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

Wallace Jacob,  Desilet-dobbs Debbie

Final Pr. ID: Poster #: EDU-052

Learning the skills used to master pediatric fluoroscopic exams can be challenging. Hand-eye coordination and specific timing is required while at the same time being mindful of radiation dose and interpreting the images generated in real time. Training on live neonates will often mean less diagnostic exams and increased radiation dose for those exams.

An inexpensive reusable simulator model was devised to allow residents practice of upper GI fluoroscopic exams to increase efficiency using ALARA principles and utilizing 3D printing technology off-the-shelf dolls. Generic gastrografin provided a cost effective contrast medium as its concerns in real UGI studies are of no issue on the training models. A 30ml bottle of generic gastrografin can be purchased for less than $20, which would last for several simulated exams.

The 3D model was based on a computer generated imagery (CGI) mesh of a stomach which was modified in Blender™ to try to best replicate the full duodenum and effect of the ligament of Treitz. The final iteration of the model was printed in polylactic acid polymer (PLA) in a size that would fit inside the plastic doll, which already contained portions of the necessary tubing. The model was sealed to be watertight.

Testing under fluoroscopy showed that the model behaved similar enough to an infant when placed in various positions then filled with an appropriate volume contrast.

There are several limitations of this model including the lack of the distractions of a real pediatric patient. Also, the flow of contrast is purely gravity dependent without the effects of sphincters and peristalsis. Overlying skeletal structures and bowel gas are not represented, however these could also be simulated in various ways.

Future work on this and similar projects could include expansion into other organ systems such as the colon. Read More

Authors:  Wallace Jacob , Desilet-dobbs Debbie

Keywords:  ALARA, 3D, Simulation

Huang Yungui,  Krishnamurthy Rajesh,  Hu Houchun,  Luna John,  Krishnamurthy Ramkumar,  Lubeley Lacey,  Buskirk Tricia,  Karczewski Arleen,  Garrett Whitney,  Lin Simon,  Mcallister Aaron

Final Pr. ID: Poster #: EDU-040

Background: Image quality in MRI is often degraded by patient motion. To reduce the need for repeat exams, sedation or general anesthesia is used in pediatric patients. This requires additional clinical staff, and leads to increased scheduling wait times and overall procedure times that impact workflow. Many institutions prepare children for MRI using mock-up replicas. While effective in acclimating patients to the MRI environment, the availability of mock-up practices are often limited. Mock-ups also require physical space and do not simulate the full MRI environment and exam experience.

Purpose: We build an affordable, scalable, and portable immersive virtual reality (IVR) platform for simulating MRI exams. Specifically, we designed an IVR environment that accurately mimics a Siemens 3 Tesla suite within our Radiology practice, including intricate details such as room size, color, lighting, ancillary equipment, pulse sequence audio, and background noise. The IVR platform also attempts to simulate the complete sequence of events and environments a child will experience during an exam, including the check-in process, interactions with staff (e.g., nurses, technologists), the waiting area and changing rooms, the positioning and motion of the MRI table, placement of coils, and within-exam instructions, such as breath-holds. Our platform also allows the patient to move around in the VR space and interact with the environment. Additionally, the platform can be easily converted to mimic any other MR suite. We hypothesize that our platform can be easily adopted by Child Life and hospital staff to quickly acclimate a patient and assess whether he/she can suitably undergo an MRI exam without sedation or general anesthesia.

We believe the IVR platform can overcome the limitations of mock-up replicas. First, IVR has a smaller footprint and is scalable and portable across the hospital. This allows multiple IVR sessions to be held in parallel. Second, IVR can give the patient a hospital-specific and scan-specific first-person experience. The patient can interact with realistic 3D representations of the MRI environment and processes. Our current implementation of IVR was developed using HTC VIVE headsets with a dedicated laptop for control. To further improve portability, the IVR setup can be adopted using simple goggles and handheld devices. This will enable future IVR sessions to be conducted at the bedside, in patient’s homes, and in referring physician offices. Read More

Authors:  Huang Yungui , Krishnamurthy Rajesh , Hu Houchun , Luna John , Krishnamurthy Ramkumar , Lubeley Lacey , Buskirk Tricia , Karczewski Arleen , Garrett Whitney , Lin Simon , Mcallister Aaron

Keywords:  magnetic resonance imaging, virtual reality, simulation

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

Sharma Priya,  Rajderkar Dhanashree,  Schaiberger Gregory,  Batmunh Bayar,  Slater Roberta,  Mancuso Anthony

Final Pr. ID: Paper #: 173

The purpose of this study is to identify how well radiology residents are able to diagnose gastrointestinal emergencies on ultrasound using a simulated emergency radiology call shift. Read More

Authors:  Sharma Priya , Rajderkar Dhanashree , Schaiberger Gregory , Batmunh Bayar , Slater Roberta , Mancuso Anthony

Keywords:  simulation, gastrointestinal, emergency

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

O'brien Kevin,  Ong Seng

Final Pr. ID: Poster #: SCI-041

We intended to develop and test a PACS based radiology simulation program as an objective tool to evaluate residents. We utilized the simulator as the pediatric “end of rotation” (EOR) exam and compared it to our institution’s traditional EOR review. We hypothesized that a simulator evaluation tool would better identify areas for residents to improve, create a clear gradient of resident performance, or identify a struggling resident. Read More

Authors:  O'brien Kevin , Ong Seng

Keywords:  Simulation, Pediatrics, Resident, Education