3D Printing & Interventional Radiology
By Dr Sagar Kulkarni

3D printing enables users to manufacture intricate objects using a 3D printer and an STL file. 3D printing has been used in healthcare for pre-procedural planning, creating custom-made implants and in trainee education. In interventional radiology (IR), 3D printing holds unique promise as interventional radiologists often access structures in the body without direct vision; therefore, having a 3D printed model of a structure can help consultants, trainees and patients improve their understanding of the procedure.

 

Pre-procedural planning

For most clinicians, pre-procedural planning is the first application that comes to mind when 3D printing is discussed. 3D printers are capable of creating resin models of a patient’s vasculature from their imaging data. By creating 3D printed models for percutaneous ablation, splenic artery aneurysms and transarterial chemoembolization, Ghodadra et al. (1) showed that models can be printed inexpensively (median cost per model: USD$8.41), although the printing time is extensive (median time to print: 6.0 hours). The authors found that 100% of interventional radiologists recommended using 3D printed models, reporting improvements in assessing the patient’s pathology, spatial orientation and aiding in confidence in the treatment approach.

 

Simulation

Simulation is a key part of IR training. 3D printing offers the chance to improve the simulation experience for trainees. Illustrating this, Mafield et al. created a life-size transparent resin model of the entire aorta (2). The model, known as ArterioSim (see figures), can be filled with tap water and could be used to help trainees directly see how catheters and wires behave inside blood vessels and enable them to improve their technique. Such models could become widespread in IR, enabling trainees to practice endovascular interventions at an early stage of training.

 

Bioprinting and tissue engineering

Looking further in the future, bioprinting could become a reality in IR. Bioprinting uses 3D printing techniques to manufacture layers of biological cells, forming tissues and eventually organs. In IR, pancreatic islet cell transplantation (a treatment for type 1 diabetes mellitus) currently requires a deceased donor to acquire the cells required for transplantation. If these cells could be produced on-demand by bioprinting, IR could lead a revolution in the treatment of diabetes. Research in this area is still highly experimental (3,4), however the potential exists for development in the future.

 

Conclusion

3D printing is an exciting area that is likely to become integrated into IR in the future. In the short term, 3D printing of resin models will help interventional radiologists prepare for challenging cases and trainees to practice their skills. In the longer term, advanced cellular therapies such as bioprinting could open up new fields of treatment for interventional radiologists.

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Figures 1, 2 and 3: ArterioSim, a 3D printed endovascular simulator. Credit: UKETS – UK Endovascular TraineeS.

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References

1. Ghodadra A, Varma R, Santos E, Pinter J, Amesur N. Inexpensive 3D printed models supplement interventional radiology procedure planning. J Vasc Interv Radiol [Internet]. 2017 Feb 1 [cited 2021 Aug 8];28(2):S14–5. Available from: http://www.jvir.org/article/S105104431631510X/fulltext

2. Mafeld S, Nesbitt C, McCaslin J, Bagnall A, Davey P, Bose P, et al. Three-dimensional (3D) printed endovascular simulation models: a feasibility study. Ann Transl Med [Internet]. 2017 Feb 1;5(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326638

3. Duin S, Schütz K, Ahlfeld T, Lehmann S, Lode A, Ludwig B, et al. 3D Bioprinting of Functional Islets of Langerhans in an Alginate/Methylcellulose Hydrogel Blend. Adv Healthc Mater. 2019 Apr 11;8(7).

4. Lee SJ, Lee J Bin, Park YW, Lee DY. 3D bioprinting for artificial pancreas organ. Adv Exp Med Biol. 2018;1064:355–74.

Further Reading

How Bioprinting Will Break Into Healthcare | The Medical Futurist:  https://medicalfuturist.com/3d-bioprinting-overview/

3D bioprinting of tissues and organs | Nature Biotechnology: https://www.nature.com/articles/nbt.2958