Some larger radiology departments have added 3D printing as a new service over the past few years, enabling CT and MRI scans to be turned into 1:1 scale models of a patient's anatomy. In complex cases, surgeons can hold these prints in their hands to enable better procedural planning and act as a reference for peri-procedural guidance.
To find out what is involved in creating one of the programs, Radiology Business spoke with medical 3D printing expert Summer Decker, PhD, formerly a professor and vice chair for research and innovation, and director of 3D clinical applications, University of South Florida Morsani College of Medicine and Tampa General Hospital. She took a new position in February 2024 as director, Center for Advanced Visualization Technologies in Medicine (VISTA), professor of clinical radiology, surgery and pathology, Keck School of Medicine, University of Southern California. She presented on this topic at the Radiological Society of North America 2023 meeting.
"We can go beyond our usual clinical work with pre-op planning for our surgical colleagues. Our lab works with the most complex cases that the hospital sees. We are often trying to help solve that puzzle that someone can't quite figure out and they need that advanced imaging to be able to address that. So we give them the tools that they do not have access to and taking the imaging and translating it for them into a 3D printed model," Decker explained.
Education and training are another area where these labs can help. She said the 3D lab can produce anatomical models of complex cases to teach new doctors, or help educate patients about their condition. Models also can be printed to help in practicing a new type of procedure, or to see how devices fit and can be moved around in the anatomy.
Also known as additive manufacturing, 3D printing is opening up a new realm of one-off, customized, patient specific devices. These include pediatric implantable devices, surgical bracing to repair fractures or to anchor sections of removed skull in place after brain surgery, or customized orthopedic implants. At RSNA 2023, one vendor was showing how customized orthopedic shoe inserts could be created from imaging and printed in a 3D lab for each patient. 3D printing is already a mainstay technology in dentistry where 3D scans of the mouth are now used to create retainers and other dental devices rather than using casts of the teeth.
3D printing helped save the life of a newborn
One of the complex cases Decker described involved a fetus who had a gap in his airway. Once delivered, the neonate would only survive a couple minutes without a quick intervention by the hospital lateral and fetal medicine team. Decker's lab created a detailed 3D model from the fetal imaging, which was made of clear plastic. It included color coding so the team could discuss and prep for the intervention before birth and have a physical reference for the imaging on hand in the OR.
"They were able to nail the timing down exactly. I got the call after the case and they said everything went beautifully, and they still send me videos of how the little guy is doing. And those are the kinds of wins we want, and they know radiology is the place to come to get access to that kind of technology," Decker said.
The business case for 3D printing labs in radiology
The price of printers that are FDA-cleared for medical use have come down significantly from a decade ago, making it is easier to enter 3D printing, Decker said. But you still need staff who know how to troubleshoot the printers, understand the anatomy, convert medical imaging into 3D files, and segment and align the anatomy if printed as separate files.
The ROI for these programs is in the time saved during procedures and improved diagnostic and planning confidence that lead to improved patient outcomes. Decker said increasing diagnostic confidence and fully understanding complex anatomy before a procedure greatly helps reduce risks. This also can reduce the number of tools or devices used for a procedure, she added.
"There are a lot of places where there are intangible benefits, such as reduced OR time, that can serve as the mechanism for coming up with some of the funding to get that lab started," Decker said.
3D printing can improve patient understanding
Other benefits include better communication between patients and physicians, especially in discussions with parents about fetal and pediatric cases.
Patients get excited about this technology and being able to hold a model made from their medical images.
"When I walk through the hospital holding a heart, they want to talk to us about that. I hear from patients all the time asking how do they get their organ printed. I remember when we put a 3D printed liver with a tumor into the hands of a patient, they told us that was the first time they truly understood their condition," she said.
3D printing helped address supply chain issues during COVID
When personal protective face shields and nasal swabs used for COVID testing quickly became unavailable due to massive demand during the COVID-19 pandemic, Decker's lab was among the first in the country to step forward with a solution. They designed and printed the parts needed to build face shields and create a new type of 3D printed nasal swab. The swabs were printed, tested and used by both USF and Northwell Health until normal supplies became available again.
"We were able to help keep hospitals going," she said.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com