3D Physical and Virtual Models in Fetal Medicine: Applications and Procedures

Description:

Technological innovations accompanying advances in medicine have given rise to the possibility of obtaining better-defined fetal images that assist in medical diagnosis and contribute toward genetic counseling offered to parents during the prenatal care. 3D printing is an emerging technique with a variety of medical applications such as surgical planning, biomedical research and medical education.

Clinical Relevance: 3D physical and virtual models from ultrasound and magnetic resonance imaging have been used for educational, multidisciplinary discussion and plan therapeutic approaches.

The authors describe techniques that can be applied at different stages of pregnancy and constitute an innovative contribution to research on fetal abnormalities. We will show that physical models in fetal medicine can help in the tactile and interactive study of complex abnormalities in multiple disciplines. They may also be useful for prospective parents because a 3D physical model with the characteristics of the fetus should allow a more direct emotional connection to their unborn child.

Introduction

The aim of this book is to demonstrate the current state of the art in terms of the production of 3D virtual and physical models in fetal medicine: the evolution from conventional representations to digital technologies, highlighting the improvements made during a period of continuous evolutionary technological progress including current and diverse topics as the use of artificial intelligence.

Basically, 3D virtual models can be developed and combined from three sources: built on software from coordinate input (parametric or not), from 3D scanning surface acquisition technologies (such as photogrammetry, laser scanners, and structured light), and directly from files obtained through noninvasive image technologies (such as 3D ultrasound, magnetic resonance imaging, computed tomography, and micro-CT scanners). In fetal medicine, volumetric images obtained by ultrasound or magnetic resonance imaging are used routinely to provide 3D models for surface/volumetric reconstruction.

Having the 3D data files, it is possible also to materialize very accurate and reliable physical models through additive manufacturing technologies. Nowadays, it is possible to physically reproduce features as color, specific gravity, densities, transparency, and even biomaterials, giving real characteristics to the final reproduced parts when compared to the human body.

The same data can be also used to develop virtual navigation (VN), giving the possibility to the user to traveling inside realistic 3D environment of the fetus and mother, allowing features as the visualization of fetal malformations, the umbilical cord, and placenta.

The VN can be experienced direct on a varied type of screens, ranging from mobile phones to computers, as well from virtual reality (VR) and augmented reality (AR) technologies that use software generated realistic images enriched by other senses, such as sound and tactile sensations through haptic technologies, to replicate an immersive sensation of a real body environment. VR/AR systems are growing in popularity in the medical community as clinicians and researchers become aware of its potential benefits and tend to increase the possibilities with the advent of metaverse also described on this book.

Table of contents :

