cranium, or brain case. The frontal bone plays a vital role in supporting and protecting the delicate nervous tissue of the brain. It gives shape to the skull and supports several muscles of the head. At its inferior border, the frontal bone forms the roof of the orbits and the brow. The coronal suture forms the posterior boundary of the frontal bone where it meets the parietal bones. The primary functions of the frontal bone are the protection of the brain and the support of the structures of the head. The hard mineral matrix of the frontal bone provides protection for the soft brain tissue. Although the frontal bone follows the ridges of the brain very closely, a small gap between the frontal bone and brain houses the meninges and the cerebrospinal fluid of the cranium. The pressure exerted by cerebrospinal fluid on the interior of the cranium holds the brain in place and prevents the brain from colliding with the skull. 2. A 3D Model of the Skull Base in Exquisite Detail A 3D model of the skull base with exquisite detail. The skull base forms the floor of the cranial cavity and separates the brain from other facial structures. This anatomic region is complex and poses surgical challenges for otolaryngologists and neurosurgeons alike. Working knowledge of the normal and variant anatomy of the skull base is essential for effective surgical treatment of disease in this area. The 5 bones that make up the skull base are the ethmoid, sphenoid, occipital, paired frontal, and paired temporal bones. The skull base can be subdivided into 3 regions: the anterior, middle, and posterior cranial fossae. (See the image below.) The petro-occipital fissure subdivides the middle cranial fossa into 1 central component and 2 lateral components. This article discusses each region, with attention to the surrounding structures, nerves, vascular supply, and clinically relevant surgical landmarks. 3. A 3D Model of the Paranasal Sinuses The paranasal sinuses are air-filled spaces located within the bones of the skull and facial bones. They are centered on the nasal cavity and have various functions, including lightening the weight of the head, humidifying and heating inhaled air, increasing the resonance of speech, and serving as a crumple zone to protect vital structures in the event of facial trauma. Four sets of paired sinuses are recognized: maxillary, frontal, sphenoid, and ethmoid (see the image below 4. Right Maxillary Bone Show in Anatomically Accurate Detail The maxilla consists of maxillary bones that form the upper jaw; together they are the keystone of the face, for all other immovable facial bones are connected to them. Portions of these bones make up the front of the roof of the mouth (hard palate), the floors of the orbits, and the sides and floor of the nasal cavity. They also contain the sockets of the upper teeth. Inside the maxillae, on the sides the nasal cavity, are the maxillary sinuses (antrum of Highmore). These air-filled spaces are the largest of the sinuses, and they extend from the floor of the orbits to the roots of the upper teeth. 5. Create a 3D Printed Anatomical Sphenoid Bone The sphenoid bone is wedged between several other bones in the front of the cranium. It consists of a central part and two wing-like structures that extend sideways toward each side of the skull. This bone helps form the base of the cranium, the sides of the skull, and the floors and sides of the orbits (eye sockets). Along the middle, within the cranial cavity, a portion of the sphenoid bone rise. 6. A Mandible (Jawbone) 3D Printed from a CT Scan with democratiz3D® The mandible, or jawbone, is the only movable bone in the skull. It is the strongest and most massive bone in the face. The mandible plays a vital role in many common tasks, including chewing, speech, and facial expression. The mandible is one of the twenty-two bones that make up the skull and the only one of those bones that is not fused to its neighbors. It is often called the lower jawbone as it is located inferior to the maxillae, which contain the top row of teeth. Stretching from the left temporal bone to the right temporal bone, the mandible forms a flat arch with 16 teeth embedded in its superior surface. At the left and right temporal bones, the mandible begins as a pair of bony cylinders known as the condyles. The condyles form the temporomandibular joints (TMJ) with the temporal bones before narrowing into the necks of the mandible. From the necks, the mandible widens considerably as it descends obliquely in the inferior and anterior directions to form the rami of the mandible. A large pointed projection, known as the coronoid process, extends superiorly from each ramus and is separated from the condyle by the mandibular notch. The mandibular foramina, a pair of holes for nerves and blood vessels to enter the mandible and support the teeth, perforate the rami on their medial surface just below the coronoid process. 7. A Highly Detailed, 3D Printer-Ready File of the Ethmoid Bone The ethmoid bone is located in front of the sphenoid bone. It consists of two masses, one on each side of the nasal cavity, which is joined horizontally by thin cribriform plates. These plates form part of the roof of the nasal cavity, and nerves (ethmoidal cells) associated with the sense of smell pass through tiny openings in them. Portions of the ethmoid bone also form sections of the cranial floor, eye sockets, and nasal cavity walls. A perpendicular plate projects downward in the middle from the cribriform plates to form the bulk of the nasal septum. Delicate scroll-shaped plates called superior and middle nasal conchae project inward from the sides of the ethmoid bone toward the perpendicular plate. These bones, which are called the turbinate bones, support mucous membranes that line the nasal cavity. 8. A 3D-Printable Mandible (Jawbone) File This excellent 3D-printed mandible and the the 3D printer-ready file come by way of Dr. Marco Vettorello. As you likely know, the mandible forms the lower portion of the skull. This upload shows all the nuances of the CT scan-generated, anatomically accurate mandible. 9. Three-Dimensional Model of Labyrinthitis of the Inner Ear Labyrinthitis is an inflammatory disorder of the inner ear, or labyrinth. Clinically, this condition produces disturbances of balance and hearing to varying degrees and may affect one or both ears. Bacteria or viruses can cause acute inflammation of the labyrinth in conjunction with either local or systemic infections. Autoimmune processes may also cause labyrinthitis. Vascular ischemia may result in acute labyrinthine dysfunction that mimics labyrinthitis. ( 10. A 3D Printable Skull with Fracture (STL Format) A 3D printable STL file of a face and skull with bone fractures was generated from real CT scan data and is thus anatomically accurate as it comes from a real person. Facial fractures occur for a variety of reasons related to sports participation: contact between players (eg, a head, fist, elbow); contact with equipment (eg, balls, pucks, handlebars); or contact with the environment, obstacles, or a playing surface (eg, wrestling mat, gymnastic equipment, goalposts, trees). Direct body contact accounts for the majority of sports-related injuries, and the most commonly associated soft tissue injuries were found in the head and neck region. Sports like football, baseball, and hockey account for a high percentage of facial injuries among young adults. Forces that are required to produce a fracture of the facial bones are as follows: Nasal fracture – 30 g Zygoma fractures – 50 g Mandibular (angle) fractures – 70 g Frontal region fractures – 80 g Maxillary (midline) fractures – 100 g Mandibular (midline) fractures – 100 g Supraorbital rim fractures – 200 g References 1. Human Anatomy: Learn All About the Human Body at InnerBody.com. (2018). InnerBody. Retrieved 22 July 2018, from http://www.innerbody.com/ 2. Medscape Reference - Comprehensive peer-reviewed medical condition, surgery, and clinical procedure articles with symptoms, diagnosis, staging, treatment, drugs and medications, prognosis, follow-up, and pictures. (2018). Reference.medscape.com. Retrieved 22 July 2018, from https://reference.medscape.com/ 3. Kim, H., Roh, H., & Lee, I. (2016). Craniosynostosis : Updates in Radiologic Diagnosis. Journal Of Korean Neurosurgical Society, 59(3), 219. doi:10.3340/jkns.2016.59.3.219
  17. 3D-Printed Models of the Spine In this week's post, we want to share with you some of the best 3D-printed models of the spine uploaded by embodi3D® members. We will explore features of this unique anatomy and some of the main uses of 3D printing as it relates to the spine . To convert your own scans and download and 3D-print STL files from other users, all you have to do is register with embodi3D®. It's quick, easy, and costs absolutely nothing to join. Anatomical models have applications in clinical training and surgical planning as well as in medical imaging research. The Wall Street Journal recently ran an article to discuss the many ways 3D printing is changing the face of healthcare. The article also highlighted a case where a 3D model of a pelvis was used to plan a surgical operation on a young female patient. A full-scale, anatomical model of a human lumbar vertebra created with embodi3D®. In terms of clinical applications, the physical interaction with models facilitates learning anatomy and how different structures interact spatially in the body. Simulation-based training with anatomical models reduces the risks of surgical interventions, which are directly linked to patient experience and healthcare costs. Surgical planning 3D printing (3DP) is most frequently utilised in spinal surgery in the pre-operative planning stage. A full-scale, stereoscopic understanding of the pathology allows for more detailed planning and simulation of the procedure. Assessing complex pathologies on a model overcomes many of the issues associated with traditional 3D imaging, such as the lack of realistic anatomical representation and the associated complexity of computer-related skills and techniques. Summary of 3DP in spinal surgery planning 1999 D’Urso et al. (4) Osteogenesis imperfecta, cervicothoracic deformity, lumbar spinal fusion, cervical osteoblastoma 1999 D’Urso et al. (5) Craniofacial, maxillofacial and skull base cervical spine pathologies. 