New Directions in 3D Medical Modeling: 3D-Printing Anatomy and Functions in Neurosurgical Planning.

This paper illustrates the feasibility and utility of combining cranial anatomy and brain function on the same 3D-printed model, as evidenced by a neurosurgical planning case study of a 29-year-old female patient with a low-grade frontal-lobe glioma. We herein report the rapid prototyping methodology utilized in conjunction with surgical navigation to prepare and plan a complex neurosurgery. The method introduced here combines CT and MRI images with DTI tractography, while using various image segmentation protocols to 3D model the skull base, tumor, and five eloquent fiber tracts. This 3D model is rapid-prototyped and coregistered with patient images and a reported surgical navigation system, establishing a clear link between the printed model and surgical navigation. This methodology highlights the potential for advanced neurosurgical preparation, which can begin before the patient enters the operation theatre. Moreover, the work presented here demonstrates the workflow developed at the National University Hospital of Iceland, Landspitali, focusing on the processes of anatomy segmentation, fiber tract extrapolation, MRI/CT registration, and 3D printing. Furthermore, we present a qualitative and quantitative assessment for fiber tract generation in a case study where these processes are applied in the preparation of brain tumor resection surgery.