A mold design for creating low-cost patient specific models with complex anatomy

Physical models of patient anatomy have been used increasingly as 3D printing technologies have become mainstream. Such models can be used for both the validation of new minimally invasive surgical techniques, as well as surgical rehearsal and training. However, current workflows for creating flexible models with complex anatomy rely on the use of expensive 3D printing techniques. We present a mold design with which we create patient-specific physical models using low-cost techniques and materials. This generic mold makes it possible to create physical models with multiple components and complex internal structures including tumours, vasculature and other anatomic components with accuracy. To demonstrate this, we have created kidney models derived from the CT of excised porcine kidneys, including vasculature and an artificial tumor. We created the models in two parts, first using a rigid positive model to create a negative mold, and then creating a silicone model with the 3D printed vasculature inside, and removing it to leave wall-less vessels. The vasculature models include at least six separate bifurcations with minimum lumen diameters of approximately 1mm. The mean Euclidean offset distance between the model and original vessels was 0.42 mm, with a standard deviation of 0.50 mm. Both generic and patient specific models can be built with this workflow.

[1]  Adrien E Desjardins,et al.  Construction of 3‐Dimensional Printed Ultrasound Phantoms With Wall‐less Vessels , 2016, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[2]  A. Jemal,et al.  Cancer statistics, 2016 , 2016, CA: a cancer journal for clinicians.

[3]  I. Gill,et al.  The evolving presentation of renal carcinoma in the United States: trends from the Surveillance, Epidemiology, and End Results program. , 2006, The Journal of urology.

[4]  J. Ross,et al.  The shape of things to come: 3D printing in medicine. , 2014, JAMA.

[5]  P. Russo,et al.  Urinary fistulae after partial nephrectomy , 2010, BJU international.

[6]  Caroline E. Webster,et al.  Pre-operative simulation of pediatric mastoid surgery with 3D-printed temporal bone models. , 2015, International journal of pediatric otorhinolaryngology.

[7]  Ali R. Khan,et al.  Design and evaluation of a diffusion MRI fibre phantom using 3D printing , 2018, Medical Imaging.

[8]  N. Dubrawsky Cancer statistics , 1989, CA: a cancer journal for clinicians.

[9]  K. Alqasem,et al.  Trends of partial and radical nephrectomy in managing small renal masses. , 2017, Turkish journal of urology.

[10]  B. Chung,et al.  Risk Factors for Postoperative Hemorrhage After Partial Nephrectomy , 2014, Korean journal of urology.

[11]  Carl Schubert,et al.  Innovations in 3D printing: a 3D overview from optics to organs , 2013, British Journal of Ophthalmology.

[12]  Frederik L. Giesel,et al.  3D printing based on imaging data: review of medical applications , 2010, International Journal of Computer Assisted Radiology and Surgery.

[13]  Milan Sonka,et al.  3D Slicer as an image computing platform for the Quantitative Imaging Network. , 2012, Magnetic resonance imaging.

[14]  Jonathan M. Morris,et al.  3-Dimensional Printed Anatomic Models as Planning Aids in Complex Oncology Surgery. , 2016, JAMA oncology.

[15]  Shuai Leng,et al.  Three-dimensional Physical Modeling: Applications and Experience at Mayo Clinic. , 2015, Radiographics : a review publication of the Radiological Society of North America, Inc.

[16]  Raju Thomas,et al.  Physical models of renal malignancies using standard cross-sectional imaging and 3-dimensional printers: a pilot study. , 2014, Urology.

[17]  K. Bensalah,et al.  The use of partial nephrectomy: results from a contemporary national prospective multicenter study , 2014, World Journal of Urology.

[18]  Paul Russo,et al.  Partial nephrectomy versus radical nephrectomy in patients with small renal tumors--is there a difference in mortality and cardiovascular outcomes? , 2009, The Journal of urology.

[19]  Raju Thomas,et al.  3D-printed soft-tissue physical models of renal malignancies for individualized surgical simulation: a feasibility study , 2018, Journal of Robotic Surgery.

[20]  L. Harlan,et al.  Toward greater adoption of minimally invasive and nephron-sparing surgical techniques for renal cell cancer in the United States. , 2016, Urologic oncology.