2005 D’Urso et al. (6) Complex spinal disorders. 2007 Guarino et al. (7) Multiplane spinal and pelvic deformities. 2007 Izatt et al. (8) Deformities, spinal tumours. 2007 Paiva et al. (9) Cervical Ewing Sarcoma. 2008 Mizutani et al. (10)Rheumatoid cervical spine. 2009 Madrazo et al. (11)Degenerative cervical disease. 2010 Mao et al. (12) Kyphoscoliosis, congenital malformations, neuromuscular disease. 2010 Yang et al. (13) Kyphoscoliosis. 2011 Wu et al.(14) Severe congenital scoliosis. 2013 Toyoda et al. (15) Atlantoaxial subluxation. 2014 Yang et al. (16) Atlantoaxial instability. 2015 Li et al.(17) Revision lumbar discectomy. 2015 Kim et al. (18)Thoracic tumours. 2015 Sugimoto et al. (19) Congenital kyphosis. 2015 Yang et al. (20) Adolescent idiopathic scoliosis. 2016 Goel et al. (21) Craniovertebral junction anomalies. 2016 Wang et al. (22) Congenital scoliosis, atlas neoplasm, atlantoaxial dislocation. 2016 Xiao et al. (23) Cervical bone tumours. 2017 Guo et al. (24) Cervical spine diseases. Imaging Anatomy There are 33 spinal vertebrae, which comprise two components: A cylindrical ventral bone mass, which is the vertebral body,and the dorsal arch. 7 cervical, 12 thoracic, 5 lumbar bodies • 5 fused elements form the sacrum • 4-5 irregular ossicles form the coccyx Arch • 2 pedicles, 2 laminae, 7 processes (1 spinous, 4 articular, 2 transverse) • Pedicles attach to the dorsolateral aspect of the body • Pedicles unite with a pair of arched flat laminae • Lamina capped by dorsal projection called the spinous process • Transverse processes arise from the sides of the arches The two articular processes (zygapophyses) are diarthrodial joints. • (1) Superior process bearing a facet with the surface directed dorsally • (2) Inferior process bearing a facet with the surface directed ventrally Pars interarticularis is the part of the arch that lies between the superior and inferior articular facets of all subatlantal movable elements. The pars are positioned to receive biomechanical stresses of translational forces displacing superior facets ventrally, whereas inferior facets remain attached to dorsal arch (spondylolysis). C2 exhibits a unique anterior relation between the superior facet and the posteriorly placed inferior facet. This relationship leads to an elongated C2 pars interarticularis, which is the site of the hangman's fracture. 1. An Exceptional Human Lumbar Vertebra Converted from a CT Scan with embodi3D® An anatomically accurate full-size human lumbar vertebra created from a real CT scan. The lumbar vertebral bodies are large, wide and thick, and lack a transverse foramen or costal articular facets. The pedicles are strong and directed posteriorly. The superior articular processes are directed dorsomedially and almost face each other. The inferior articular processes are directed anteriorly and laterally. 2. Create Your Own Lumbar Spine Model with a 3D-Printable STL File A 3D printable STL file and medical model of the lumbar spine was generated from real CT scan data and is thus anatomically accurate as it comes from a real person. It shows the detailed anatomy of the lumbar (lower back) spine, including the vertebral bodies, facets, neural foramina and spinous proceses. 3. A 3D Printer-Ready Spinal Column in Amazing Detail Thoracic bodies are heart-shaped and increase in size from superior to inferior. Facets are present for rib articulation and the laminae are broad and thick. Spinous processes are long, directed obliquely caudally. Superior facets are thin and directed posteriorly. The T1 vertebral body shows a complete facet for the capitulum of the first rib, and an inferior demifacet for capitulum of second rib. The T12 body has transitional anatomy, and resembles the upper lumbar bodies with the inferior facet directed more laterally 4. Create a 3D-Printed Model of Lumbar Vertebrae The lumbar spine is formed by 5 lumbar vertebrae labelled L1-L5 and the intervening discs. Its main function is to provide stability and permits movement. The lumbar vertebral body is formed of 3 parts : Body, arch and spinal processes. The body of the lumbar vertebrae is large, its transverse diameter is larger than is AP diameter, and is more thickened anteriorly. The arch of the lumbar vertebra on the other hand is formed of pedicle, a strong structure that is projected from the back of the upper part of the vertebrae, and lamina which forms the posterior portion of the arch. Another well reported benefit of 3DP models is improved patient education. A physical model is much easier for a patient to understand than complex MRI and CT scans. 5. An NRRD File Showing the Whole Spine — See the Future of Medical 3D Printing A Whole Spine (Dorsal-Lumbar-Sacral) and Aorta NRRD file from CT Scan for Medical 3D Printing As 3DP technology continues to become cheaper, faster and more accurate, its use in the setting of spinal surgery is likely to become routine, and in a greater number of procedures. 6. Download a 3D-Printable Thoracic Spine with Prevalent Scoliosis A 3D printable STL file contains a model of the thoracic spine derived from a CT. The spine has significant scoliosis. In a recent embodi3D® article, we touched on the topic of how medical 3D printing is being used to plan spinal surgeries, such as in correcting the spinal curvature in scoliosis patients. Scoliosis is considered to be present when there is a coronal plane curvature of the spine measuring at least 10°. However, treatment is not generally instituted unless the curvature is > 20-25°. The curvature may be balanced (returning to midline) or unbalanced. The vertebrae at the ends of the curve are designated the terminal (or end) vertebrae, while the apical vertebra is at the curve apex. Curvatures are described by the side to which they deviate. A dextroscoliosis is convex to the right, with its apex to the right of midline. A levoscoliosis is convex to the left, with its apex to the left of midline. Curvatures can be categorized as flexible (normalizing with lateral bending toward the side of the curve) or structural (failing to correct). Most scoliotic curvatures are associated with abnormal curvature in the sagittal plane. These are described as kyphosis (apex dorsal) or lordosis (apex ventral). Morphology of the Curvature Scoliosis due to fracture, congenital anomaly, or infection typically has an angular configuration. Other causes of scoliosis tend to have a smooth curvature. Scoliosis most commonly involves the thoracic spine, followed by the thoracolumbar spine. In the past, curves were categorized as primary and secondary (compensatory), but it is often difficult to make the distinction and so these designations are no longer commonly used. Measurement of Scoliosis The Cobb method is most commonly used to measure scoliosis. The vertebrae at each end of the curve (the terminal vertebrae) are chosen. These are the endplates with the greatest deviation from the horizontal. The curvature is the angle between a line drawn along the superior endplate of superior terminal vertebra and a line along the inferior endplate of the inferior terminal vertebra. In severe curvatures, the endplates are often difficult to see. In that case, the inferior cortex of the pedicle can be used as the landmark for making the measurement. If measurements are made on hard copy radiographs, it is usually necessary to draw lines perpendicular to the endplates and measure the angle between the perpendicular lines. Scoliosis is almost always associated with abnormal curvature in the sagittal plane. The most common finding is loss of normal thoracic kyphosis. The Cobb method can be used to determine sagittal plane deformity. Rotational deformity is often present but can only be grossly assessed on radiographs. It can be measured on CT scan by superimposing the apical and terminal vertebrae. Normally, the T1 vertebra is centered over the L5 vertebra in both the coronal and sagittal planes. Coronal or sagittal plane imbalance can be measured as the horizontal distance between the center of the L5 vertebral body and a plumb line drawn through the center of the T1 vertebral body. 7. Dr. Mike's Excellent Tutorial on Converting CT Scans to 3D Printer-Ready STL Models An excellent tutorial of 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. 8. An MRI of a Lumbar Spine with Disc Bulge at L4-L5 and L5-S1 The term bulge is used to describe a generalized extension greater than 50% of the circumference of the disc tissues, extending a short distance (< 3 mm) beyond the edges of the adjacent apophyses. A bulge is not a herniation, although 1 portion of the disc may be bulging and another portion of the disc may herniate. A bulge is often a normal variant, particularly in children in whom all normal discs appear to extend slightly beyond the vertebral body margin. Bulge may also be associated with disc degeneration or may occur as a response to axial loading or angular motion with ligamentous laxity. Occasionally, a bulge in 1 plane is really a central subligamentous disc herniation in another plane. Asymmetric bulging of disc tissue greater than 25% of the disc circumference may be seen as an adaptation to adjacent deformity, and is not considered a form of herniation. Herniations are a localized displacement of disc material beyond the limits of the intervertebral disc space in any direction. 