Purpose or Case Report: Establish and evaluate a process for 3DPrinting (3DP) patient specific functional anatomical models of the brain from multiple MRI sequences in patients with epileptic focal lesions.The second objective was to evaluate the clinical utility of the models.
Methods & Materials: Eight patients with intractable epilepsy and focal lesions in the brain were selected for the study.Data acquisition:T1 and T2 weighted MR images with DTI fiber Tractography were acquired on GE Medical systems, Siemens Prisma and Skyra MRI scanners with a field strength of 3 TESLA.Slice thickness range-1.00-1.6mm and the slice increment was 0.5-1mm.Image data processing:Using the segmentation,region growing and 3D modeling algorithms of MIMICS^TM(Materialise, Belgium)3D virtual models of the structural anatomy of the affected hemisphere and the lesion were created. DTI fiber tracts and the vasculature were segmented from Dynasuite^TM(InvivoInternationalUSA)and exported as DICOM data.3D models of the vasculature and the DTI FIBERs were created and integrated into the structural model of the brain.3DPrinting:After preprint preparation the with Geomagic Freeform(3Dsystems,SC,USA)the model were printed with Stratasys PolyjetCONNEX 3 Objet 350 multicolor printer.Models were post processed with high-pressure waterjet.Model verification:The 3DP models were scanned with Toshiba Aquilion CT scanner with a slice thickness and slice increment of 0.5mm.The Dicom image data was imported into MIMICS^TM and a 3D model created.The model so created was overlayed on the virtual model created from the MRI data. Surface variation of the 3DP model and the virtual model created from MRI data was mapped with 3Matics^TM.Models were resliced into 2D contours and overlayed on the MRI image dataset for verification.3DP models of the brain were used for team discussion,resident and fellows and patient education of the specific neuro anatomy.
Results: Comparative analysis of the CT 3DP model and the 3D models created from 2D MRI image data showed a mean difference of -0.36 mm with STD Dev.+/-0.5mm.
Conclusions: Precise patient specific functional anatomic brain models can be created from multiple MRI sequences using 3D modeling and Polyjet printing. 3DP patient specific models are a valuable adjunct to neurosurgical planning.Brain models help surgeons to educate the patients, parents, residents and fellows to understand neuroanatomy better.Parents understand the clinical situation and suggested treatment implications better and give better informed consent.