Bogdanov Todor G, Mileva Rene, Ferdinandov Dilyan
Department of Medical Physics, Medical University - Sofia, Sofia, BGR.
Department of Physiology, Faculty of Medicine, Medical University - Sofia, Sofia, BGR.
Cureus. 2024 Aug 18;16(8):e67119. doi: 10.7759/cureus.67119. eCollection 2024 Aug.
This study presents a detailed methodology for integrating three-dimensional (3D) printing technology into preoperative planning in neurosurgery. The increasing capabilities of 3D printing over the last decade have made it a valuable tool in medical fields such as orthopedics and dental practices. Neurosurgery can similarly benefit from these advancements, though the creation of accurate 3D models poses a significant challenge due to the technical expertise required and the cost of specialized software. This paper demonstrates a step-by-step process for developing a 3D physical model for preoperative planning using free, open-source software. A case involving a 62-year-old male with a large infiltrating tumor in the sacrum, originating from renal cell carcinoma, is used to illustrate the method. The process begins with the acquisition of a CT scan, followed by image reconstruction using InVesalius 3, an open-source software. The resulting 3D model is then processed in Autodesk Meshmixer (Autodesk, Inc., San Francisco, CA), where individual anatomical structures are segmented and prepared for printing. The model is printed using the Bambu Lab X1 Carbon 3D printer (Bambu Lab, Austin, TX), allowing for multicolor differentiation of structures such as bones, tumors, and blood vessels. The study highlights the practical aspects of model creation, including artifact removal, surface separation, and optimization for print volume. It discusses the advantages of multicolor printing for visual clarity in surgical planning and compares it with monochromatic and segmented printing approaches. The findings underscore the potential of 3D printing to enhance surgical precision and planning, providing a replicable protocol that leverages accessible technology. This work supports the broader adoption of 3D printing in neurosurgery, emphasizing the importance of collaboration between medical and engineering professionals to maximize the utility of these models in clinical practice.
本研究提出了一种将三维（3D）打印技术整合到神经外科术前规划中的详细方法。在过去十年中，3D打印能力不断提升，使其成为骨科和牙科等医学领域的宝贵工具。神经外科同样可以从这些进步中受益，不过由于所需的技术专长和专业软件的成本，创建精确的3D模型面临重大挑战。本文展示了使用免费开源软件为术前规划开发3D物理模型的逐步过程。以一名62岁男性为例，其骶骨有一个源自肾细胞癌的巨大浸润性肿瘤，用于说明该方法。该过程首先获取CT扫描，然后使用开源软件InVesalius 3进行图像重建。然后在Autodesk Meshmixer（Autodesk公司，加利福尼亚州旧金山）中处理生成的3D模型，在该软件中对各个解剖结构进行分割并准备打印。使用Bambu Lab X1 Carbon 3D打印机（Bambu Lab公司，德克萨斯州奥斯汀）打印模型，可对骨骼、肿瘤和血管等结构进行多色区分。该研究突出了模型创建的实际方面，包括去除伪影、表面分离和打印体积优化。它讨论了多色打印在手术规划中提高视觉清晰度的优势，并将其与单色和分段打印方法进行了比较。研究结果强调了3D打印在提高手术精度和规划方面的潜力，提供了一个利用可获取技术的可复制方案。这项工作支持在神经外科更广泛地采用3D打印，强调了医学和工程专业人员之间合作的重要性，以最大限度地提高这些模型在临床实践中的效用。
