Gould Sharon,  Thacker Mihir

Final Pr. ID: Poster #: CR-022

Knee deformity is the most common and complex lower extremity abnormality associated with Thrombocytopenia Absent Radius (TAR) syndrome. Conventional pre-operative imaging includes radiographs and computed tomography (CT) for assessment of joint alignment. We report utilizing 3-D MRI series and manual segmentation on commeicially available software to create 3-D printed models for pre-operative planning in a TAR syndrome patient with largely unossified epiphyses who had unusually severe femoral anteversion and genu varum. We discuss the methods used for imaging and segmentation as well as the value and limitations of the 3D print in pre-operative planning for this case. Even with the limitations we encountered, better understanding of the spatial relationships and joint alignment was achieved with 3-D model generation and aided in planning for correction of the knee varus deformity and femoral torsion. In addition, the diagnostic MRI information provided the basis to forgo construction of cruciate ligaments at this stage due to an increased risk of failure related to severe joint deformity. Because the prognosis for TAR syndrome is good if the child survives the first 2 years, it is important that orthopedic interventions are well planned to give a good outcome. Utilization of advanced imaging tools such as 3D imaging and printing may aid in definitive surgical planning in complex cases such as this one, and MRI can be used to generate usable anatomical models for pre-operative planning in children with incompletely ossified epiphyses. Read More

Authors:  Gould Sharon , Thacker Mihir

Keywords:  3D printing, MRI, segmentation

Zabala-travers Silvina,  Sattler Juan,  Perdomo Jose

Final Pr. ID: Poster #: EDU-006 (S)

Detailed understanding of complex patients in CT and MRI can be challenging, particularly to non-radiologists. 3D modeling is a new language available to radiologists through which relevant details from an imaging study can be presented to readers in a straight-forward, easier to interpret way. Our Innovation Department in Pediatric Radiology has included 3D models in current practice. We briefly present how this models are built, some cases and a short review of 3D models contribution to a better practice of medicine. Read More

Authors:  Zabala-travers Silvina , Sattler Juan , Perdomo Jose

Keywords:  3D modeling, patient-specific medicine, 3D printing

Parthasarathy Jayanthi,  Scharschmidt Thomas,  Rees Mitchell,  Selvaraj Bhavani

Final Pr. ID: Poster #: SCI-047

We describe a process for pre-operative virtual surgical planning and creation of patient specific surgical guides for bony tumor resection in pediatric orthopedic surgery and demonstrate a case in which this process was used for successful surgical guidance. Read More

Authors:  Parthasarathy Jayanthi , Scharschmidt Thomas , Rees Mitchell , Selvaraj Bhavani

Keywords:  Patient-Specific, 3D printing, Sugical Guides

Lall Neil,  Mcgee Jack,  Sarkar Korak

Final Pr. ID: Poster #: EDU-043

Fluoroscopy of the upper GI tract (UGI) can be difficult to master given the time-sensitive nature of the examination, the necessary hand-eye coordination, the complex button layout and broad featureset of the fluoroscopic equipment, the desire for minimizing radiation dose, and the required understanding of normal anatomy. Additionally, encountering abnormal findings for the first time, particularly before one is familiar with normal findings, can lead to confusion and increased difficulty in performing the examination. The use of 3D printed models of normal anatomy in pediatric fluoroscopic UGI training simulation has previously been demonstrated as a viable alternative to learning on live patients; however, such a technique has not previously been used with known pathological anatomic configurations. Read More

Authors:  Lall Neil , Mcgee Jack , Sarkar Korak

Keywords:  3D printing, fluoroscopy, simulation

Wong Lincoln,  Love Terri,  Abdessalam Shahab,  Linke Ronald,  Vonhlefeld Thomas

Final Pr. ID: Poster #: EDU-038

The exponential growth in medical imaging parallels today’s growth in consumer technology. At the forefront of this growth are 3D printing and augmented reality. Their uses in medicine today are in their infancy and radiologists play a key role in nurturing these technologies to ensure their meaningful use in medicine.

