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Review
. 2018 Jan;25(1):52-65.
doi: 10.1016/j.acra.2017.08.004. Epub 2017 Oct 10.

Clinical Applications of 3D Printing: Primer for Radiologists

David H Ballard  1 , Anthony Paul Trace  2 , Sayed Ali  3 , Taryn Hodgdon  4 , Matthew E Zygmont  5 , Carolynn M DeBenedectis  6 , Stacy E Smith  7 , Michael L Richardson  8 , Midhir J Patel  9 , Summer J Decker  9 , Leon Lenchik  10
Affiliations
Review

Clinical Applications of 3D Printing: Primer for Radiologists

David H Ballard et al. Acad Radiol. 2018 Jan.

Abstract

Three-dimensional (3D) printing refers to a number of manufacturing technologies that create physical models from digital information. Radiology is poised to advance the application of 3D printing in health care because our specialty has an established history of acquiring and managing the digital information needed to create such models. The 3D Printing Task Force of the Radiology Research Alliance presents a review of the clinical applications of this burgeoning technology, with a focus on the opportunities for radiology. Topics include uses for treatment planning, medical education, and procedural simulation, as well as patient education. Challenges for creating custom implantable devices including financial and regulatory processes for clinical application are reviewed. Precedent procedures that may translate to this new technology are discussed. The task force identifies research opportunities needed to document the value of 3D printing as it relates to patient care.

Keywords: 3D printing; additive manufacturing; personalized medicine; preoperative planning; radiology; three-dimensional printing.

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Figures

Figure 1.
Figure 1.
3D printed model of a right orbital blowout fracture. 22-year-old man following an altercation. a. Coronal reconstructions computed tomography (CT) image of the facial bones with shows a right orbital blowout fracture involving the medial and inferior walls. b. CT DICOM data used to create a STL file (3D Slicer version 4.6, www.slicer.org). c. 3D printed anatomical model of both orbits. d. Photograph of the right orbit, which delineates the nature of the blowout fracture.
Figure 1.
Figure 1.
3D printed model of a right orbital blowout fracture. 22-year-old man following an altercation. a. Coronal reconstructions computed tomography (CT) image of the facial bones with shows a right orbital blowout fracture involving the medial and inferior walls. b. CT DICOM data used to create a STL file (3D Slicer version 4.6, www.slicer.org). c. 3D printed anatomical model of both orbits. d. Photograph of the right orbit, which delineates the nature of the blowout fracture.
Figure 1.
Figure 1.
3D printed model of a right orbital blowout fracture. 22-year-old man following an altercation. a. Coronal reconstructions computed tomography (CT) image of the facial bones with shows a right orbital blowout fracture involving the medial and inferior walls. b. CT DICOM data used to create a STL file (3D Slicer version 4.6, www.slicer.org). c. 3D printed anatomical model of both orbits. d. Photograph of the right orbit, which delineates the nature of the blowout fracture.
Figure 1.
Figure 1.
3D printed model of a right orbital blowout fracture. 22-year-old man following an altercation. a. Coronal reconstructions computed tomography (CT) image of the facial bones with shows a right orbital blowout fracture involving the medial and inferior walls. b. CT DICOM data used to create a STL file (3D Slicer version 4.6, www.slicer.org). c. 3D printed anatomical model of both orbits. d. Photograph of the right orbit, which delineates the nature of the blowout fracture.
Figure 2.
Figure 2.
3D printed model of a tibial fracture nonunion. 42-year-old man 5 months following open reduction and internal fixation of a comminuted tibial fracture. a and b. Coronal reconstruction computed tomography (CT) image of the tibia and fibula with show a healed fibula fracture and a reduced and internally fixated, non-united tibial fracture. b. CT DICOM data used to create a STL file (3D Slicer version 4.6, www.slicer.org). Anterior (c) and posterior (d) photographs of a 3D printed anatomical model of the tibia and fibula show the orientation of the tibial fracture nonunion.
Figure 2.
Figure 2.
3D printed model of a tibial fracture nonunion. 42-year-old man 5 months following open reduction and internal fixation of a comminuted tibial fracture. a and b. Coronal reconstruction computed tomography (CT) image of the tibia and fibula with show a healed fibula fracture and a reduced and internally fixated, non-united tibial fracture. b. CT DICOM data used to create a STL file (3D Slicer version 4.6, www.slicer.org). Anterior (c) and posterior (d) photographs of a 3D printed anatomical model of the tibia and fibula show the orientation of the tibial fracture nonunion.
Figure 2.
Figure 2.
3D printed model of a tibial fracture nonunion. 42-year-old man 5 months following open reduction and internal fixation of a comminuted tibial fracture. a and b. Coronal reconstruction computed tomography (CT) image of the tibia and fibula with show a healed fibula fracture and a reduced and internally fixated, non-united tibial fracture. b. CT DICOM data used to create a STL file (3D Slicer version 4.6, www.slicer.org). Anterior (c) and posterior (d) photographs of a 3D printed anatomical model of the tibia and fibula show the orientation of the tibial fracture nonunion.
Figure 2.
Figure 2.
3D printed model of a tibial fracture nonunion. 42-year-old man 5 months following open reduction and internal fixation of a comminuted tibial fracture. a and b. Coronal reconstruction computed tomography (CT) image of the tibia and fibula with show a healed fibula fracture and a reduced and internally fixated, non-united tibial fracture. b. CT DICOM data used to create a STL file (3D Slicer version 4.6, www.slicer.org). Anterior (c) and posterior (d) photographs of a 3D printed anatomical model of the tibia and fibula show the orientation of the tibial fracture nonunion.
Figure 3.
Figure 3.
Aortic root model used as a training simulation for transcatheter aortic valve replacement (TAVR). Patient specific models can be used to preoperatively size the TAVR stent. The model was fabricated using the Form 2 3D printer (Formlabs Inc, Somerville, MA) using standard resin.
Figure 4.
Figure 4.
3D printed drug eluting surgical meshes using fused deposition modeling. a.) Photograph of a 3D printed surgical mesh printed using both polylactic acid and polycaprolactone. These two plastics were extruded together to create the proof-of-concept mesh variable pliability. b.) Antibiotic-eluting surgical mesh fragment shows inhibition of bacterial growth in plate culture.
Figure 4.
Figure 4.
3D printed drug eluting surgical meshes using fused deposition modeling. a.) Photograph of a 3D printed surgical mesh printed using both polylactic acid and polycaprolactone. These two plastics were extruded together to create the proof-of-concept mesh variable pliability. b.) Antibiotic-eluting surgical mesh fragment shows inhibition of bacterial growth in plate culture.
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