CAD/CAM-assisted breast reconstruction

The application of computer-aided design and manufacturing (CAD/CAM) techniques in the clinic is growing slowly but steadily. The ability to build patient-specific models based on medical imaging data offers major potential. In this work we report on the feasibility of employing laser scanning with CAD/CAM techniques to aid in breast reconstruction. A patient was imaged with laser scanning, an economical and facile method for creating an accurate digital representation of the breasts and surrounding tissues. The obtained model was used to fabricate a customized mould that was employed as an intra-operative aid for the surgeon performing autologous tissue reconstruction of the breast removed due to cancer. Furthermore, a solid breast model was derived from the imaged data and digitally processed for the fabrication of customized scaffolds for breast tissue engineering. To this end, a novel generic algorithm for creating porosity within a solid model was developed, using a finite element model as intermediate.

[1]  C. Patrick,et al.  Breast tissue engineering. , 2004, Annual review of biomedical engineering.

[2]  O. Tepper,et al.  Virtual 3-dimensional modeling as a valuable adjunct to aesthetic and reconstructive breast surgery. , 2006, American journal of surgery.

[3]  Achim Goepferich,et al.  In vivo development and long-term survival of engineered adipose tissue depend on in vitro precultivation strategy. , 2008, Tissue engineering. Part A.

[4]  G. Schiroli,et al.  Accuracy of computer-aided oral implant surgery: a clinical and radiographic study. , 2009, The International journal of oral & maxillofacial implants.

[5]  I Naert,et al.  Individualised, micro CT-based finite element modelling as a tool for biomechanical analysis related to tissue engineering of bone. , 2004, Biomaterials.

[6]  Colleen L Flanagan,et al.  Bone tissue engineering using polycaprolactone scaffolds fabricated via selective laser sintering. , 2005, Biomaterials.

[7]  Silvia Farè,et al.  Adipose tissue engineering: state of the art, recent advances and innovative approaches , 2009, Expert review of medical devices.

[8]  N Jacobson The socially constructed breast: breast implants and the medical construction of need. , 1998, American journal of public health.

[9]  Gernot Brockmann,et al.  Optimization of 3-Dimensional Imaging of the Breast Region With 3-Dimensional Laser Scanners , 2006, Annals of plastic surgery.

[10]  I. Zein,et al.  Fused deposition modeling of novel scaffold architectures for tissue engineering applications. , 2002, Biomaterials.

[11]  J. Bostwick,et al.  Plastic and Reconstructive Breast Surgery , 1990, Atlas of Breast Surgery.

[12]  Malcolm N. Cooke,et al.  Use of stereolithography to manufacture critical-sized 3D biodegradable scaffolds for bone ingrowth. , 2003, Journal of biomedical materials research. Part B, Applied biomaterials.

[13]  J H Keyak,et al.  Automated three-dimensional finite element modelling of bone: a new method. , 1990, Journal of biomedical engineering.

[14]  F. Melchels,et al.  A review on stereolithography and its applications in biomedical engineering. , 2010, Biomaterials.

[15]  J Beumer,et al.  Surgical planning using three-dimensional imaging and computer modeling. , 1994, Otolaryngologic clinics of North America.

[16]  Predrag Sukovic,et al.  Accuracy of implant placement with a stereolithographic surgical guide. , 2003, The International journal of oral & maxillofacial implants.

[17]  P. D'urso,et al.  Custom cranioplasty using stereolithography and acrylic. , 2000, British journal of plastic surgery.

[18]  Maximilian Eder,et al.  Brustvolumenbestimmung anhand der 3-D-Oberflächengeometrie: Verifizierung der Methode mit Hilfe der Kernspintomographie / Breast volume assessment based on 3D surface geometry: verification of the method using MR imaging , 2008, Biomedizinische Technik. Biomedical engineering.

[19]  Katja Schwenzer-Zimmerer,et al.  New Aspects of Breast Volume Measurement Using 3-Dimensional Surface Imaging , 2006, Annals of plastic surgery.

[20]  W. Binder,et al.  Reconstruction of Posttraumatic and Congenital Facial Deformities with Three‐Dimensional Computer‐Assisted Custom‐Designed Implants , 1994, Plastic and reconstructive surgery.

[21]  Katia Bertoldi,et al.  Mathematically defined tissue engineering scaffold architectures prepared by stereolithography. , 2010, Biomaterials.

[22]  Duc Truong Pham,et al.  A comparison of rapid prototyping technologies , 1998 .

[23]  David L. Kaplan,et al.  Synthetic Adipose Tissue Models for Studying Mammary Gland Development and Breast Tissue Engineering , 2010, Journal of Mammary Gland Biology and Neoplasia.

[24]  Katja Schwenzer-Zimmerer,et al.  Comparison between breast volume measurement using 3D surface imaging and classical techniques. , 2007, Breast.

[25]  Chee Kai Chua,et al.  An integrated experimental approach to link a laser digitiser, a CAD/CAM system and a rapid prototyping system for biomedical applications , 1998 .

[26]  P. Cordeiro,et al.  Breast reconstruction after surgery for breast cancer. , 2008, The New England journal of medicine.

[27]  Sin-Daw Lin,et al.  Engineered adipose tissue of predefined shape and dimensions from human adipose-derived mesenchymal stem cells. , 2008, Tissue engineering. Part A.

[28]  J. Anthony,et al.  Plastic and Reconstructive Breast Surgery, 2nd ed , 2000 .

[29]  Minna Kellomäki,et al.  A review of rapid prototyping techniques for tissue engineering purposes , 2008, Annals of medicine.

[30]  S. Hollister Porous scaffold design for tissue engineering , 2005, Nature materials.

[31]  V. K. Popov,et al.  Laser stereolithography and supercritical fluid processing for custom-designed implant fabrication , 2004, Journal of materials science. Materials in medicine.

[32]  P. M. Gronet,et al.  Preformed acrylic cranial implants using fused deposition modeling: a clinical report. , 2003, The Journal of prosthetic dentistry.