9. Using 3D Modeling to Understand the Severity of a Scoliosis Case A 3D model of a severe scoliosis. CT scan should always be performed with reformatted images. Angled reformatted images and 3D reformations are often useful in assessment of severe curvatures. Some physicians find it useful to obtain both SPECT and CT images of degenerative scoliosis. An area of arthritis on CT scan, which shows increased uptake on SPECT, is probably a pain generator. MR can be difficult to interpret when scoliosis is severe. Angled axial images should be obtained based on both sagittal and coronal scout images and angled along the plane of the vertebral endplate on both scouts. Sagittal images should be angled along each segment of the curvature. The coronal plane is often the most useful for evaluating bony anomalies, spondylolysis, or degeneration of the discs and facet joints. References 1. Bücking, T. M., Hill, E. R., Robertson, J. L., Maneas, E., Plumb, A. A., & Nikitichev, D. I. (2017). From medical imaging data to 3D printed anatomical models. PloS one, 12(5), e0178540. 2. Wilcox, B., Mobbs, R. J., Wu, A. M., & Phan, K. (2017). Systematic review of 3D printing in spinal surgery: the current state of play. Journal of Spine Surgery, 3(3), 433. 3. Ross, J. S., Moore, K. R., Bryson Borg, M. D., Julia Crim, M. D., & Shah, L. M. (2010). Diagnostic imaging: spine: published by Amirsys®. Lippincott Williams & Wilkins, Baltimore. 4. D'Urso PS, Askin G, Earwaker JS, et al. Spinal biomodeling.Spine (Phila Pa 1976) 1999;24:1247-51. 10.1097/00007632-199906150-00013. 5. D'Urso PS, Barker TM, Earwaker WJ, et al. Stereolithographic biomodelling in cranio-maxillofacial surgery: a prospective trial. J Craniomaxillofac Surg 1999;27:30-7. 10.1016/S1010-5182(99)80007-9 6. D'Urso PS, Williamson OD, Thompson RG. Biomodeling as an aid to spinal instrumentation. Spine (Phila Pa 1976) 2005;30:2841-5. 10.1097/01.brs.0000190886.56895.3d 7. Guarino J, Tennyson S, McCain G, et al. Rapid prototyping technology for surgeries of the pediatric spine and pelvis: benefits analysis. J Pediatr Orthop 2007;27:955-60. 10.1097/bpo.0b013e3181594ced 8. Izatt MT, Thorpe PL, Thompson RG, et al. The use of physical biomodelling in complex spinal surgery. Eur Spine J 2007;16:1507-18. 10.1007/s00586-006-0289-3 9. Paiva WS, Amorim R, Bezerra DA, et al. Aplication of the stereolithography technique in complex spine surgery. Arq Neuropsiquiatr 2007;65:443-5. 10.1590/S0004-282X2007000300015 10. Mizutani J, Matsubara T, Fukuoka M, et al. Application of full-scale three-dimensional models in patients with rheumatoid cervical spine. Eur Spine J 2008;17:644-9. 10.1007/s00586-008-0611-3 11. Mao K, Wang Y, Xiao S, et al. Clinical application of computer-designed polystyrene models in complex severe spinal deformities: a pilot study. Eur Spine J 2010;19:797-802. 10.1007/s00586-010-1359-0 12. Yang JC, Ma XY, Lin J, et al. Personalised modified osteotomy using computer-aided design-rapid prototyping to correct thoracic deformities. Int Orthop 2011;35:1827-32. 10.1007/s00264-010-1155-9 13. Wu ZX, Huang LY, Sang HX, et al. Accuracy and safety assessment of pedicle screw placement using the rapid prototyping technique in severe congenital scoliosis. J Spinal Disord Tech2011;24:444-50. 10.1097/BSD.0b013e318201be2a 14. Toyoda K, Urasaki E, Yamakawa Y. Novel approach for the efficient use of a full-scale, 3-dimensional model for cervical posterior fixation: a technical case report. Spine (Phila Pa 1976)2013;38:E1357-60. 10.1097/BRS.0b013e3182a1f1bd 15. Yang JC, Ma XY, Xia H, et al. Clinical application of computer-aided design-rapid prototyping in C1-C2 operation techniques for complex atlantoaxial instability. J Spinal Disord Tech 2014;27:E143-50. 16. Li C, Yang M, Xie Y, et al. Application of the polystyrene model made by 3-D printing rapid prototyping technology for operation planning in revision lumbar discectomy. J Orthop Sci 2015;20:475-80. 10.1007/s00776-015-0706-8 17. Kim MP, Ta AH, Ellsworth WA, 4th, et al. Three dimensional model for surgical planning in resection of thoracic tumors. Int J Surg Case Rep 2015;16:127-9. 10.1016/j.ijscr.2015.09.037 18. Sugimoto Y, Tanaka M, Nakahara R, et al. Surgical treatment for congenital kyphosis correction using both spinal navigation and a 3-dimensional model. Acta Med Okayama 2012;66:499-502. 19. Yang M, Li C, Li Y, et al. Application of 3D rapid prototyping technology in posterior corrective surgery for Lenke 1 adolescent idiopathic scoliosis patients. Medicine (Baltimore) 2015;94:e582. 10.1097/MD.0000000000000582 20. Goel A, Jankharia B, Shah A, et al. Three-dimensional models: an emerging investigational revolution for craniovertebral junction surgery. J Neurosurg Spine 2016;25:740-4. 10.3171/2016.4.SPINE151268 21. Wang YT, Yang XJ, Yan B, et al. Clinical application of three-dimensional printing in the personalized treatment of complex spinal disorders. Chin J Traumatol 2016;19:31-4. 10.1016/j.cjtee.2015.09.009 22. Xiao JR, Huang WD, Yang XH, et al. En Bloc Resection of Primary Malignant Bone Tumor in the Cervical Spine Based on 3-Dimensional Printing Technology. Orthop Surg 2016;8:171-8. 10.1111/os.12234 23. Guo F, Dai J, Zhang J, et al. Individualized 3D printing navigation template for pedicle screw fixation in upper cervical spine. PLoS One 2017;12:e0171509. 10.1371/journal.pone.0171509
  18. Creating a Dog Skeleton Model with 3D Printing and Other Veterinary Uploads Like all things in the early 21st century, change moves fast and this technology is quickly displacing outdated modalities and changing that face of veterinary care. 3D printing has a range of clinical applications, including pre-surgical planning, as well as in interventional radiology approaches, such as portosystemic shunts. Benefits are also experienced by researchers and students, who may use a dog skeleton model to understand gait and complex skeletal features, or even study the anatomy of rare and exotic animals. 3D printing enhances veterinary care by allowing more hands-on study, research, and assessment. In providing advanced diagnoses, 3D printing is being used as an extension of treatment planning for oncologic masses, vascular ring anomalies, and other malformations. 3D-printed veterinary models improve communication with the client in the treatment of complex fractures and corrective osteotomies. Currently, there are at least eight Colleges of Veterinary Medicine that are incorporating this technology into their programs: Auburn University, Cornell University, Mississippi State University, North Carolina State University, Ohio State University, University of California-Davis, University of Missouri, and the University of Pennsylvania. Private practices, such as South Paws Specialty Surgery for Animals and the Equine Podiatry and Lameness Centre (both in Australia) are also utilizing 3D scanning and printing as well. This week we bring you the best 3d models in veterinary medicine. If you want to have access to these amazing 3D models you just have to register in the following link: https://www.embodi3d.com/register/. Those in the veterinary profession may find interest in the canine and feline uploads created by the embodi3D® community. 1. Using a Converted CT Scan to Create this Awesome Polar Bear Skull An excellent 3D printable polar bear skull was generated from CT scan data. This 3D model shows bony anatomy of the skull in exquisite detail, including the maxilla, mandible, teeth and other structures of the skull. The veterinarians also use 3D printing technology to explore different ways of treating animals. 2. A Highly Detailed 3D Model of a Canine Skull A 3D model of a canine's skull. To start, a CT and MRI scans of the canine head is used to create highly accurate 3D models of the skull and brain, respectively. Slices of each type of scan were first segmented to construct basic models, and the creators tagged important anatomic landmarks (such as brain sulci and gyri) in each segment. Next, various software tools are used to assemble the sliced skull and brain images, smooth out image irregularities, and give the finished models a seamless appearance. 3. Another Take on the 3D Model of a Polar Bear Skull in Sections This is a great 3D model shows bony anatomy of the skull in exquisite detail, including the maxilla, mandible, teeth and other structures of the skull. The skull has been sectioned in half so that the inner bony anatomy is clearly visible. 4. An Example of How 3D Modeling Helps with Tumor Removals in Dogs This awesome 3D model is of the thorax and rib cage of a dog. There is a tumor at the thoracic outlet at the base of the cervical spine. Before the animal comes in for surgery and gets on the operating table, the veterinary surgeons have had the chance to plan out, and even rehearse, complicated procedures and operations. 5. A 3D-Printable Model of a Dog Skeleton (Femur, Fibula, Tibia, Patella, etc.) A 3D model of the skeleton of a dog showing thigh, femur, fibula, tibia, patella, coccygeal vertebrae, tail, talus, calcaneus 6. An Excellent 3D-Printable Model of a Dog's Foreleg and Carpal A 3D model of a dog's forearm/foreleg. The ulna, radius, humerus, carpal, metacarpal and phalanges bones are shown. 7. Using a 3D-Printable Model of a Luxated Canine Elbow for Pre-Surgical Planning A luxated elbow of a dog excellent for surgical planning. The spine is also shown. 8. CT Scan-Converted 3D Model of a Feline Spine Member Gustavo uploaded this excellent CT-derived scan showing a cat's spine. The ribs and joints can be seen in high detail, making this a 3D model well-suited for veterinary purposes. 9. STL File of a Dog's Pelvis Bones This STL file, uploaded by embodi3D® member allaxis3d, details the canine pelvis lumbar vertebrae, discs, caudal vertebrae, and sacrum. 10. Imaging the Skeletal Deformities of a Canine Using STL 3D Modeling Veterinary clinical applications have been reported. Angular limb deformities of both the forelimb and hindlimb were treated using rapid prototyping technology. This is a 3D model of a dog showing the important anatomical structures of the skull, forearm and spine. References 1. Hespel, A. M., Wilhite, R., & Hudson, J. (2014). INVITED REVIEW‐APPLICATIONS FOR 3D PRINTERS IN VETERINARY MEDICINE. Veterinary Radiology & Ultrasound, 55(4), 347-358. 2. Quinn-Gorham, D. M., & Khan, J. M. (2016). Thinking Outside of the Box: The Potential of 3D Printing in Veterinary Medicine. J Vet Sci Technol, 7(360),
