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Evaluating 3D-printed models of coronary anomalies: a survey among clinicians and researchers at a university hospital in the UK
  1. Matthew Lee1,
  2. Sarah Moharem-Elgamal2,3,
  3. Rylan Beckingham1,
  4. Mark Hamilton3,
  5. Nathan Manghat3,
  6. Elena Giulia Milano4,5,
  7. Chiara Bucciarelli-Ducci1,3,
  8. Massimo Caputo1,3,
  9. Giovanni Biglino1,3,5
  1. 1 Bristol Medical School, University of Bristol, Bristol, UK
  2. 2 National Heart Institute, Giza, Egypt
  3. 3 University Hospitals Bristol, NHS Foundation Trust, Bristol, UK
  4. 4 Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy
  5. 5 Cardiorespiratory Division, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
  1. Correspondence to Dr Giovanni Biglino; g.biglino{at}bristol.ac.uk

Abstract

Objective To evaluate the feasibility of three-dimensional (3D) printing models of coronary artery anomalies based on cardiac CT data and explore their potential for clinical applications.

Design Cardiac CT datasets of patients with various coronary artery anomalies (n=8) were retrospectively reviewed and processed, reconstructing detailed 3D models to be printed in-house with a desktop 3D printer (Form 2, Formlabs) using white resin.

Setting A University Hospital (division of cardiology) in the UK.

Participants The CT scans, first and then 3D-printed models were presented to groups of clinicians (n=8) and cardiovascular researchers (n=9).

Intervention Participants were asked to assess different features of the 3D models and to rate the models’ overall potential usefulness.

Outcome measures Models were rated according to clarity of anatomical detail, insight into the coronary abnormality, overall perceived usefulness and comparison to CT scans. Assessment of model characteristics used Likert-type questions (5-point scale from ‘strongly disagree’ to ‘strongly agree’) or a 10-point rating (from 0, lowest, to 10, highest). The questionnaire included a feedback form summarising overall usefulness. Participants’ imaging experience (in a number of years) was also recorded.

Results All models were reconstructed and printed successfully, with accurate details showing coronary anatomy (eg, anomalous coronary artery, coronary roofing or coronary aneurysm in a patient with Kawasaki syndrome). All clinicians and researchers provided feedback, with both groups finding the models helpful in displaying coronary artery anatomy and abnormalities, and complementary to viewing 3D CT scans. The clinicians’ group, who had substantially more imaging expertise, provided more enthusiastic ratings in terms of models’ clarity, usefulness and future use on average.

Conclusions 3D-printed heart models can be feasibly used to recreate coronary artery anatomy and enhance understanding of coronary abnormalities. Future studies can evaluate their cost-effectiveness, as well as potentially explore other printing techniques and materials.

  • coronary artery anomalies
  • 3d printing
  • computed tomography
  • coronary arteries

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Footnotes

  • Contributors ML created the models and carried out the survey, with RB, as well as analysing survey results. SM-E, MH, NM, EGM, CB-D and MC aided with selection of cases, clinical insight and model checking. GB conceived the study and oversaw the creation of models and the analysis. ML drafted the manuscript with GB and all authors critically contributed to revising and finalising the manuscript.

  • Funding The work is supported by a David Telling Charitable Trust equipment grant and by the British Heart Foundation. The authors also acknowledge support from the Bristol National Institute for Health Research (NIHR) Biomedical Research Centre.

  • Disclaimer The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data pertinent to the study are included in the manuscript, no additional unpublished data.

  • Patient consent for publication Not required.

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