The impact of using three-dimensional printed liver models for patient education

Abstract

Objective To investigate the impact of using a three-dimensional (3D) printed liver model for patient education. Methods Children with hepatic tumours who were scheduled for hepatectomy were enrolled, and patient-specific 3D liver models were printed with photosensitive resin, based on computed tomography (CT) images. Before surgery, their parents received information regarding liver anatomy, physiology, tumour characteristics, planned surgery, and surgical risks using these CT images. Then, parents completed questionnaires regarding this information. Thereafter, 3D printed models of each patient were presented along with an explanation of the general printing process, and the same questionnaire was completed. The median number of correct responses in each category before and after the 3D printed model presentation was compared. Results Seven children and their 14 parents were enrolled in the study. After the presentation of 3D printed models, parental understanding of basic liver anatomy and physiology, tumour characteristics, the planned surgical procedure, and surgical risks significantly improved. Parents demonstrated improvements in their understanding of basic liver anatomy by 26.4%, basic liver physiology by 23.6%, tumour characteristics by 21.4%, the planned surgical procedure by 31.4%, and surgical risks by 27.9%. Conclusions Using 3D printed liver models improved parental education regarding the understanding of liver anatomy and physiology, tumour characteristics, surgical procedure, and associated surgical risks.

Keywords: Three-dimensional printing; children; hepatic surgery; hepatoblastoma.

Figure 1.

Representative computed tomography images of a hepatic tumour in a child: (a) axial view; and (b) coronal view.

Figure 2.

A representative three-dimensional (3D) printed model of a hepatic tumour in a child: (a) anterior view; and (b) posterior view. The tumour is shown in white, the hepatic vein in blue, the portal vein in purple, and the artery is shown in red. Anatomical structures were segmented from enhanced multidetector computed tomography data. Surface extraction of segmented data into a digital 3D model was then performed. Data were converted to .STL format files; the files were electronically delivered to a 3D printer, and then printed with photosensitive resin. Finally, the models underwent post-manufacture processing. The colour version of this figure is available at: http://imr.sagepub.com.

Figure 3.

The percentage of correct responses per patient, before and after the three-dimensional printed model was presented to the parents of the patient. Individual analysis of improvements in understanding of the five educational components (the mean of the father’s and mother’s correct responses as the representative number for each child): (a) liver anatomy; (b) liver physiology; (c) tumour characteristics; (d) surgical procedure; (e) surgical risks. Pt: patient.

Figure 4.

Mean percentage of correct responses per educational component, before and after a three-dimensional printed model was presented to the parents of the patient.