MEDICAL IMAGING - A Way Forward Using 3D Printing And Its Challenges

By Firoza Kothari, Co-Founder & CTO at Anatomiz3D Medtech Private Limited

Anatomiz3D Medtech is one of the ‘patient- specific’ solution providers to the healthcare industry, utilizing Design, 3D Printing and Bio-printing technologies.

Exploring the unknown, in any aspect of life, is a combination of excitement and fear. Humans are more inclined towards either side of the spectrum, depending on how much risk the unknown poses for them. Excitement leads to unveiling more of the unfamiliar subject and fear entails calculated decisions towards or away from any data available. This typically leaves us with two broad categories of people – believers and skeptics, thriving in a symbiotic relationship. In industry terms, it is then up to the believers to invent and convert the skeptics to consumers.

Be it any industry - Medical, Aerospace, Defense, Food, Clothing, etc, inventors put their hearts on their sleeve to create something new, but unless the consumers don’t utilize it, their creations can be rendered irrelevant. Unsurprisingly, the fate of any new technology is highly dependent on its acceptance by the particular industry. In the medical field, this can mean a long gestation period. Reason? Fear of risk to life.

What’s Old?
Restricting our discussion to medical imaging henceforth, the utility of X-rays in this sector has been known for a little over 120 years. Initially just 1 image to extract all anatomical data from, the last century saw a huge leap with the invention of CT and MRI machines, now being able to take hundreds of images of the region of interest, allowing for more detailed diagnosis. These stacks of 2D Images, based on the type of scan and other technical variables, are capable of providing varying levels of differences across bones and soft tissues. The constant improvement in accuracies and automation in2D imaging is fairly ensuring precision. However, the output data for diagnosis remains 2D and is still weary to variances in perception between individual doctors.

" Doctors now have the choice to overstep the ‘one size fits all’ approach in the operation theatre and customize their tools and devices"

What’s New?
As a spokesperson of the 3D printing industry and as someone trying to create awareness about the same in the medical community, I can vouch for it being a revolutionary technology to personalize surgical practices for complex cases. It relies on the patient DICOM (Digital Imaging and Communications in Medicine) data acquired by the CT/MRI/Echo machines and takes this 2D dataset one dimension higher, complimenting it.

DICOM datasets are essentially stacks of images, one above the other, of the anatomical region of interest, and are intercepted through knowledge of the Grey scale. Black represents air, white represents bone/implant/contrast and variants of grey depict different tissues. Software capable of reading and editing on this dataset recreates different parts of the patient’s body using this grey scale segmentation. Upon verification of the designed part, a 3D Printable format is fed into an appropriate 3D printer based on the final application of the said part, and is additively manufactured layer by layer in 1:1 scale.

This replica of the patient’s anatomy is then utilized by the medical team to help them in diagnosis and surgical planning. The communication amongst doctors improves greatly as everyone is on the same page with respect to understanding the anatomy and the challenges associated with it. It’s not just a step forward in imaging and visualization - they can simulate the real time surgery on the model, alert themselves for any unforeseen circumstances and change their surgical plan accordingly, thereby reducing final surgical time.

Doctors now have the choice to overstep the ‘one size fits all’ approach in the operation theatre and customize their tools and devices best suited to the patient. A personalized treatment like this is bound to increase the chances of faster recovery and better lifestyle down the road.

So where’s the diffi culty?
• Awareness is less.
• Not all specializations can benefit from this technology.
• Not all surgeries are complex enough to require this level of customization.
• The concept is still quite nascent and hence it has not yet become a routine for complex cases.
• Availability of the right vendors, who are well trained in anatomy, medical designing and additive manufacturing is scarce. Understanding of the overall scenario is highly   important, else it may damage the reputation of the technology.
• Time to provide the products depend of the complexity of the anatomies and speed of the relevant printers. Emergency cases can rarely be catered to.
• No one knows where the liabilities fall in case something fails – the doctor, the designer or the manufacturer?
• The industry is still not highly regulated.
• Relevant patients are not educated well about its benefits.
• Patients have to pay for these services. It is not directly covered under insurance. Is there a bright side? - Yes.
• The regulatory bodies are taking keen interest.
• The technology is improving greatly to get faster and more robust.
• Software and Hardware costs are decreasing.
• Products are getting cheaper.
• Hospitals and Diagnostic centers are taking the initiative to include this in their routine services.
• Word of mouth and Social media is helping spread awareness exponentially
• Existing giant companies have started taking interest in the technology’s capabilities.

A technology that makes medical diagnostics and practices easier is destined to gain momentum and acceptance, as long as the industry ensures and its constant enhancement and leads the way forward with patience.

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