Translating Imaging Into 3D Printed Cardiovascular Phantoms: A Systematic Review of Applications, Technologies, and Validation

Joël Illi; Benedikt Bernhard; Christopher Nguyen; Thomas Pilgrim; Fabien Praz; Martin Gloeckler; Stephan Windecker; Andreas Haeberlin; Christoph Gräni

doi:10.1016/j.jacbts.2022.01.002

Translating Imaging Into 3D Printed Cardiovascular Phantoms: A Systematic Review of Applications, Technologies, and Validation

JACC Basic Transl Sci. 2022 Apr 6;7(10):1050-1062. doi: 10.1016/j.jacbts.2022.01.002. eCollection 2022 Oct.

Authors

Joël Illi^{1

2

3}, Benedikt Bernhard¹, Christopher Nguyen^{4

5

6

7}, Thomas Pilgrim¹, Fabien Praz¹, Martin Gloeckler¹, Stephan Windecker¹, Andreas Haeberlin^{1

3}, Christoph Gräni^{1

3}

Affiliations

¹ Department of Cardiology, University Hospital Bern, Bern, Switzerland.
² Swiss Med Tech Center, Switzerland Innovation Park Biel/Bienne AG, Biel, Switzerland.
³ Translational Imaging Center, sitem Center for Translational Medicine and Biomedical Entrepreneurship, University of Bern, Bern, Switzerland.
⁴ Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, Massachusetts, USA.
⁵ Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.
⁶ Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
⁷ Division of Health Science Technology, Harvard-Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.

Abstract

Translation of imaging into 3-dimensional (3D) printed patient-specific phantoms (3DPSPs) can help visualize complex cardiovascular anatomy and enable tailoring of therapy. The aim of this paper is to review the entire process of phantom production, including imaging, materials, 3D printing technologies, and the validation of 3DPSPs. A systematic review of published research was conducted using Embase and MEDLINE, including studies that investigated 3DPSPs in cardiovascular medicine. Among 2,534 screened papers, 212 fulfilled inclusion criteria and described 3DPSPs as a valuable adjunct for planning and guiding interventions (n = 108 [51%]), simulation of physiological or pathological conditions (n = 19 [9%]), teaching of health care professionals (n = 23 [11%]), patient education (n = 3 [1.4%]), outcome prediction (n = 6 [2.8%]), or other purposes (n = 53 [25%]). The most common imaging modalities to enable 3D printing were cardiac computed tomography (n = 131 [61.8%]) and cardiac magnetic resonance (n = 26 [12.3%]). The printing process was conducted mostly by material jetting (n = 54 [25.5%]) or stereolithography (n = 43 [20.3%]). The 10 largest studies that evaluated the geometric accuracy of 3DPSPs described a mean bias <±1 mm; however, the validation process was very heterogeneous among the studies. Three-dimensional printed patient-specific phantoms are highly accurate, used for teaching, and applied to guide cardiovascular therapy. Systematic comparison of imaging and printing modalities following a standardized validation process is warranted to allow conclusions on the optimal production process of 3DPSPs in the field of cardiovascular medicine.

Keywords: 3D printing; 3D, 3-dimensional; 3DPSP, 3-dimensional printed patient-specific phantom; AM, additive manufacturing; CCT, cardiac computed tomography; CMR, cardiac magnetic resonance; DICOM, Digital Imaging and Communications in Medicine; FDM, fused deposition modeling; PBF, powder bed fusion; SLA, stereolithography; TEE, transesophageal echocardiography; VP, voxel printing; additive manufacturing; cardiovascular disease; patient-specific phantoms; personalized medicine; silicone casting; voxel printing.

Publication types

Review

Grants and funding

R01 HL151704/HL/NHLBI NIH HHS/United States