Role of 3D Printing and Modeling to Aid in Neuroradiology Education for Medical Trainees

Abstract

Background: Applications of 3-dimensional (3D) printing in medical imaging and health care are expanding. Currently, primary uses involve presurgical planning and patient and medical trainee education. Neuroradiology is a complex subdiscipline of radiology that requires further training beyond radiology residency. This review seeks to explore the clinical value of 3D printing and modeling specifically in enhancing neuroradiology education for radiology physician residents and medical trainees.

Methods: A brief review summarizing the key steps from radiologic image to 3D printed model is provided, including storage of computed tomography and magnetic resonance imaging data as digital imaging and communications in medicine files; conversion to standard tessellation language (STL) format; manipulation of STL files in interactive medical image control system software (Materialise) to create 3D models; and 3D printing using various resins via a Formlabs 2 printer.

Results: For the purposes of demonstration and proof of concept, neuroanatomy models deemed crucial in early radiology education were created via open-source hardware designs under free or open licenses. 3D-printed objects included a sphenoid bone, cerebellum, skull base, middle ear labyrinth and ossicles, mandible, circle of Willis, carotid aneurysm, and lumbar spine using a combination of clear, white, and elastic resins.

Conclusions: Based on this single-institution experience, 3D-printed complex neuroanatomical structures seem feasible and may enhance resident education and patient safety. These same steps and principles may be applied to other subspecialties of radiology. Artificial intelligence also has the potential to advance the 3D process.

FIGURE 1

Trigulation in Producing 3-Dimmensional Anatomical Models In 2 dimensions, the left 2 images demonstrate that 3 and 4 lines (red), respectively, poorly approximate a circle (black). On the right, increasing the number of lines to 6 and 16 better approximates the circle. Analogously, using many small triangles can create a high-quality model of complex 3-dimensional human anatomy.

FIGURE 2

Correlation of the Sphenoid Bone Between Computed Tomography and 3-Dimmensional Model Axial (A) and coronal (B) head computed tomography scans depicting the sphenoid bone. The greater (red arrow) and lesser wings (blue arrow), medial (pink arrow) and lateral pterygoid plates (yellow arrow), and superior orbital fissure (green arrow) can be easily delineated on the superior (C) and posterior (D) views of the sphenoid bone 3-dimensional model.–

FIGURE 3

Models of Complex Structures of the Head and Neck Formlabs 2 three-dimensional printer using standard tessellation language technology. A, resin models depict the anterior view of the cerebellum; B, middle ear bony and membranous labyrinth; C, ossicles; D, anterior/superior view of the mandible; and E, oblique view of the mandible.–

FIGURE 4

Normal Intracranial Vasculature vs a Pathologic Aneurysm Models Formlabs 2 three-dimensional printer using standard tessellation language technology. A, elastic resins depict the normal circle of Willis, the anterior and posterior circulation is highlighted and its association to the anterior, middle, and posterior cranial fossa; B, the large outpouching with a narrow neck arising from the internal carotid artery consistent with an internal carotid artery aneurysm can be compared.–

FIGURE 5

Lumbar Spine 3-Dimensional Model A, lateral; and B, posterior views of the lumbar spine. The vertebral bodies (red arrow), spinous (green arrow) and transverse processes (blue arrow), and intervertebral discs (yellow arrow) are all clearly demonstrated.–