  19. Top 10 Muscle Anatomy Models Uploaded to embodi3D® Muscles of the human anatomy form an amazingly quilted patchwork that allow us to do, well whatever is we do. There are muscles that allow us to perform intricate tasks, such as finagling with a screw to fix eyeglasses, or paint a highly detailed portrait. Then there are those muscles that allow us to run, swing a bat, and don't forget the cardiac muscle, which helps supply the blood necessary to complete all these tasks. Long before the days of Da Vinci, the human musculature has long fascinated medically minded individuals. Through 3D printing, medical students are discovering a new way to create muscle anatomy models and gain more hands-on knowledge of the human musculoskeletal system. From Da Vinci's "Vitruvian Man" to 3D-printable muscles, we continue to expand our understanding of the human anatomy. Although learning of complex geometries in human anatomy has been facilitated with 3D three-dimensional visualization methods and novel educational applications, there is little dispute that physical models provide an optimal method of learning human anatomy. While 3D printing is quickly becoming the new norm, it's amazing to think that just a few short years ago ScienceDaily was heralding the arrival of 3D-printed anatomical parts for the purpose of medical training. On the embodi3D® website, we now have a number of subcategories exploring human musculature in 3D-printable STL files. Become a Registered embodi3D® Member — It's Absolutely Free to Join! This week, we want to share the most amazing 3D-printed muscle models. But, before you begin uploading, converting, and printing muscle models from your own CT scans (and others), you need to become a registered member of the embodi3D® community. It is absolutely free to join and you will have access to many of the most popular tools and algorithms. 1. An Excellent Muscle 3D Model of the Human Foot Dr. Mike uploaded this amazing CT scan-converted STL file in the Extremity, Lower (Leg) Muscles form. This is an incredible 3D model of the foot showing with exquisite detail the following structures excellent for education purposes: Interosseous muscles: extensor digiti II muscle (tendon), flexor digitorum longus muscle (tendon), Adductor hallucis muscle (transverse head), lumbrical muscle, dorsal tarsal ligaments, adductor hallucis muscle, peroneus (fibularis) longus muscle (tendon), flexor digitorum brevis muscle, extensor digitorum longus muscle (tendon), tibia, abductor digiti minimi muscle, flexor hallucis longus muscle (tendon), calcaneus and Achilles’ tendon (calcaneal tendon). 2. Left Thigh Muscle with Myxoid Fibrosarcoma Shown in a 3D Model This model is the right foot and ankle muscle rendering of a 65-year-old male with left thigh myxoid fibrosarcoma. At the time of diagnosis, the patient had metastases to his lungs. Laterally, the peroneus brevis and tertius attach on the proximal fifth metatarsal to evert the foot. The peroneus longus courses under the cuboid to attach on the plantar surface of the first metatarsal, acting as the primary plantarflexor of the first ray and, secondarily, the foot. Together, these muscles also assist in stabilizing the ankle for patients with deficient lateral ankle ligaments from chronic sprains. Medially, the posterior tibialis inserts on the plantar aspect of the navicular cuneiforms and metatarsal bases, acting primarily to invert the foot and secondarily to plantarflex the foot. The flexor hallucis longus inserts on the base of the distal phalanx of the great toe to plantarflex the great toe, and the flexor digitorum inserts on the bases of the distal phalanges of the lesser four toes, acting to plantarflex the toes. The gastrocnemius inserts on the calcaneus as the Achilles tendon and plantarflexes the foot. Anteriorly, the tibialis anterior inserts on the dorsal medial cuneiform and plantar aspect of the first metatarsal base as the primary ankle dorsiflexor and secondary inverter. The Extensor hallucis longus and extensor digitorum longus insert on the dorsal aspect of the base of the distal phalanges to dorsiflex the great toe and lesser toes, respectively. 3. A 3D Model Showing the Musculature of the Human Femur and Tibia The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shinbone (tibia). The smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) are the other bones that make the knee joint. Is also formed by some ligaments and cartilage called (menisci) which are best imaged by MRI. 4. An Amazing CT Scan-Converted 3D-Printable Model of the Legs A detailed 3D printable model of the musculature of the legs was derived from the CT scan of a 22 year old female. It shows all major muscle groups: Sartorius, tensor fasciae latae, gluteus maximus, medius, gemellus muscles, quadratus femoris, obturator internus, semitendinosus, semimembranosus, biceps femoris, peroneus group: peroneus brevis (fibularis brevis), peroneus longus (fibularis longus), quadriceps: rectus femoris Vastus lateralis, medialis, and intermedius. 5. Hand and Wrist Muscles in a 3D-Printable Format An excellent 3D model of the hand and wrist showing the following muscles extensor pollicis longus and brevis, extensor indicis, muscles of Hand: dorsal and palmar interosseous, lumbrical, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris, abductor pollicis longus and abductor pollicis brevis, opponens pollicis, flexor pollicis brevis, adductor pollicis, abductor digiti minimi, flexor digiti minimi brevis, opponens digiti minimi 6. 3D-Printable Model of a Woman's Chest, Abdomen, and Pelvis A 3D model of the muscles of a woman's whole body: chest, abdomen and pelvis with exquisite detail of latissimus dorsi muscle, subscapularis muscle, pectoralis minor muscle, pectoralis major muscle, sternum, intercostal muscles, teres major muscle, infraspinatus muscle, scapula, rhomboid major muscle, ribs, trapezius muscle, erector spinae muscle, gluteus maximus, medius, thoracolumbar fascia, rectus abdominis muscle, external oblique muscle and breasts. 7. A 3D-Printable Model of a Human Torso (Converted from a Real Medical CT Scan) This is a 3D printable model of the torso, neck, and arms derived from a real medical CT scan and shows anatomic structures in great detail. Similar uploads can also be found in an embodi3D® forum showcasing the muscles of the abdomen and pelvis. 8. Using a 3D Model to Show the Muscles of the Hip Joint The muscles of the hip joint are those muscles that cause movement in the hip. Most modern anatomists define 17 of these muscles, although some additional muscles may sometimes be considered. These are often divided into four groups according to their orientation around the hip joint: the gluteal group, the lateral rotator group, the adductor group, and the iliopsoas group. For example the gluteal muscles include the gluteus maximus, gluteus medius, gluteus minimus, and tensor fasciae latae. They cover the lateral surface of the ilium. The gluteus maximus, which forms most of the muscle of the buttocks, originates primarily on the ilium and sacrum and inserts on the gluteal tuberosity of the femur as well as the iliotibial tract, a tract of strong fibrous tissue that runs along the lateral thigh to the tibia and fibula. The gluteus medius and gluteus minimus originate anterior to the gluteus maximus on the ilium and both insert on the greater trochanter of the femur. The tensor fasciae latae shares its origin with the gluteus maximus at the ilium and also shares the insertion at the iliotibial tract. 9. 3D-Printable STL File of Left Pelvic Region, as Converted from a CT Scan This is a 3D printable medical file converted from a CT scan DICOM dataset of a 68-year old male presented by a swelling at the posterior aspect of the left pelvic region (notice the contour bulge at the posterior aspect of the left side). Histopathological examination revealed the swelling to be leiomyosarcoma of intermediate grade of malignancy. Soft tissue sarcoma is a rare type of cancer that begins in the tissues that connect, support and surround other body structures. This includes muscle, fat, blood vessels, nerves, tendons and the lining of your joints. More than 50 subtypes of soft tissue sarcoma exist. Some types are more likely to affect children, while others affect mostly adults. These tumors can be difficult to diagnose because they may be mistaken for many other types of growths. A soft tissue sarcoma may not cause any signs and symptoms in its early stages. As the tumor grows, it may cause: A noticeable lump or swelling Pain, if a tumor presses on nerves or muscles 10. Using 3D-Printed Muscle Models for Oncological Purposes This 3D model represents a case of undifferentiated pleomorphic spindle cell sarcoma implicating the right parascapular region of a 61 years old male. The patient represented with lung metastasis and was treated by surgical excision follower by chemotherapy as well as radiotherapy. A cross sectional CT image is attached showing the lesion in axial, coronal and sagittal planes. Undifferentiated pleomorphic sarcoma (UPS), formerly referred to as malignant fibrous histiocytoma, is a type of soft tissue cancer. The word "undifferentiated" in undifferentiated pleomorphic sarcoma means that the cells don't resemble the body tissues in which they develop. The cancer is called pleomorphic (plee-o-MOR-fik) because the cells grow in multiple shapes and sizes. While sarcomas are not common tumors, they do represent one of the most common soft tissue malignancies in adults. Soft tissue sarcomas can develop in blood vessels and in deep skin, fat, muscle, fibrous or nerve tissues. References 1. Smith, M. L., & Jones, J. F. (2018). Dual‐extrusion 3D printing of anatomical models for education. Anatomical sciences education, 11(1), 65-72.