In this educational exhibit, we showcase the use of 3D printing and augmented reality in helping a pediatric surgeon visualize a complex brachial plexus tumor in a 6-year-old boy prior to its resection. We will describe the process of developing the models, including our role as radiologists. Read More

Authors:  Wong Lincoln , Love Terri , Abdessalam Shahab , Linke Ronald , Vonhlefeld Thomas

Keywords:  3d printing, augmented reality, technology

Chacko Anith,  Andronikou Savvas,  Shearn Andrew,  Thai Ngoc Jade

Final Pr. ID: Paper #: 131

3D printed models from MRI scans can effectively demonstrate the surface structure of the brain. Previous workflows focus on adult brains as a basis for prints. Our database of pediatric MRI brains who had perinatal hypoxic ischemic injury and presented late for imaging, with pathology causing cortical surface irregularities and parenchymal cysts. Difficulties arise in accurate depiction of the cortex on 3D print models in these pathologic brains. We aim to demonstrate effective workflows to accurately and efficiently print 3D models of especially pathologic pediatric MRI brains. Also, to critically and empirically test and refine the various steps involved in producing 3D print models which include segmentation of the MRI volume into tissue classes, generation of a surface model from this volume, preparation and final print of a 3D model. Read More

Authors:  Chacko Anith , Andronikou Savvas , Shearn Andrew , Thai Ngoc Jade

Keywords:  3D Printing, Hypoxic Ischaemic Injury, 3D Models

Venkatakrishna Shyam Sunder,  Chacko Anith,  Schoeman Sean,  Andronikou Savvas

Final Pr. ID: Poster #: SCI-029

Effective text-based communication, through radiologist reports, of imaging findings in term Hypoxic Ischemic Injury (HII) to family members, non-radiologist colleagues and members of the legal profession can be extremely challenging. Utilization of 3D printed models, where the actual findings of the brain can be communicated via tactile perception and rotating/grasping the models is a potential solution which has not been tested in practice. We aimed to determine the sensitivity and specificity of different groups, comprising trained radiologists, non-radiologist physicians and non-physicians, in the detection of gross disease of the cerebral cortex from 3D printed brain models derived from MRI scans of children. Read More

Authors:  Venkatakrishna Shyam Sunder , Chacko Anith , Schoeman Sean , Andronikou Savvas

Keywords:  Magnetic Resonance Imaging, 3D Printing, Hypoxic Ischemic Injury

Schoeman Sean,  Venkatakrishna Shyam Sunder,  Chacko Anith,  Andronikou Savvas

Final Pr. ID: Poster #: SCI-026

To assess the utility and adaptability of some widely used automated segmentation methods when applied to abnormal pediatric magnetic resonance imaging (MRI) brain scans. Segmentation is an essential component of the workflow when building 3D anatomical models of abnormal pediatric brains to demonstrate surface pathology. Read More

Authors:  Schoeman Sean , Venkatakrishna Shyam Sunder , Chacko Anith , Andronikou Savvas

Keywords:  Segmentation, 3D Printing, MRI Brain

Dennis Rebecca,  Silvestro Elizabeth,  Hill Lamont,  Andronikou Savvas,  Anupindi Sudha,  Hwang Misun

Final Pr. ID: Poster #: SCI-022

To create a three dimensional (3D) ultrasound (US) bowel phantom that simulates bowel sonographic characteristics to aid in education for bowel scanning techniques and for microbubble contrast utilization in bowel. Read More

Authors:  Dennis Rebecca , Silvestro Elizabeth , Hill Lamont , Andronikou Savvas , Anupindi Sudha , Hwang Misun

Keywords:  Bowel Phantom, Bowel Ultrasound, 3D Printing

Maier Pia,  Silvestro Elizabeth,  Andronikou Savvas

Final Pr. ID: Poster #: EDU-044

Successful bronchoscope handling requires the skill to orient bronchoscope position and direction in response to the intraluminal view provided by the bronchoscope camera. Additional challenges for pediatric physicians are smaller airways and the physiologically higher breathing frequency and airway collapsibility in babies and toddlers. We aimed to create a set of anatomically accurate 3D printed pediatric static and dynamic airway models that can be further used to teach and train residents/fellows in bronchoscopy and foreign body removal. Read More

