Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

3D Printing in Radiology Education

Introduction Diagnostic radiology programs currently encompass image-based diagnosis and image-guided therapeutic techniques using multiple available imaging modalities. Three-dimensional (3D) image post-processing of radiologic images routinely uses high-resolution computed tomography (CT) and magnetic resonance imaging (MRI) datasets for diagnostic evaluation and treatment planning. Dedicated training in 3D modeling may be incorporated into some radiology training programs, although it is not required, and formal training programs are limited.…

Regulatory Perspectives for 3D Printing in Hospitals

Introduction The United States (US) Food and Drug Administration (FDA) has overseen medical device marketing in the US since May 28, 1976, when the Medical Device Amendments to the Federal Food, Drug and Cosmetic Act were passed. The system that was established has first and foremost the public safety in mind, focusing on regulations for the marketing of medical devices in the US. While safety is…

Documentation and Reimbursement for 3D Printed Anatomic Models and Guides

Introduction In the American healthcare system, standardized documentation is critical to ensure accurate medical billing and coding for appropriate reimbursement. An encounter for radiology services starts with a test order from a referring physician which includes the patient’s signs/symptoms or a reason for performing the test. Once the imaging exam is performed, information about the exam and the diagnosis including the International Classification of Diseases-10 codes must…

Quality Assurance of 3D Printed Anatomic Models

Quality Assurance (QA), defined as the maintenance of a desired level of quality in a service or a product, is a subset of the quality management system (QMS) and provides the framework that ensures quality requirements are met. A proper QA program has many components that objectively demonstrate confidence in product or service quality to the user. A QA program includes components such as document controls,…

3D Printed Anatomic Models and Guides

Introduction Three-dimensional (3D) printed anatomic models and guides designed from volumetric medical imaging data are used clinically to provide increased comprehension of anatomy, more exact pathology evaluation, and more precise surgical intervention. Historically, obtaining a 3D printed patient-specific anatomic model was typically made possible through independent companies, several of which began building anatomic models for surgeons in the early to mid-1990s. Today, a variety of third…

3D Printing Principles and Technologies

Introduction Three-dimensional (3D) printing, also known as additive manufacturing or rapid prototyping, originated in the 1980s and encompasses various processes that create physical 3D objects by fabricating them layer by layer from a digital file. , Whether the 3D printed part begins with radiological images or is designed from the ground up, specialized software is necessary to help generate the appropriate digital computer-aided design (CAD) file…

Computer-Aided Design Principles for Anatomic Modeling

Introduction The process of creating a physical three-dimensional (3D) printed model from medical imaging data is complicated and involves numerous steps. In order for a patient-specific anatomic model to be suitable for 3D printing, segmented anatomical regions of interest must be designed, prepped, and then converted into 3D file types that are recognized by vendor-specific 3D printing slicing software. Common, vendor neutral file formats for printing…

Image Segmentation and Nonuniformity Correction Methods

Introduction In medical imaging, a three-dimensional (3D) image, or volume, is often acquired by stacking up a series of two-dimensional (2D) slice images. Just as 2D images are made up of pixels, 3D volumes such as computed tomography (CT) or magnetic resonance imaging (MRI) scans consist of voxels as the basic elements. The printing of a specific object (bone, tissue, etc.) from a medical image usually…

Medical Imaging Technologies and Imaging Considerations for 3D Printed Anatomic Models

Medical imaging technologies, which allow us to “see into” and understand living systems, play a significant role in biology and medicine. The X-ray has paved the way for many high-tech medical imaging technologies that are used today including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and positron emission tomography (PET). It is possible a number of scientists inadvertently produced X-rays including William Morgan and Nicola…

An Abbreviated History of Medical 3D Printing

Introduction Three-dimensional (3D) printing technologies are now entering their fourth decade of use and many medical applications now are very well established and optimized. Despite this, many in the medical field are surprised to hear that 3D printing is not relatively new. This chapter is not an exhaustive look at every development along the timeline for medical 3D printing but instead meant to point out some…