  20. A Foot 3D Model and Other Anatomical Models of the Lower Extremities Food 3D Model | embodi3D® This week we want to share some of the best representations of how embodi3D® members are using democratiz3D® conversions to create a foot 3D model and other skin, tissue, and skeletal features of the lower extremities. Successful 3D (three-dimensional) printing from radiologic images is multidisciplinary; accurate models that represent patient anatomy and pathologic processes require close interaction between radiologists and referring physicians. Preoperative 3D printing of bone structures has expanded planning and navigation of orthopedic procedures. Recently, the American Journal of Roentgenology published a research article on how a 3D printing was used to plan a femoracetabular impingement surgery. 3D printing is also contributing to novel surgical approaches for osteotomies, fracture fixation, and arthroplasties. Three-dimensional printing is an essential tool in the design and testing of complicated or innovative reconstructive surgeries. If you are Interested in lower limb 3D Printing here are some resources: Free downloads of hundreds of 3D printable lower limb models. Automatically generate your own 3D printable lower limb models from CT or CBCT scans. Have a question? Post a question or comment in the forum. Dr. Mike has also put together a tutorial on how convert CT scans to 3D-printable bone STL files (in minutes), as well as creating multiple bone model STL files from a single CT scan. Be sure to check these out. We look forward to your uploads! 1. A CT DICOM Dataset Conversion Showing the Bones of the Feet An excellent example of lower extremity 3D model of bony anatomy and skin surface of the L and R feet, as extracted from a CT DICOM dataset (0.5 mm slice thickness x 250 slices). 2. An Anatomically Precise 3D-Printed Talus Bone (Available for Free in STL Format) A 3D model human talus bone was generated from real CT scan data and is thus anatomically accurate as it comes from a real person. It shows the detailed anatomy of the talus bone -- a critical component of the ankle. In the attached thumbnails, the talus is shown in white with the rest of the foot bones in clear glass. 3. An Incredible 3D-Printed Leg model Showing Femur and Shaft Coxa vara describes a deformity of the hip where the angle formed between the head and neck of the femur and its shaft (Mikulicz angle) is decreased, usually defined as less than 120 degrees. Pathology It can be congenital or acquired. The common mechanism in congenital cases is a failure of medial growth of the physeal plate Classification One of the very early classifications proposed by Fairbank in 1928, is often considered most useful from a radiologic point of view. A slight modifcation of this system includes: idiopathic: congenital: mild or severe coxa vara, with associated congenital anomalies: see associations developmental: progressive, usually appearing between the ages of two and six years, with characteristic roentgenologic features rachitic: usually associated with active rickets adolescent: secondary to slipped capital femoral epiphysis traumatic: usually following fracture of the femoral neck (rare in children) inflammatory: secondary to tuberculosis or other infection secondary to other underlying bone diseases such as: osteogenesis imperfecta cretinism dyschondroplasia(s) Paget's disease osteoporosis capital coxa vara: occasionally seen in severe osteoarthritis and Legg-Perthes' disease 4. Use This STL File to 3D-Print an Ankle Bone This whole ankle was generated from real CT scan data and is thus anatomically accurate as it comes from a real person. It shows the detailed anatomy of the ankle bones. 5. View the Intricate Bones of the Calcaneus (Heel Bone) with this CT-Converted STL File This left calcaneus was generated from real CT scan data and is thus anatomically accurate as it comes from a real person. It shows the heel and articular surfaces of the calcaneus in great detail. 6. 3D-Print a Left Knee Joint Model with this Excellent STL Upload (Converted from CT Scan) 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. 7. Colorized STL Files of the Uploader's Own Lower Leg This is an excellent 3D model of the segmented bones from a partial weight bearing CT scan of a healthy 25 year old male. There is also a model of the outer foot surface (skin) to have the full foot volume. All bones are separate as well as combined as a single file. Shoe size 10.5 for reference. 8. A 3D-Printable Distal Tibia Bone (Generated from CT Scan Data) This 3D printable distal tibia bone from the left leg was generated from real CT scan data and is thus anatomically accurate as it comes from a real person. It shows the detailed anatomy of how the tibia articulates with the talus and distal fibula to form the ankle joint. In the thumbnails, the tibia is shown in white and the rest of the ankle bones in glass. 9. A CT-Converted Scan of the Feet, Showing the Intricate Bone Structure User mikefazz makes another appearance in our list with this CT scan of a 25-year-old healthy male (himself a few years back) partial weight bearing. 0.9766mm in plane and 0.5mm out of plane resolution. 10. Osteochondroma Detailed in a 3D-Printed Model of the Hip Bone A 3D model of a large osteochondroma on the posterior surface of the proximal femur. The popliteal artery is in close proximity to the osteochondroma. Osteochondroma, the most common benign bone lesion (representing about 45% of all benign bone tumors and 12% of all bone tumors) , is a cartilage- capped bony projection on the external surface of a bone. Usually diagnosed before the third decade, it most commonly involves the metaphyses of long bones, particularly around the knee and the proximal humerus. In general, the lower extremities are more often affected than the upper extremities. Malignant transformation to chondrosarcoma very rare, occurring in less than 1% of solitary lesions. Pain (in the absence of a fracture, bursitis, or pressure on nerves) and a growth spurt or continued growth of the lesion beyond skeletal maturity are highly suspicious for this complication. Variants of osteochondroma include subungual exostosis, turret exostosis, traction exostosis, bizarre parosteal osteochondromatous proliferation (BPOP), florid reactive periostitis, and dysplasia epiphysealis hemimelica (also known as intraarticular osteochondroma). References 1. Differential diagnosis of tumors and tumor-like lesions of bones and joints/Adam Greenspan and Wolfgang Remagen. 2007. 2. Marro, A., Bandukwala, T., & Mak, W. (2016). Three-dimensional printing and medical imaging: a review of the methods and applications. Current problems in diagnostic radiology, 45(1), 2-9. 3. Mitsouras, D., Liacouras, P., Imanzadeh, A., Giannopoulos, A. A., Cai, T., Kumamaru, K. K., ... & Ho, V. B. (2015). Medical 3D printing for the radiologist. Radiographics, 35(7), 1965-1988.
  21. Create a 3D Hand Model and Other Models with STL Files Anatomically speaking, the bones found within the upper limbs help us to perform incredible feats, such as holding and grasping objects. While we may not see these types of tasks as anything extraordinary, it does take five bone and muscle regions (shoulder, axilla, arm, forearm, and hand) to help us complete all the things we do with our hands and arms, such as swing a bat, write a letter, create a painting, and others too numerous to list. For all the reasons we've just mentioned, embodi3D® is proud to introduce some of our favorite uploads, including a 3D hand model, upper limbs, wrists, shoulders, and other 3D printer-ready models that have been shared with the embodi3D® community. While these CT-converted STL files have been used in pre-operative planning and for purposes of education, these uploads will appeal to anyone with an interest in the human form. An article in the International Journal of the Care of the Injured (Injury) revealed how 3D-printed models give orthopedic surgeons tactile and visual experience. As a sensory and reference tool, these models helped them to better understand a patient's unique anatomy and pathology prior to orthopedic surgery. 3D-printed models converted from 2D and 3D CT scans have made fracture line comminution diagnoses more accurate. Patients that can experience a scan on a three-dimensional scale are better equipped mentally to understand the pathology and the surgical procedure necessary to its correction. To download and create 3D-printed models from STL files and CT scans, be sure to register with embodi3D® today! 1. A Highly Detailed Hand 3D Model in STL Format User Phil H uploaded this incredibly detailed anatomically correct hand 3D model to help visualize the hand bones, including the carpus, and metatarsal. The human hand has 27 distinct bones, which allow us to complete a range of tasks. Amazingly, the number of bones in the hand can vary from person to person due to the presence of sesamoid bones, which are essentially bones that are embedded within a muscle or tendon, as is the case with hands. Download this model and create your anatomical hand model! 2. A 3D-Printed Model of an Elbow Joint (Converted from CT Scan) The elbow is one of the largest joints in the body. In conjunction with the shoulder joint and wrist, the elbow gives the arm much of its versatility, as well as structure and durability. This elbow joint was generated from real CT scan data and is thus anatomically accurate as it comes from a real person. It shows the distal humerus, the olecranon as it sits in the olecranon fossa, the two humeral epicondyles, and the distal radius and radial head. There are full size and double size files available. The enlarged double size file shows anatomy in terrific detail. 3. Detailed 3D Model of Hand and Wrist Bones in STL An embodi3D® user going by "than" uploaded this detailed 3D model featuring the hand and wrist bones. Even the joint surfaces are shown in remarkable detail. 4. 3D Rendering from CT Scan of a Shoulder Joint with Multiple Epiphyseal Dysplasia This 3D model created on embodi3D® features a shoulder with epiphysis dysplasia. The imaging findings include the following : Minor epiphyseal involvement, severe involvement (hatchet head group) ,malformed humeral head; broad metaphysis; bowing of the proximal shaft; hypoplasia of the glenoid. If this topic interests you, you may find Matt Johnson's write-up on how 3D printing is being used in cancer screens highly interesting. 3D printing has also been called the "new frontier in oncology research" by The World Journal of Clinic Oncology. 5. 3D Model of Undifferentiated Pleomorphic Spindle Cell Sarcoma This 3D model represents a case of undifferentiated pleomorphic spindle cell sarcoma implicating the right parascapular region of a 61 years old male. The patient represented with lung metastasis and was treated by surgical excision follower by chemotherapy as well as radiotherapy. A cross sectional CT image is attached showing the lesion in axial, coronal and sagittal planes. Unfortunately pleomorphic undifferentiated sarcoma has an aggressive biological behaviour and a poor prognosis. Pleomorphic undifferentiated sarcomas can occur almost anywhere in the body, they have a predilection for the retroperitoneum and proximal extremities. They are usually confined to the soft tissues, but occasionally may arise in or from bone. 6. An Amazing 3D-Printable Model of a Hand An awesome 3D model of the hand´s bones with carpus and metatarsal detailed. 7. Shoulder and Humerus 3D Model Converted from CT Scan This shoulder and humerus was generated from real CT scan data and is thus anatomically accurate as it comes from a real person. It shows the left scapula, humerus, proximal radius and ulna bones, and the shoulder and elbow joints. The humerus has been joined to the scapula at the glenohumeral joint to form one solid piece. 8. A Wrist Fracture Shown in Stunning 3D Detail A great 3D model showing a wrist´s fracture. 9. STL File Showing a Three-Dimensional Model of a Hand and Fingers In this terrific 3D model, the skin surfaces of the hand, fingers, and nails are shown. This is a great demonstration of how the different tissue filters on embodi3D® can creating stunningly realistic renderings. 10. 3D Imaging Tendons of the Hands and Wrists Tendons are fibrous cords, similar to a rope, and are made of collagen. They have blood vessels and cells to maintain tendon health and repair injured tendon. Tendons are attached to muscles and to bone. As the muscle contracts it pulls on the tendon and the tendon moves the bone to which it is attached as well as any joints it crosses. Our growing library of 3D anatomical models also features muscles and tendons of the lower extremities. FCR TENDON The flexor carpi radialis tendon is one of two tendons that bend the wrist. Its muscle belly is in the forearm and then travels along the inside of the forearm and crosses the wrist. It attaches to the base of the second and third hand bones. It also attaches to the one of the wrist bones, the trapezium. FCU TENDON The flexor carpi ulnaris tendon is one of two tendons that bend the wrist. Its muscle belly is in the forearm. The tendon travels along the inside of the forearm on the side of the small finger and crosses the wrist. It attaches to the wrist bone, the pisiform, and as well as the 5th hand bone. ECRB TENDON The extensor carpi radialis brevis tendon is one of 3 tendons, including ECRL and ECU, which act together to bend back the wrist. Its muscle belly is in the forearm and then travels to the thumb side of the wrist on the back part of the forearm. Along with the ECRL, it attaches to the base of the hand bones. It is shorter and thicker than the ECRL ECRL TENDON The extensor carpi radialis longus tendon acts along with the ECRB and ECU to bend back the wrist. ECRL and ECRB also help bend the wrist in the direction of the thumb. Its muscle belly is in the forearm. It is thinner and longer than ECRB. It travels along the back aspect of the forearm and attaches to the base of the hand bones. ECU TENDON The extensor carpi ulnaris tendon works along with the ECRL and ECRB to straighten the wrist. It differs from these other two tendons in that it moves the wrist in the direction of the pinky. Its muscle belly is in the forearm. The tendon travels along the back forearm, through a groove in the ulna, and attaches to the base of the hand bones. References 1. Osagie, L., Shaunak, S., Murtaza, A., Cerovac, S., & Umarji, S. (2017). Advances in 3D Modeling: Preoperative Templating for Revision Wrist Surgery. HAND, 12(5), NP68-NP72. 2. Handcare.org > Anatomy > Tendons . (2018). Assh.org. Retrieved 3 June 2018, from http://www.assh.org/handcare/Anatomy/Tendons#Wrist
