José Luis Martín, head of the Radiodiagnosis Service at the San Cecilio University Hospital in Granada.
radiologist Jose Luis Martinhead of the Radiodiagnosis Service of the San Cecilio University Hospital of Granada, is clear and concise: “Collaboration between engineers and radiologists in 3D printing improves health”. This has been stated in the X Global Meeting of Hospital Engineeringorganized by Medical Writing. Likewise, Martín added that this relationship between the two professionals “is already a reality”.
The specialist explained during his presentation at the table ‘Management of Medical Technology with an Impact on Health‘ the importance of 3D printing in the health of patients. In this sense and to put a bit of context, Martín has underlined that “the evolution of the image in Radiology goes from the motherboard, the computed tomography (CT), to the virtual models that are made in the teams of the different Services. However, the step that really adds value to the radiological image is to have these models in plastic, so that the surgeon can touch and manipulate it“.
“Having plastic models gives added value to the radiological image”
Some models or prototypes of additive manufacturing that, according to Martín, “began to be made by laboratory engineers”. In this sense, the radiologist added that “the 3D imaging has taken an exponential leap since engineers have joined radiologists. All this is included in the same objective that all professionals have: “Improving the patient’s health”.
The process and clinical applications of 3D printing
The entire 3D printing process is carried out in the Radiology Services and this is so because “the key factor in 3d print is the image”, pointed out Martín. In this regard he added that “the images are found in a formato Dicom (Digital Imaging and Communication On Medicine)which is how the communication of images in Medicine is produced”. However, with this format a main problem arises and that is that “the 3D printer does not accept Dicom images, it only accepts other types of formats” which, according to Martín, are the following:
- STL format (Standar Tessellation Language): This standard tessellation language defines surfaces as a collection of triangles, called facets, that are put together like a puzzle, and the more triangles you get, the more precision you get.
- AMF format (Additive Manufacturing File Format) that is designed to overcome the limitations of the STL and allows features such as surface texture, color, and material properties to be incorporated into each part.
Likewise, Martín has also expressed during his speech all the process that is carried out for 3D printing. It begins with “the obtaining the imagecontinue with the segmentation (not everything is printed, only what is needed), continue with the step of change dicom format to stl and finally the Print of the model“. Regarding the first step of obtaining the image, Martín explained that “high resolution images neededpreferably collected through CT, since they have high contrast, high spatial resolution and minimize the effect of partial volume”.
The symbiosis between doctors and engineers
The radiologist has specified that, when carrying out all these tasks, it is necessary to talk about “the symbiosis of doctors and engineers“. To carry out the four steps mentioned above, Martín has expressed that “the first part of obtaining the images is done by the X-ray technicians. Subsequently, they are reviewed by the radiologist who is the one who performs the segmentation, that is, ‘draws’ which part can be printed, since not everything is printed. And, in the third step of change dicom format to stl it is carried out by the engineers with the medical team, and from there, the last one is carried out, which would be the 3d print“.
“Teamwork creates the almost perfect symbiosis between doctors and engineers. A real symbiosis, nothing futuristic”
For Martín, all of this is “teamwork and create that almost perfect symbiosis between doctors and engineers. A symbiosis that is real, nothing futuristic because it is already providing solutions to patients.”
Clinical applications of 3D printing
Martín has also listed what are the clinical applications that the 3d print and has highlighted some such as the Cardiologyvascular and column cases such as the complex scoliosis, among other. In fact, the radiologist has given an example that is only done in the United States and it is “the impression of the face of a patient who has had an accident and has suffered facial trauma. Therefore, they print the face of the deceased patient and reconstruct the possible deformations it has suffered”.
In this sense, the radiologist explained that the advantages of 3D printing “They are, fundamentally, surgical planning and the reduction of time in the operating room. This reduction supposes a saving that exceeds what the manufacture of the object is worth. In addition, reduces time in the operating roomwhich means that the patient spends less time in the ICU, fewer complications and, thus, hospital discharge is brought forward”. To all this, Martín has pointed out that, “despite all these advantages, 3d printing It can’t be done for all patients, but for special ones.”
“3D printing contributes in teaching, in healthcare practice and in research and innovation”
Lastly, the radiologist wanted to put on the table a new line that his hospital is already working on and that is “tissue printing using so-called bioinks. What is done is liposuction, the fat is extracted from the one you get the stem cells and the differences to the tissue you want to print. Those cells are printed, sterilized and placed”. Ultimately, “the 3D printing contributes in teaching, in healthcare practice and in research and innovationMartin concluded.
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