Fetal Pathology

Introduction Perinatal/paediatric pathology is a medical subspecialty with particular expertise in diseases affecting the placenta, fetus, infant and child. In the United Kingdom, paediatric pathology has evolved rapidly over recent decades from a small area of practice for general histopathologists, to becoming a recognized subspecialty by the Royal College of Pathologists. The workload of a practising paediatric pathologist can be broadly separated into two fields: 1.…

Fetal Magnetic Resonance Imaging

Introduction Over the last ten years, the interest of radiologists and obstetricians in imaging the unborn child by means of magnetic resonance imaging (MRI) has grown significantly, not least facilitated by accelerated technical developments, especially in terms of fast imaging sequences. Thanks to scientific progress, fetal MRI features nowadays more and more in the multidisciplinary approach to fetal medicine. In routine clinical practice, ultrasound remains the…

Fetal Tumours

Introduction to Fetal Tumours Fetal tumours are fortunately rare. They can be associated with serious illness or even death in the fetal or neonatal period and the prenatal diagnosis of fetal tumours may have significant implications on the well-being of both mother and fetus, as well as on perinatal and neonatal outcome. The reported prevalence for congenital tumours is 1.7–13.5 per 100,000 live births. Definition Differentiation…

Haematological Disorders

Red Cell Disorders Causes of Fetal Anaemia Rhesus D Alloimmunization Rhesus D (RhD) alloimmunization is the major cause of haemolytic disease of the fetus and newborn (HDFN). Over the past 40 years, the incidence of HDFN has fallen dramatically due to greater understanding of the pathophysiology of the disease and advances in management including the widespread use of prophylactic anti-D immunoglobulin. The reduction in stillbirths and…

Urinary Tract Abnormalities

Introduction Abnormalities of the urinary tract are relatively common, accounting for approximately 20% of all fetal malformations. The exact incidence of prenatally detected urinary tract anomalies is difficult to determine and varies from centre to centre and with the timing of the ultrasound examination. Although advances in ultrasound machine technology have meant that the diagnosis of renal disease is more accurate, there remains a significant false-positive…

Abdominal and Abdominal Wall Abnormalities

Introduction Congenital anomalies of the gastrointestinal tract, (including those of the anterior abdominal wall) account for approximately 15% of congenital abnormalities detected by routine prenatal ultrasound. The prenatal detection rates from routine ‘screening ultrasound’ either in the first trimester (usually between 11 to 13 +6 weeks) or in the second trimester (18 to 22 weeks), are dependent upon the type of congenital anomaly as well as…

Skeletal Abnormalities

Introduction Abnormalities of the fetal limbs rank as the third most common after those of the cardiac and renal systems according to EUROCAT data (1980–2010). The most common limb abnormalities amenable to prenatal diagnosis are: club foot/talipes (9.5 in 10,000 births); polydactyly (8.9 in 10,000 births); syndactyly (6.24 in 10,000 births); limb reduction defects (6 in 10,000 births); Combine these prevalence figures with: skeletal dysplasias (1.69…

Pulmonary Abnormalities

Ultrasound of the Normal and Abnormal Fetal Lungs The fetal lungs are well-visualized either in the axial planes at the level of the four-chamber view ( Figure 15-1A ), the three-vessel view ( Figure 15-1B ), the upper abdomen transition to the chest ( Figure 15-2A ) or in a parasagittal plane ( Figure 15-2B ). In a right parasagittal view the lung length can be…

Cardiac Abnormalities and Arrhythmias

Introduction Cardiac abnormalities are among the most common birth defects and are the leading cause of death in children from congenital defects. They occur in about 8–11 cases per 1000 livebirths but only 3 per 1000 are major cardiac abnormalities requiring early intervention. Despite well-recognized risk factors ( Table 14-1 ), most cardiac abnormalities occur in low-risk pregnancies. Hence, the best practice is to screen the…

Abnormalities of the Face and Neck

Introduction The face is the focus of social interaction, and therefore facial abnormalities have a significant impact both in psychological and emotional terms. Facial abnormalities are often associated with other anomalies and may be a clue to the detection of chromosomal disease or a more complex syndrome. This has practical implications in terms of need for invasive tests to identify karyotype and genetic counselling. The detection…