Authors:  Maier Pia , Silvestro Elizabeth , Andronikou Savvas

Keywords:  3D printing, Phantom, Bronchial tree

Silvestro Elizabeth,  Shellikeri Sphoorti,  Trahan Sean,  Sze Raymond,  Cahill Anne Marie

Final Pr. ID: Poster #: SCI-035

3D printing technology presents a unique opportunity for the creation of custom phantoms for training and simulation for pediatric interventional procedures that are complex and/or uncommonly performed. The purpose of this study was to describe the elements of designing a 3D phantom for simulation of pediatric abdominal intra -vascular procedures. Read More

Authors:  Silvestro Elizabeth , Shellikeri Sphoorti , Trahan Sean , Sze Raymond , Cahill Anne Marie

Keywords:  3d printing, Simulation, Phantom

Parthasarathy Jayanthi,  Gedela Satya,  Ostendorf Adam,  Pindrik Jonathan,  Jones Jeremy,  Mcallister Aaron,  Selvaraj Bhavani,  Long Alexander

Final Pr. ID: Poster #: SCI-058

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. Read More

Authors:  Parthasarathy Jayanthi , Gedela Satya , Ostendorf Adam , Pindrik Jonathan , Jones Jeremy , Mcallister Aaron , Selvaraj Bhavani , Long Alexander

Keywords:  Brain model, MRI brain, 3D Printing

Smitthimedhin Anilawan,  Silvestro Elizabeth,  Shellikeri Sphoorti,  Whitaker Jayme,  Cahill Anne Marie

Final Pr. ID: Paper #: 141

The renal artery ostial anatomy, balloon profile, and stent deployment are all challenges of complex procedural RAS planning in children. In such cases there is an increased risk of renal artery rupture secondary to angioplasty requiring placement of a covered stent. This study aims to establish the feasibility of simulating renovascular stent deployment in three 3D printed pediatric patient-specific RAS endovascular phantoms. Read More

Authors:  Smitthimedhin Anilawan , Silvestro Elizabeth , Shellikeri Sphoorti , Whitaker Jayme , Cahill Anne Marie

Keywords:  3D Printing, Stent, Simulation

Parthasarathy Jayanthi,  Hatoum Hoda,  Flemister Dorma,  Mery Carlos,  Molossi Silvana,  Dasi Lakshmi Prasad,  Krishnamurthy Rajesh

Final Pr. ID: Paper #: 044

Morphological features including intramural course, high ostial location, and slit-like ostium are considered risk factors for sudden death in patients with AAOCA. Assessment of coronary blood flow at rest and hyperemia may contribute to understanding the cause of death, and to risk stratification and management. A patient-specific biomechanical 3D printed model incorporating morphological features derived from CTA was developed to quantify coronary blood flow in AAOCA. Read More

Authors:  Parthasarathy Jayanthi , Hatoum Hoda , Flemister Dorma , Mery Carlos , Molossi Silvana , Dasi Lakshmi Prasad , Krishnamurthy Rajesh

Keywords:  Anomalous coronary, 3D Printing, FFR

Revia Richard,  Patel Pushpak,  Johnson Craig

Final Pr. ID: Poster #: SCI-006

Three-dimensional (3D) printed models of patient anatomy are increasingly becoming a component of the healthcare practice of many physicians. Here, we investigate physician perceptions of an in-house high-fidelity medical 3D-printing service in a large pediatric health system. We aim to elucidate how physicians perceive 3D-printed models assist in their roles as healthcare providers and to illustrate how a 3D-printing service may add value to a healthcare system. Read More

