Three Dimensional Radiologic Visualization and Modeling in

Clinical PracticeKaylesh Pandya, OMS-IV

Nova Southeastern University College of Osteopathic Medicine

Objectives

• Overview of diagnostic radiology technologies, shortfalls

• Introduce Osirix DICOM viewer and demonstrate 3D reconstructions

• 3D Printing and modeling of CT using a MakerBot

Introduction

• Diagnostic radiology is a staple of most fields of medicine - guides both diagnosis and treatment• Taught as a core competency starting in medical school• Requires understanding and knowledge of anatomy,

imaging modality physics, • 'thinking in three dimensions while seeing in only two'

• Only 1.2% of US physicians are radiologists (AMA)• Even fewer patients are radiologists!• Communicating radiology findings between medical

professionals and with patients can be difficult

DICOM Medical Imaging Format

Digital Imaging and COmmunications in Medicine• Industry standard file format and network communication

protocol for storing, retrieving, and manipulating medical imaging 

• Allows for centralized server storage of radiology studies• PACS - Picture Archiving and Communication System

• "Mix and match" DICOM viewers depending on specialty and modality:• X-ray• CT• MRI• PET / PET-CT• U/S• Bone Scan

Imaging studies

• Radiology modalities and technologies are evolving, yet interpreting these studies has remained relatively static• PACS systems• 2D viewing on-screen• Printed films• Outside studies on CD

• Different viewers depending on the imaging center• May not be opened on hospital-owned computers

(security settings)• Difficult to view radiologic imaging at point-of-care

OSIRIX - osirix-viewer.com

• Full featured DICOM / PACS viewing system for Mac• Free for non-medical use, $600 for FDA-approved

• iPad / iPhone version• Extensive 3D (4D, 5D) viewing capability in clinical context• Can export and interoperate with 3D modeling formats

• Same tools used in other industries & sciences• Virtual Reality• CNC Mills • Rapid Prototyping

• MakerBot• P&O?

2D vs 3D Visualization of a CVA 

•B.E.: 70M c/o 3 days confusion, difficulty reading

•CT: Large left-sided parietal-occipital hemorrhage

•Neuro: Transcortical sensory aphasia

3D Visualization of a Head Trauma

• 20Y, unknown history (anonymized CT)

• s/p L Decompressive Craniectomy

• s/p L Inferior Orbit Reconstruction

3D CT Reconstructions Using OSIRIX

3D Modeling using a Makerbot• Automated 3D Desktop printer

• Uses ABS, PVA, PLA extruded through a heated nozzle

• ~$1500, sold as a DIY kit (similar to IKEA)

• Open source designAllows and encourages users to modify their Makerbot

Makerbot 101 (makerbot.com)

Workflow for CT to MakerBotData Transformation Resource

Export CT to ‘Surface Rendered’ Object

•Pick appropriate density level for imaging

Osirix (osirix-viewer.com)

“Clean up” 3D model•Reduce detail level•Fill in dead spaces•Add scaffolding

Blender (blender.org)MeshLab (meshlab.sourceforge.net)SketchUp (sketchup.google.com

Generate Machine Code and print to MakerBot

ReplicatorG (replicat.org)

MakerBot (makerbot.com

Applications and Implications• Patient and family education

• Surgical and Rehab planning

• Medical education

• Prosthetics and Orthotics prototyping

• FDA – approved implantable parts in the future?

• HIPAA issues of manufacturing 3D models?

• Souvenirs?

Acknowledgements

Allhandsactive.com @Ech0labs Matthew Oishii

Blender.org

hackerspaces.org @hackerspaces

@i3detroit i3detroit.com

@makerbot wiki.makerbot.com

Osirix-viewer.com