  22. In this week's blog entry, we'd like to share some of the best medical 3D printing models, as well as a few detailed examples that garnered the attention of embodi3D® users over the past month. 3D-printable STL files like these are helping physicians and medical students to further their understanding of complex diagnoses and treatments — and your contributions are a big part of embodi3D's continued success. If you are not yet an embodi3D member, we invite you to register and take advantage of all the wonderful resources available to you. Registering is free and allows you to upload, download, and share 3D-printable medical models with our diverse community. While Gray's Atlas of Anatomy and other classic reference pieces remain beneficial, there is nothing like seeing a true-to-life, full-scale 3D model that can be held and studied. Become a registered member of embodi3D so you can access the many free resources available. 1. Cerebrum Scan in 3D-Printable STL Format Dr. Mike uploaded an excellent 3D model of the cerebrum. Just look at the details of those gyri! This model was created from a high-resolution MRI scan and uploaded for use by the embodi3D community. 2. 3D-Printable Stable Slices of a Human Heart in STL Format Dr. Mike has uploaded several 3D-printable stable slices of a human heart. This STL file was created using contrast-enhanced CT scans, and this upload wins our hearts for its detailed anatomy and exquisite details. 3. STL File of Anterior Muscles of a Human Torso A big "thank you" to Infinity Print for uploading this STL file featuring the sternocleidomastoid, deltoid, pectoralis major, brachioradialis, abductor longus, and other highly detailed anterior muscles of the torso. 4. A 3D-Printable Model of a Dilated Biliary System In this upload from an MRCP image, user nevitdilmen uploaded a detailed file of a dilated biliary system (tree). This patient has a benign biliary stricture, and this 3D-printable rendering will serve as a great tool in the surgical process of correction the obstruction and fixing the hydropic gallbladder. 5. Scoliosis Example as a 3D-Printable STL File User hewtech uploaded a 3D-printable STL file to the Spine and Pelvis forum depicting a severe case of scoliosis, a disorder that causes an abnormal curve of the spine, or backbone. The spine has normal curves when looking from the side, but it should appear straight when looking from the front. Kyphosis is a curve in the spine seen from the side in which the spine is bent forward. There is a normal kyphosis in the middle (thoracic) spine. Lordosis is a curve seen from the side in which the spine is bent backward. There is a normal lordosis in the upper (cervical) spine and the lower (lumbar) spine. People with scoliosis develop additional curves to either side of the body, and the bones of the spine twist on each other, forming a "C" or an "S" shape in the spine. You may also want to check out the upload by user markchui, showing another highly detailed rendering of a patient with scoliosis. 6. Full-Size, 3D-Printable Human Left Foot in STL Format GMorein uploaded full-size, human left foot 3D rendering to the Extremity, Lower (Leg) forum. This 3D-printable STL file was created from MRI images. 7. 3D-Printable Mandible and Teeth Scan Featuring Deep Third Molar Inclusions Uploaded to the forum Dental, Orthodontic, Maxillofacial by user Nicola, this well-defined 3D rendering of a human mandible with teeth. This 3D-printable scan features deep inclusions of the third molars ("wisdom teeth"), as well as a supernumerary tooth. Great upload, Nicola! 8. A CT Scan Illustrating a Right Maxilla Fracture Dr. Raghavendra Byakodi uploaded a CT scan showing a right maxilla fracture to the Skull, Head, and Neck CTs section of the Medical CT Scan Files portion of the Downloads page. 9. Cervical Spine 3D Model with Great Details This upload by FroOkk to the Spine and Pelvis forum shows a 3D-printable model of a cervical spine in exquisite detail. 10. Highly Detailed 3D-Printable Human Skull Last but certainly not least, James Greatrex uploaded a highly detailed human skull to the embodi3D Skull and Head forum. References: 1. Pujol, S., Baldwin, M., Nassiri, J., Kikinis, R., & Shaffer, K. (2016). Using 3D modeling techniques to enhance teaching of difficult anatomical concepts. Academic radiology, 23(4), 507-516.
  23. Welcome to this week's Top Ten, featuring some exciting STL files and medical models, many of which you can download and print using your own 3D printing machine. When you upload your organ STL files to embodi3d®, you are helping researchers, students, and inquisitive minds everywhere to develop innovative diagnostic, interventional, and surgical techniques. Medical 3D printing can be used to create centimeter- to sub-millimeter-accurate models. These include the hearts, lungs, kidney, and colon featured in this week's Top Ten, but can be used to create just about any type of 3D organ or tissue model. The democratiz3D® conversion algorithms used on the embodi3D® website are sophisticated enough to recreate the cellular arrangements of various tissues and organs, but are straightforward enough to be used by just about everyone. Even the complex anatomy of the heart can be successfully replicated using various pliable 3D printing materials. These models could serve a future role in preoperative planning, medical education, and enhanced communication between radiologists and others involved in patient care. The prospect of 3D medical models being used to advance research and educational knowledge is truly exciting. We're glad to have you along to share in the experience of this rapidly developing science and art form. But, to receive much of what embodi3D® has to offer you have to register on the website. But, signing up is absolutely free. Become a Registered Member (it's Free) Remember to register on embodi3D.com so you can upload, download, share, and create stunningly realistic 3D models of hearts, lungs, mandibles, and just about anything having to do with the human anatomy. Plus, it is absolutely free to become a registered member. #1. 3D-Printable Model of Human Heart in Tissue Slices Dr. Mike created and submitted this 3D-printable human heart, separated into stackable slices for educational purposes. This STL file originated from a contrast-enhanced CT scan. The embodi3D® community was very excited about this model; it demonstrates the complex anatomy of the heart in a way that can be held, studied, taken apart, and put back together — all activities real-life patients would rather you not try with their own hearts. Representing some of the best uses of medical 3D printing on the embodi3D.com website, this downloadable STL file has earned a rightful place on this week's Top 10 downloads list. #2. Create a 3D Model of a Heart and Pulmonary Artery Tree This anatomically accurate heart and pulmonary artery tree was extracted from a CT angiogram DICOM dataset (0.4 mm slice thickness x 300 slices). This model may serve as an excellent, hands-on educational tool for those entering the medical profession. The uploaded STL files shows the aorta, coronary sinus, coronary arteries, pulmonary arteries, as well as the cardiac ventricles and atria. A special "thank you" goes out to Health Physics for contributing this magnificent file! #3. Full-Size Model of a Human Heart Number 3 on our list is a 3D-printable model of a full-size human heart. Using this STL file, you can create a scale model of a heart, complete with all the complex cardiac anatomy. You will achieve the best results by using a flexible medium when completing your 3D print. Please note: This model has yet to be fully optimized for 3D printing. Therefore, some issues related to minimum wall thickness can be expected. #4. Great Example of a 3D-Printable, Anatomically Accurate Human Heart Dr. Marco Vettorello graciously created and shared this highly accurate human heart STL file, ready for use in your 3D printer. Thank you, Dr. Vettorello! #5. 3D-Print and Compare a Healthy Lung to a Lung with COPD Lung tissue inflammation in patients with chronic obstructive pulmonary disease (COPD) makes it difficult to fully expel air and creates an obstruction in breathing in fresh air. To compare the three STL files of a lung with COPD, embodi3D® has also uploaded three files of a healthy lung. Chronic obstruction pulmonary disease chronic lung disease is often caused by long-term exposure to particulates, cigarette smoke, harmful gases, and other irritants. Those with COPD are at a higher risk of developing heart disease, lung cancer, and a number of other life-threatening conditions. #6. Have a Heart... in a Medical 3D Printing-Ready Format! We'd like to say a special "thank you" to the creators of this 3D-printable heart file, Dr. Beth Ripley and Dr. Tatiana, who have graciously shared this 3D-printable human heart in STL format. This file originally appeared in the "Top 10 Killers" list. While it appears in sixth place for this week's chart, the cardiac events we collectively refer to as "heart disease" remain the developed world's top "killer" and these files should serve to remind us why this type of research is so important — not only to the medical community, but the many patients cardiovascular disease affect each day. #7. 3D-Print a Lung with Pneumonia Pneumonia is one of the leading causes of hospitalization in many parts of the world. This inflammatory condition affects the microscopic alveoli (tiny air sacs) of the lungs, which leads to coughing, sneezing, and difficulty breathing. The 3D-printable files uploaded in STL format feature the lung, airways, and detailed imaging of the alveoli. #8. Compare Healthy and Diseased Kidneys by Creating a 3D Model Chronic kidney disease (chronic renal disease) presently affects around 26 million American adults, with many others at risk of developing this devastating disease. The STL files uploaded for your medical 3D printing use allow you to compare a healthy kidney to one with chronic renal disease. These are available in a format that is ready to be 3D-printed to create your three-dimensional model. #9. Create a 3D Model of a Human Colon with this STL File Surgical procedures, such as hemorrhoidectomies, require a surgeon with a solid grasp of three-dimensional human anatomy. By uploading and sharing medical 3D printing-ready files, such as this colon extracted from a CT DICOM dataset (0.8 mm slice thickness x 467 slices), those entering the profession can acquire this essential knowledge outside the confines of the operating room. Available for educational purposes, this 3D model includes the cecum, appendix, and overall layout of the small and large bowel. #10. A democratiz3D®-Created, 3D-Printable STL File of a Human Right Kidney Dr. Mike uploaded this printable STL file of a human kidney (right side), showing all the nuances of the kidney and renal collecting system in clear, stunning detail. Dr. Mike used the democratiz3D® premium tissue algorithms to bring out all the details of the kidney. Sharing 3D-printable files is just one of the many ways users are creating the future of preoperative planning and surgical performance. References 1. Zheng, B., Wang, X., Zheng, Y., & Feng, J. (2018). 3D-printed model improves clinical assessment of surgeons on anatomy. Journal of robotic surgery, 1-7.
