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All content in this area was uploaded by Bennett P Samuel on Jun 24, 2015
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Content uploaded by Bennett P Samuel
Author content
All content in this area was uploaded by Bennett P Samuel on Jun 24, 2015
Content may be subject to copyright.
Content uploaded by Bennett P Samuel
Author content
All content in this area was uploaded by Bennett P Samuel on Jun 24, 2015
Content may be subject to copyright.
CSI 25-27 June 2015- Frankfurt, Germany
Hybrid Three-Dimensional Printing Derived from Multiple Imaging Modalities
Jordan M. Gosnell1 BS, RDCS; Todd Pietila2 BS; Bennett P. Samuel1 MHA, BSN, RN; Joseph J. Vettukattil1 MBBS, MD, FRCPCH, FRSM, FRCP
1Congenital Heart Center, Helen DeVos Children’s Hospital of Spectrum Health, Grand Rapids, Michigan, USA; 2Materialise, Plymouth, Michigan, USA
Background
Three-dimensional (3D) printing of patient specific cardiovascular
models is an emerging experimental field for enhanced visualization
of cardiac morphology.
Computed tomography (CT) and magnetic resonance imaging (MRI)
are established imaging tools for derivation of 3D printable models.
Three-dimensional ultrasound has recently been reported as a
feasible imaging modality to generate 3D printing in congenital heart
disease.
Each imaging modality has different strengths which can improve
3D printing: CT enhances visualization of extracardiac anatomy;
MRI is superior to other imaging modalities for quantification of
ventricular volumes and myocardial architecture; and 3D
transesophageal echocardiography (TEE) provides the best
visualization of valve anatomy.
We describe registration of CT and 3DTEE datasets to derive a
hybrid model for 3D printing of the systemic atrioventricular valve in
a patient with congenitally corrected transposition of the great
arteries (L-TGA).
Methods
Image acquisition was performed using the Philips iE33 ultrasound
system (Philips Medical Systems, Andover, Massachusetts, USA),
and volume computed tomography scanner (GE Healthcare,
Waukesha, WI) in the Cartesian digital imaging and communication
in medicine (DICOM) format.
After completing multiplanar reformatting of the images, the DICOM
datasets were imported into a dedicated post-processing software
(Mimics® Innovation Suite, Materialise NV, Leuven, Belgium) for
registration of the two datasets.
Segmentation was performed followed by 3D rendering for
visualization (Figure 1). The file was converted to stereolithography
(.stl) format and printed using a 3D printer (Materialise NV).
Results
The CT dataset provided visualization of the extracardiac anatomy.
The 3DTEE dataset was added for enhanced visualization of the
systemic atrioventricular valve.
The merged datasets resulted in an accurate model for enhanced
visualization of the cardiac morphology (Figure 2), color coded to
represent the data from different modalities.
Conclusion
Our experience shows the feasibility and proof of concept of printing
3D cardiovascular models derived from multiple imaging modalities.
The hybrid models have the potential to provide more detailed and
anatomically accurate 3D rendering and printed models.
Further research is required to evaluate the efficacy of hybrid 3D
models in decision-making for transcatheter or surgical interventions.
Fig. 1A and B:
Coronal and
transverse images
demonstrating the
registration of CT and
3DTEE datasets of a
patient with
congenitally corrected
L-TGA.
Fig. 1C: 3DTEE image
shows the systemic
atrioventricular valve
anatomy.
Fig. 1D: 3D rendering
of the registered CT
and 3DTEE datasets.
Tricuspid valve (Systemic
atrioventricular valve)
Systemic right
ventricle
Mitral valve
Right ventricular
outflow tract to aorta
Left ventricular outflow
tract to pulmonary artery
Descending aorta
Morphologic left ventricle
A B
C D
Fig. 2: 3D printed model; the extracardiac
structures and the cardiac contour were
derived from CT and right and left
atrioventricular valve morphology was derived
from 3DTEE.
