World Neurosurgery. dx.doi.org/10.1016/j.wneu.2016.02.081
Using 3D printing to create personalized brain models for neurosurgical training and preoperative planning
Caitlin C. Ploch, B.Sc, Chris S.S.A. Mansi, MRCS, Jayaratnam Jayamohan, FRCS, Ellen Kuhl, Dr.-Ing
Three-dimensional (3D) printing holds promise for a wide variety of biomedical applications, from surgical planning, practicing, and teaching to creating implantable devices. The growth of this cheap and easy additive manufacturing technology in orthopaedic, plastic, and vascular surgery has been explosive; however, its potential in the field of neurosurgery remains underexplored. A major limitation is that current technologies are unable to directly print ultrasoft materials like human brain tissue. In this technical note, the authors present a new technology to create deformable, personalized models of the human brain. The method combines 3D printing, molding, and casting to create a physiologically, anatomically, and tactilely realistic model based on magnetic resonance images. Created from soft gelatin, the model is easy to produce, cost-efficient, durable, and orders of magnitude softer than conventionally printed 3D models. The personalized brain model cost $50, and its fabrication took 24 hours. In mechanical tests, the model stiffness (E=25.29 ± 2.68kPa) was five orders of magnitude softer than common 3D printed materials, and less than an order of magnitude stiffer than mammalian brain tissue (E=2.64 ± 0.40kPa). In a multicenter surgical survey, model size (100.00%), visual appearance (83.33%), and surgical anatomy (81.25%) were perceived as very realistic. The model was perceived as very useful for patient illustration (85.00%), teaching (94.44%), learning (100.00%), surgical training (95.00%), and preoperative planning (95.00%). With minor refinements, personalized, deformable brain models created via 3D printing will improve surgical training and preoperative planning with the ultimate goal to provide accurate, customized, high precision treatment.
KEYWORDS: Neurosurgery; Training; Clinical Skills; Simulation; 3D Printing