  24. The human heart beats an astonishing 115,000 times each day. It's a fascinating (and essential) organ, which is why we are highlighting the heart and its support structures in this week's post, as well as sharing some intriguing STL files so you can create your own heart 3D model by using your own 3D printer. In this week's post, we will introduce you to the top 3D-printable STL files published on the embodi3D® website. Before you get started creating your own heart 3D model, you will need to register through embodi3D® (https://www.embodi3d.com/register/). Registering is absolutely free, so become a member today! We recently reported on how researchers have used a 3D printed heart to treat arrhythmia, yet 3D printing is also be used to combat other types of cardiovascular disease. After all, heart disease is the leading cause of premature death in Western countries. According to the National Institutes of Health, nearly half a million individuals succumb to cardiovascular disease each year. While coronary artery disease leads the pack in terms of cardiovascular diseases, congenital heart conditions and acquired diseases of the heart such as tumors, cardiomyopathy, pericardial processes, and valvular disease unfortunately remain present in the modern era. In the early 2000s, an average 1.5 million patients received some type of invasive heart catheter, a figure brought to our attention through the book "Computed Body Tomography with MRI Correlation, Volume 1" (edited by Joseph K. T. Lee). The answer to reducing the number of invasive heart procedures may be in medical 3D printing, whether CT scans can be converted into STL files in order to create 3D models of the heart and nearly every part of the human anatomy. Medical 3D Printing and STL Files: An Alternative to Invasive Cardiac Catheterization? Echocardiography is widely available, portable, and essentially non-invasive when compared to MDCT and MR scans, while CT and MRI scans give us a clear advantage in terms of creating output files that are ready to be converted into a 3D printing-ready format such as STL (stereolithography) files. STL files and tissue algorithm conversion technologies from companies such as embodi3D® are bringing medical 3D printing within reach of researchers, radiologists, physicians, and medical students. Radiologists have witnessed the evolution of medical imaging, from two-dimensional scans to the three-dimensional scans aided by the latest technologies. 3D-printable files open the door to less invasive diagnostic procedures and have also proven useful in pre-surgical planning. Multiplanar imaging with computed tomography (CT) and magnetic resonance imaging (MRI) gave rise to 3D reconstructions, improving the evaluation of complex anatomies. Medical 3D printing takes imaging data from the limited two-dimensional view on a computer screen to a three-dimensional model that can be held, studied, and referenced. The Meteoric Rise of Additive Manufacturing in Medicine The additive manufacturing technique known as 3D printing has seen exponential growth in health care sectors over the last decade, with most of that growth coming in just the last few years. As a tool to improve patient care and lower the costs of care, 3D printing can be used in pre-operative planning, education, and also to replace bone materials, such as knee joints. For these reasons, the McKinsey Global Institute recently called 3D printing a "disruptive technology that will transform life, business and the global economy." This management consulting company also predicated that 3D printing will have impact the global economy by a range of $200 billion to $600 billion in the coming decade. What started out as a technology for garage tinkerers and those looking to replace hard-to-find mechanical parts was only recently introduced into the medical world. The adoption rates of this technology within the health care community have been staggering. In 2000, only six publications made mention of 3D printing's use in medicine. That figure had jumped to nearly 200 publications in the years spanning 2011 and 2015. This brings us to the present, where nearly 2,000 publications have cited the amazing utility of 3D printing across a diverse range of medical applications. The National Additive Manufacturing Innovation Institute was launched in 2012 as a way to grow and encourage the adoption of this life- and industry-changing technology. 3D Printing in Cardiology and Cardiothoracic Surgery The use of 3D printing in cardiology to detect abnormal heart structures and predict heart attacks has followed a similar growth trend in the past decade. In the research article "Cardiac 3D Printing and its Future Directions," Vukicevic, et al. detailed the utility of 3D printing in the area of cardiovascular care, focusing primarily on acquired structural heart disease. 3D-printed heart and aortic models have been used for treatment planning in both percutaneous cardiology applications and cardiothoracic surgery. In cardiothoracic surgery, 3D-printed anatomic models have been used to plan surgical approaches, perform resections, and guide the process of tissue reconstruction. Computed tomography angiography (CTA) is frequently performed before catheter-based and surgical treatments in situations of congenital heart disease (CHD). To date, little is known about the accuracy and advantage of different 3D-reconstructions in CT-data. For reference purposes, gaining the exact anatomical information is critical in achieving a successful outcome. According to a review published in JACC: Basic to Translational Science, 3D models may improve outcomes in patients with congenital heart disease by also improving communication among multidisciplinary teams, enhancing shared decision-making, and facilitating greater medical breakthroughs via basic science and translational clinical investigations. Approximately 3 out of 1,000 patients with congenital heart disease require a surgical or catheter-based intervention early in their lifetimes, according to the study's investigators. 3D printing can be a valuable tool to plan extra-cardiac and vascular surgery in patients with CHD. 3D models are helpful for planning high-risk unifocalization surgery. Medical 3D Printing as an Educational Tool in Congenital Heart Disease In terms of education, the use of medical 3D printing technology may lead to an educational shift from an apprenticeship-type model to a simulator-based learning method, which would augment the traditional mentored training. Using 3D printed models in congenital heart disease (CHD) can reduce the learning curve for cardiac trainees in three crucial ways: help trainees understand the complex cardiovascular structures, provide high-fidelity simulation experiences, and enable more exposure to rare CHD cases. 1. A 3D-Printable Model of a Human Heart from Contrast-Enhanced CT Scan A 3D-printable model of a human heart was generated from a contrast-enhanced CT scan. An endpoint of many patients with coronary heart disease (CHD) is heart failure requiring a ventricular assist device (VAD) or heart transplant. 3D printing can aid in ventricular assist device placement and optimizing function in complex CHD, as recently described by Farooqi et al. and Saeed et al. 2. 3D-Printable STL File of Truncus Arteriosus with Unseparated Aorta and Pulmonary Artery Truncus arteriosus is a congenital (present at birth) defect that occurs due to abnormal development of the fetal heart during the first 8 weeks of pregnancy. The heart begins as a hollow tube, and the chambers, valves, and great arteries develop early in pregnancy. The aorta and pulmonary artery start as a single blood vessel, which eventually divides and becomes two separate arteries. Truncus arteriosus occurs when the single great vessel fails to separate completely, leaving a connection between the aorta and pulmonary artery. This 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. 3. STL Files of a Neonatal Heart Defect (Ventricular Septal Defect) Ventricular septal defect (VSD) with pulmonary atresia (PA) can be considered to be the severest form of tetrology of Fallot wherein the right ventricular outflow tract obstruction has progressed to the extent of atresia. This atresia can occur either at the infundibulum or as a plate atresia of the pulmonary valve. An important observation is that the plate-type atresia is more frequently associated with well-developed pulmonary arteries. The other significant abnormality in patients with VSD and pulmonary atresia (PA) is the presence of arborization abnormalities. The blood supply to a particular lung segment can be derived from a systemic artery or a central pulmonary artery or a combination of both. 4. 3D-Printable Heart Model Showing Tetralogy of Fallot Tetralogy of Fallot, which is one of the most common congenital heart disorders, comprises right ventricular (RV) outflow tract obstruction (RVOTO) (infundibular stenosis), ventricular septal defect (VSD), aorta dextroposition, and RV hypertrophy (see the image below). The mortality rate in untreated patients reaches 50% by age 6 years, but in the present era of cardiac surgery, children with simple forms of tetralogy of Fallot enjoy good long-term survival with an excellent quality of life. This three-part 3D printed heart is from a CT scan of a 4-year-old infant with Tetrology of Fallot, a congentital heart defect and the most common cause of blue baby syndrome. 5. 3D-Printable STL of Left Heart Atrium and Ventricle 3D models promise to transform teaching in ways that go beyond the lecture hall, and over the next few years are set to revolutionize medical training, especially in percutaneous interventions. In this 3D model we can observe the anatomical relationship of all the elements of the heart and neighboring structures. 6. Left Main Coronary Artery with Abnormal Origin Rising from Pulmonary Artery Trunk Variations in coronary anatomy are often seen in association with structural forms of congenital heart disease like Fallot's tetralogy, transposition of the great vessels, Taussig-Bing heart (double-outlet right ventricle), or common arterial trunk. Importantly, coronary artery anomalies are a cause of sudden death in young athletes even in the absence of additional heart abnormalities. Prior knowledge of such variants and anomalies is necessary for planning various interventional procedures. 7. Aortic Coarctation in 3D-Printable STL File Coarctation of the aorta — or aortic coarctation — is a narrowing of the aorta, the large blood vessel that branches off your heart and delivers oxygen-rich blood to your body. When this occurs, your heart must pump harder to force blood through the narrowed part of your aorta. Coarctation of the aorta is generally present at birth (congenital). The condition can range from mild to severe, and might not be detected until adulthood, depending on how much the aorta is narrowed. Coarctation of the aorta often occurs along with other heart defects. While treatment is usually successful, the condition requires careful lifelong follow-up. 8. STL File of a Cardiac Myxoma The World Health Organization (WHO) defines a cardiac myxoma as a neoplasm composed of stellate to plump, cytologically bland mesenchymal cells set in a myxoid stroma. Myxomas can recur locally (usually with incomplete resection) and spread to distant sites through embolization. Embolization appears to be much more likely in myxomas that are friable with a broad-based attachment than they are in tumors that are fibrotic or calcified. 9. 3-D Printable Heart Anatomy from High-Spatial Resolution Imaging A heart 3d model with details of anatomy. By combining the technologies of high-spatial resolution cardiac imaging, image processing software, and fused dual-material 3D printing, several hospital centers have recently demonstrated that patient-specific models of various cardiovascular pathologies may offer an important additional perspective on the condition. With applications in congenital heart disease, coronary artery disease, and in surgical and catheter-based structural disease – 3D printing is a new tool that is challenging how we image, plan, and carry out cardiovascular interventions. 10. Human Heart Model in Stable Slices from Contrast-Enhanced CT Scan A 3D printable model of a human heart was generated from a contrast-enhanced CT scan References 1 Yoo, S. J., Spray, T., Austin, E. H., Yun, T. J., & van Arsdell, G. S. (2017). Hands-on surgical training of congenital heart surgery using 3-dimensional print models. The Journal of thoracic and cardiovascular surgery, 153(6), 1530-1540. 2. Farooqi K.M., Saeed O., Zaidi A., et al. (2016) 3D printing to guide ventricular assist device placement in adults with congenital heart disease and heart failure. J Am Coll Cardiol HF 4:301–311. 3. Saeed O., Farooqi K.M., Jorde U.P. (2017) in Rapid Prototyping in Cardiac Disease, Assessment of ventricular assist device placement and function, ed Farooqi K.M. (Springer International Publishing, Cham, Switzerland), pp 133–141. 4. Lee JKT, Sagel SS, Stanley RJ, Heiken JP. Computed Body Tomography with MRI Correlation. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2006. 5. Ballard, D. H., Trace, A. P., Ali, S., Hodgdon, T., Zygmont, M. E., DeBenedectis, C. M., ... & Lenchik, L. (2018). Clinical applications of 3D printing: primer for radiologists. Academic radiology, 25(1), 52-65. 6. Vukicevic, M., Mosadegh, B., Min, J. K., & Little, S. H. (2017). Cardiac 3D printing and its future directions. JACC: Cardiovascular Imaging, 10(2), 171-184.