Authors:  Revia Richard , Patel Pushpak , Johnson Craig

Keywords:  3D Printing, Model, Survey

Ryan Justin,  Pophal Stephen,  Aria David,  Towbin Richard

Final Pr. ID: Poster #: EDU-121

Transcatheter Aortic Valve Replacement (TAVR) is widely becoming an accepted therapy for aortic stenosis. In the last 10 years, estimates place the deployment of TAVRs as high as 50,000 worldwide. Differences in size and morphology of the aortic root and surrounding anatomy are important considerations in determining which TAVR to deploy. 3D printing based off of patient images can be leveraged to create models for patient-specific surgical planning purposes. Read More

Authors:  Ryan Justin , Pophal Stephen , Aria David , Towbin Richard

Keywords:  Transcatheter Aortic Valve Replacement (TAVR), 3D Printing

Schoeman Sean,  Venkatakrishna Shyam Sunder,  Silvestro Elizabeth,  Cajigas-loyola Stephanie,  Acord Michael

Final Pr. ID: Poster #: EDU-022

Risk stratification of the most common pediatric primary liver malignancies, hepatoblastoma and hepatocellular carcinoma, is dependent on imaging criteria that ultimately inform work-up and clinical management. The Pediatric Liver Reporting and Data System (LI-RADS) Working Group recommends use of the PRETEXT (PRE-Treatment EXTent of tumor) staging system, which is utilized in the ongoing Pediatric International Tumor Trial (1). PRETEXT staging is first performed by dividing the liver into four sections. Based on how many contiguous sections are free of tumor, a group is assigned from I-IV. Second, annotations factors are assessed depending on the presence of vessel involvement, rupture, multifocality, extrahepatic spread, or metastatic disease, which portend higher risk (2).

Understanding and applying the PRETEXT system should be a core competency for all current and aspiring pediatric radiologists. The PRETEXT system has some barriers to learning, namely in discerning the anatomical liver sections from the functional ‘Couinaud’ segments and accurately determining vessel involvement. We saw the opportunity to combine our diagnostic pediatric radiologic experience/expertise with the application of 3D printing technology. Through the segmentation of post-contrast T1 fat-saturated MRI images, we were able to build 3D models of different PRETEXT stage disease.

The aim of this educational exhibit is to provide pediatric radiologists with an alternative learning tool to appreciate the PRETEXT system and its application. It will combine the proficiency of a 3D pediatric additive manufacturing lab and diagnostic pediatric radiologists with expertise in oncologic imaging and fellowship teaching. Models and their representative 3D renderings will demonstrate the differences between PRETEXT stages, with and without the presence of various annotation factors.

1. Schooler GR, Squires JH, Alazraki A, Chavhan GB, Chernyak V, Davis JT, et al. Pediatric Hepatoblastoma, Hepatocellular Carcinoma, and Other Hepatic Neoplasms: Consensus Imaging Recommendations from American College of Radiology Pediatric Liver Reporting and Data System (LI-RADS) Working Group. Radiology. 2020 Sep;296(3):493–7.
2. Towbin AJ, Meyers RL, Woodley H, Miyazaki O, Weldon CB, Morland B, et al. 2017 PRETEXT: radiologic staging system for primary hepatic malignancies of childhood revised for the Paediatric Hepatic International Tumour Trial (PHITT). Pediatr Radiol. 2018 Apr;48(4):536–54. Read More

Authors:  Schoeman Sean , Venkatakrishna Shyam Sunder , Silvestro Elizabeth , Cajigas-loyola Stephanie , Acord Michael

Keywords:  PRETEXT Staging, 3D Printing, MRI

Ryan Justin,  Pophal Stephen,  Aria David,  Towbin Richard

Final Pr. ID: Poster #: EDU-120

Educational simulators provide a means for students and experts to learn and refinesurgical skills. Our objective was to develop a cost-effective, patient-derived medical simulacrum for cerebral lateral ventriculostomy. Read More

Authors:  Ryan Justin , Pophal Stephen , Aria David , Towbin Richard

Keywords:  3D Printing, Anatomical Modeling, Ventriculostomy