Marcia Frellick

December 04, 2015

CHICAGO — Presurgical three-dimensional printed models are among the fastest-growing opportunities for radiologists, said experts speaking here at the Radiological Society of North America 2015 Annual Meeting.

"Not only are they good for the surgeons, they have a major impact on patient education," said Gerald Grant, DMD, from the University of Louisville in Kentucky, whose expertise lies in dentistry, medical technology, and prosthodontics.

"Trying to show patients a CT scan is nothing like holding a model in your hand and showing them where the tumor is and why you have to make the approach that you do because of this nerve and that vein or that artery," he explained.

The models are also good for comparing presurgery plans with execution, and for representing missing anatomy, he said.

Printing complex organs, however, is not yet within reach. "The complexity of bioprinting and cooperation between the communities is nearly zilch, so we're not getting there very fast," said Dr Grant.

Radiologists Could Take the Lead

Trying to show patients a CT scan is nothing like holding a model in your hand and showing them where the tumor is.

As medicine moves further into 3D printing, radiologists should be leading the way, said Jonathan Morris, MD, a radiologist at the Mayo Clinic in Rochester, Minnesota.

"We are strong proponents that this should be owned by radiology," Dr Morris said during a packed session. "You have the best subspecialty knowledge of anatomy, pathology, and tumors. These models come from the images you produce. Nobody knows images like the radiologist."

Radiologists also speak the language of surgeons. Surgeons can study a guide to get the images they're looking for, "but they don't want to spendan hour on a video conference with an engineer telling them what they want," he said.

Free open-source software, a good alternative to proprietary options, is available for printing educational models, said Michael Itagaki, MD, an interventional radiologist at the Swedish Medical Center in Seattle, and a 3D printing innovator who founded the Embodi3D online community.

Free Software Might Work

"Proprietary software can be $15,000 a year for a license. If you're printing one model a week, which is a lot, that would be about $300 a model just in software licensing costs," he reported.

He described some open-source options at the meeting.

Cyrus is a picture archiving and communication system that works only on Mac computers. A version approved by the US Food and Drug Administration (FDA) is available at a premium; however, because these are educational models and not for patient use, the FDA does not regulate the making of these models, Dr Itagaki explained. In contrast, implants and cutting guides need FDA approval.

3D Slicer, an alternative to Cyrus, is used primarily for medical imaging research. It works on Mac, Linux, and Windows operating systems.

Blender is useful once you clean up a file and get it ready for 3D printing, said Dr Itagaki. It is very powerful but has a steep learning curve because it is professional-grade software that is usually used by computer animators. It works on all operating systems.

Advice and tutorials on these and other platforms are available on the Embodi3D website. The downside of these open-source freeware options is that there is no technical support. "You can't pick up the phone if you need help," he pointed out.

Dr Grant and Dr Morris have disclosed no relevant financial relationships. Dr Itagaki is founder and owner of Embodi3D.com.

Radiological Society of North America (RSNA) 2015 Annual Meeting: Abstract RCC11. Presented November 29, 2015.

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