  25. DICOM to STL Files and Other Medical Scans Uploaded to embodi3D® 3D printing is a technology that is constantly evolving, especially among medical professionals who are converting medical CT scans into 3D-printed anatomical models. Patient-specific models with anatomical fidelity created from imaging dataset have the potential to significantly improve the knowledge and skills of a new generation of surgeons. In terms of research and education, 3D-printed anatomical models have proven to be a major benefit in helping students and researchers gain first-hand knowledge of specific conditions and the human anatomy. In a recent University of Pennsylvania research article ("From medical imaging data to 3D printed anatomical models") there merits of DICOM to STL conversions are highlighted and this is a medical technology that will continue to grow in the coming years. As a manufacturing process, 3D printing is well suited for the generation of biomedical phantoms, which is essentially a low-volume process for patient-specific models. The relatively high tooling costs for alternative processes—such as lost-wax investment casting—make 3D printing a cost-effective choice. This week we want to share the top ten downloads of medical scans. 3D prnting technology can be aligned with the predefined educational need, as listed below. Teaching anatomy, patient education: To teach the anatomy and explain pathology, models constructed of hard materials are often sufficient. The low cost and most accessible method FDM is most certainly the best choice if there is no need for fine printing definition and if the size of the model is large, otherwise we would recommend SLA. Models obtained by SLA present more detail thus would be better for small printing models (eg, coronary arteries). However, in the case of the thoracic aortic model with root aneurysm we put the emphasis on the realism of the geometry by representing as much as details as possible which is why we needed to use one of the most accurate 3D printing method: PJ. It also allowed us to change easily the colours of the 3D printed model if desired. Surgical planning and review of procedure: Surgical planning and review of procedure do not necessarily require materials to have the same mechanical properties of the biological tissues. Hard material model can be well representative of the anatomical structure and once again, FDM and SLA might be your best options. Preprocedural planning: preprocedural planning models are more complicated to fabricate since they require materials mechanically representative to the biological tissues. Discussions on the matter are provided in the following section where all printing methods are eventually used. To see more CT scans, check out the embodi3D® Medical CT Scan Files library. Remember: to get the most out of embodi3D® you need to register on the embodi3D® website. It's completely free and will take only a few minutes of your time. Plus, you will gain access to many of our cutting-edge conversion tools and algorithms! 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. An Incredible CT Scan of an Open Bite CT is indicated for implant site assessment in anatomically difficult cases or when extensive implant treatment is planned. In addition, bone quantity and quality, in the implantation area are evaluated in the CT scans. Classifications are based upon jaw shape (degree of resorption), bone quality (amount of compact bone) and bone density. Information about the location of vital structures, such as mandibular canal, mental foramen, incisive foramen, maxillary sinuses and nasal cavity can be evaluated. 3. Head and Neck CT Scan — Great Addition to our Top 10 Medical CT Scans! A source Head and Neck CT scan in NRRD file format for the Radiological Society of North America (RSNA) Annual Meeting 2017 course on Open-Source and Freeware Medical 3D Printing, RCA12 and RCA21, November 26 and 27, 2017. Be sure to view the full tutorial that uses this file here. https://meeting.rsna.org/program/index.cfm Search for "3D Printing Hands-on with Open Source Software: Introduction (Hands-on)" CT angiography of the cerebral arteries is a noninvasive technique allows visualization of the internal and external carotid arteries and vertebral arteries and can include just the intracranial compartment or also extend down to the arch of the aorta. By using multidetector CT (MDCT) after intravenous contrast administration, the vessels become enhanced with contrast allow them to be differentiated from adjacent tissues. Following image acquisition, post-processing techniques are applied for better 3D visualization of the vessels and their abnormalities. 4. A Contrast-Enhanced CT Scan Showing a Chest Wall Tumor Tumors of the chest wall are varied, some of which are found most often in this region. They can be divided into benign and malignant tumors and into those which arise in the ribcage and those of soft tissue density. - Benign: soft tissue , haemangioma: common, lymphangioma: common, lipoma: chest wall lipoma, schwannoma, neurofibroma, ganglioneuroma paraganglioma, skeletal (ribcage), fibrous dysplasia: common, aneurysmal bone cyst (ABC): common, giant cell tumour (GCT), ossifying fibromyxoid tumour, chondromyxoid fibroma, osteochondroma, mesenchymal hamartoma of chest wall: sometimes even considered a developmental anomaly - Malignant: The most common malignant lesions are metastases. Lesions include: rhabdomyosarcoma: common, Ewing sarcoma: including Askin tumour (or pPNET), ganglioneuroblastoma, neuroblastoma, angiosarcoma, leiomyosarcoma, malignant fibrous histiocytoma (MFH), malignant peripheral nerve sheath tumour, dermatofibrosarcoma protuberans, skeletal (ribcage), chest wall metastases: common, myeloma, chondrosarcoma osteosarcoma, 5. CT Scan of the Brain and Structures (Without Contrast) This upload shows a CT scan of the human brain and related structures. This scan has not been contrast-enhanced. window: W:2800 L:600 Review the bones. This should always be performed, even when a bony algorithm hasn't been provided or where slice thickness is suboptimal. Note that if there is a history of trauma, then dedicated thin bony images are required to detect undisplaced fractures. Review the skull vault for any fractures or destructive lesions. Spend some time checking the base of the skull as the increased complexity of this region can make identification of abnormalities more difficult. Don't forget to ensure that both TMJs are normally aligned. Review the paranasal sinuses for evidence of fluid that may represent acute sinusitis or, in the correct setting, fractures. 6. Whole-Body NRRD File Showing the Chest, Abdomen, and Pelvis A whole body NRRD file converted from CT Scan for Medical 3D Printing includes the chest, abdomen and pelvis. It includes a skin, bone and muscle 3D model. 7. Jawbone Implant as Shown in a 3D Model A 3D model of mandible implant with exquisite detail from a CT scan from planning. Current 3D-printers are easy to use and represent a promising solution for medical prototyping. The 3D printing will quickly become undeniable because of its advantages: information sharing, simulation, surgical guides, pedagogy. They allow for better preoperative planning and training for the procedures and for pre-shaping of plates. Occlusal splints and surgical guides are intended for the smooth transfer of planning to the operating room. 8. The Whole Body of a Female — Available in a 3D Printer-Ready Format A 3D model of female's whole body (with bone, muscle and skin 3D printing) 9. Head and Neck Scan from the Cancer Imaging Archives 62yo male skull from the Head-Neck Cetuximab collection of The Cancer Imaging Archives. 10. Contrast-Enhanced CT Scan of the Skull and Brain A brain CT scan with contrast showing all the structures of the skull and brain. References 1. Lekholm U, Zarb G. Patient selection and preparation. In: Brånemark P-I, Zarb G, Albrektsson T, editors. Tissue-integrated prostheses. Osseointegration in clinical dentistry. Chicago: Quintessence; 1985 p. 199 – 209. 2. Wood MR, Vermilyea SG. A review of selected dental literature on evidence-based treatment planning for dental implants: report of the Committee on Research in Fixed Prosthodontics of the Academy of Fixed Prosthodontics. J Prosthet Dent 2004; 92: 447 – 62. 3. Lindh C, Petersson A, Klinge B. Measurements of distances related to the mandibular canal in radiographs. Clin Oral Impl Res 1995; 6: 96 – 103. 4. Garcia, J., Yang, Z., Mongrain, R., Leask, R. L., & Lachapelle, K. (2018). 3D printing materials and their use in medical education: a review of current technology and trends for the future. BMJ Simulation and Technology Enhanced Learning, 4(1), 27-40.
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