Assessment of transfer of morphological characteristics of Anomalous Aortic Origin of a Coronary Artery from imaging to patient specific 3D Printed models: A feasibility study

Jayanthi Parthasarathy; Hoda Hatoum; Dorma C Flemister; Carly M Krull; Benjamin A Walter; Wei Zhang; Carlos M Mery; Silvana Molossi; Siddharth Jadhav; Lakshmi Prasad Dasi; Rajesh Krishnamurthy

doi:10.1016/j.cmpb.2021.105947

Assessment of transfer of morphological characteristics of Anomalous Aortic Origin of a Coronary Artery from imaging to patient specific 3D Printed models: A feasibility study

Comput Methods Programs Biomed. 2021 Apr:201:105947. doi: 10.1016/j.cmpb.2021.105947. Epub 2021 Jan 21.

Affiliations

¹ Department of Radiology, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Dr, E4A Columbus, Columbus, OH 43205, USA; Department of Pediatrics, Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
² Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Department of Pediatrics, Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
³ Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA; Department of Pediatrics, Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
⁴ Department of Biostatistics & Data Science, University of Texas HSC, School of Public Health, Houston USA; Department of Pediatrics, Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
⁵ Texas Center for Pediatric and Congenital Heart Disease, University of Texas Dell Medical School / Dell Children's Medical Center, Austin, TX, USA.
⁶ Texas Center for Pediatric and Congenital Heart Disease, University of Texas Dell Medical School / Dell Children's Medical Center, Austin, TX, USA; Department of Pediatrics, Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
⁷ Department of Radiology, Texas Children's Hospital, Baylor College of Medicine Houston, TX, USA; Department of Pediatrics, Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
⁸ Department of Radiology, Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Dr, E4A Columbus, Columbus, OH 43205, USA; Department of Pediatrics, Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA. Electronic address: Rajesh.Krishnamurthy@nationwidechildrens.org.

PMID: 33535084
DOI: 10.1016/j.cmpb.2021.105947

Abstract

Background and objective: This study aims to determine the accuracy of patient specific 3D printed models in capturing pathological anatomical characteristics derived from CT angiography (CTA) in children with anomalous aortic origin of a coronary artery (AAOCA).

Methods & materials: Following institutional regulatory approval, a standardized protocol for CTA of AAOCA was utilized for imaging. Blood volume of the aorta and coronaries were segmented from the DICOM images. A total of 10 models from 8 AAOCA patients were created, including 2 post-operative models. Mechanical properties of Agilus30 a flexible photopolymer coated with a thin layer of parylene, polyurethane (PU) and silicone and native aortic tissue from a postmortem specimen were compared. AAOCA models with wall thicknesses of 2mm aorta and 1.5mm coronaries were 3D printed in Agilus30 and coated with PU. CT of the printed models was performed, and 3D virtual models were generated. Transfer of anatomical characteristics and geometric accuracy were compared between the patient model virtual models.

Results: Dynamic modulus of Agilus30 at 2mm thickness was found to be close to native aortic tissue. Structured reporting of anatomical characteristics by imaging experts showed good concordance between patient and model CTA Comparative patient and virtual model measurements showed Pearson's correlation (r) of 0.9959 for aorta (n=70) and 0.9538 for coronaries (n=60) linear, and 0.9949 for aorta (n=30) and 0.9538 for coronaries (n=30) cross-sectional, dimensions. Surface contour map mean difference was 0.08 ± 0.29mm.

Conclusions: Geometrically accurate AAOCA models preserving morphological characteristics, essential for risk stratification and decision-making, can be 3D printed from a patient's CTA.

Keywords: 3D Printed models; Anomalous Aortic Origin of Coronaries (AAOCA); Flow phantom; Sudden cardiac death (SCD).

MeSH terms

Aorta / diagnostic imaging
Child
Coronary Vessel Anomalies*
Cross-Sectional Studies
Feasibility Studies
Humans
Printing, Three-Dimensional