Three-dimensional printing to facilitate anatomic study, device development, simulation, and planning in thoracic surgery

Background: The development and deployment of new technologies in additive 3-dimensional (3D) printing (ie, rapid prototyping and additive manufacturing) in conjunction with medical imaging techniques allow the creation of anatomic models based on patient data. Objective: To explore this rapidly evolving technology for possible use in care and research for patients undergoing thoracic surgery. Methods: Because of an active research project at our institution on regional lung chemotherapy, human pulmonary arteries (PAs) were chosen for this rapid prototyping project. Computed tomography (CT) and CT angiography in combination with segmentation techniques from 2 software packages were used for rapid generation and adjustment of the 3D polygon mesh and models reconstruction of the PAs. The reconstructed models were exported as stereolithographic data sets and further processed by trimming, smoothing, and wall extrusion. Results: Flexible 3D printed replicas of 10 patient PAs were created successfully with no print failures; however, 1 initial test print with a 1 mm mural thickness was too fragile so the whole group was printed with a 1.5 mm wall. The design process took 8 hours for each model (CT image to stereolithographic) and printing required 97 hours in aggregate. Useful differences in anatomy were defined by this method, such as the expected greater number of proximal branches on the left versus right (2.5 +/- 1.1 vs 1.0 +/- 0.0; P = .001). Conclusions: Reconstructed models of pulmonary arteries using 3D rapid prototyping allow replication of sophisticated anatomical structures that can be used to facilitate anatomic study, surgical planning, and device development.