Foreword
Introduction
Contents
Contributors
1: The Use of 3D Representations in Fetal Medicine
References
Part I: Digital Input
Digital Input.
2: Imaging Technologies: Ultrasound, Computed Tomography, Magnetic Resonance Imaging, Micro-CT, 3D Scanner
2.1 Ultrasound
2.2 Computed Tomography
2.3 Magnetic Resonance Imaging
2.4 Microtomography
2.5 3D Scanners and Photogrammetry
References
3: Post-processing Images to Generate the 3D Data
3.1 Segmentation
3.2 3D Models
3.2.1 Treatment and Smoothing
3.2.2 Models and Assemblies
3.3 Archives Format
References
Part II: Physical Output
Physical Output.
4: (3D) Printing Technologies
4.1 Fused Deposition Modeling (Solid-Based System) or FDM
4.2 Selective Laser Sintering (Powder-Based System) or SLS
4.3 BJT: Binder Jetting (Joined with Bonding Plaster/Gypsum)
4.4 Material Jetting (MJ)
4.5 Stereolithography (SLA)
4.6 Digital Light Processing/Liquid Crystal Display: DLP/ LCD
4.7 Availability
4.8 Cost per Model
4.9 Productivity
4.10 Ease of Use
4.11 Average Build Volume
4.12 Print Time
4.13 Resolution and Post-Processing
4.14 Material
4.15 How to Apply Each One
4.16 Conclusion
References
Part III: Virtual Output
Virtual Output.
5: Virtual Navigation on Expanded Reality Devices (Virtual Reality, Augmented Reality, and Expanded Reality)
References
6: Artificial Intelligence Techniques for Fetal Medicine
6.1 The Present State of AI
6.2 AI in Fetal Medicine
6.3 Challenges to AI Approaches in Fetal Medicine and General Evaluation Criteria
6.4 Example: Amniotic Fluid Segmentation
6.5 Conclusion
References
7: Metaverse in Fetal Medicine
7.1 From Virtuality Continuum to Internet 4.0
7.2 Expanded Reality for Mediatic Shared Experiences
7.3 Perspectives for Fetal Medicine and Experiments
References
Part IV: Applicability in Clinical Cases
8: Three-Dimensional Printing and Virtual Models in Fetal Medicine
8.1 Study of Fetal Pathologies
8.1.1 First Trimester
8.1.2 Second and Third Trimesters
8.1.3 Central Nervous System
8.1.3.1 Ventriculomegaly
8.1.3.2 Anencephaly
8.1.3.3 Holoprosencephaly
8.1.3.4 Microcephaly
8.1.3.5 Fetal Intracranial Hemorrhage
8.1.3.6 Chiari Malformation
8.1.3.7 Dandy-Walker Malformation
8.1.3.8 Encephalocele
8.1.4 Face
8.1.4.1 Cleft Lip and Palate
8.1.4.2 Tumors (Epignathus Teratoma)
8.1.5 Cervical Masses
8.1.5.1 Fetal Goiter
8.1.5.2 Lymphangioma
8.1.5.3 Teratoma
8.1.6 Chest Anomalies
8.1.6.1 Congenital Diaphragmatic Hernia
8.1.6.2 Congenital High Airway Obstruction Syndrome
8.1.7 Congenital Heart Disease
8.1.8 Abdominal Anomalies
8.1.8.1 Omphalocele
8.1.8.2 Gastroschisis
8.1.8.3 Limb–Body Wall Complex (LBWC)
8.1.8.4 Sacrococcygeal Teratomas
8.1.9 Genitourinary Anomalies
8.1.9.1 Lower Urinary Tract Obstruction
8.1.10 Fetal Musculoskeletal Disorders
8.1.11 Genetics
References
9: 3D Printing and Virtual Models Assisting Fetal Surgeries
9.1 Introduction
9.2 Rational for Fetal Surgery
9.2.1 Bidimensional Ultrasound (2D US) in Fetal Surgeries
9.2.2 Three-Dimensional Ultrasonography (3D US) and Four-Dimensional Ultrasonography (4D US) in Fetal Surgeries
9.2.3 3D Printing Models in Fetal Surgeries
9.2.4 Virtual Reconstruction in Fetal Surgery
9.3 Conclusion
9.4 Assistance for Fetal Surgery
References
10: Postnatal Surgery
10.1 Clinical Study 1 (Neurosurgery): Craniopagus Twins—A Challenge
10.2 Clinical Study 2 (Pediatric Surgery)
10.2.1 Jejunal and Ileal Atresia
10.2.2 Esophageal Atresia with Distal Fistula
10.2.3 Choledochal Cyst
References
11: Multiple Pregnancy
11.1 Introduction
11.2 The Role of Ultrasound
11.3 Computed Tomography and Magnetic Resonance Imaging
11.4 Multiplanar Ultrasound and Model Printing
11.5 Conclusions
References
12: Maternal–Fetal Attachment in Blind Women Using Physical Model
References
Part V: Experimental and Future Applications
13: Haptics/Force Feedback Technologies
13.1 Devices
13.1.1 Actuators
13.1.1.1 Haptic Gloves
13.1.1.2 Force Feedback Pen
13.2 Process
13.2.1 Optimization of the 3D Model
13.2.2 Visualization
13.2.3 Smoothness and Roughness
13.2.4 Tenacity Map
13.2.5 Deformity of the Surface
13.3 Case Study
References
14: Recent Advances in 3D Bioprinting Technologies and Possibilities for the Fetal Medicine
14.1 Introduction
14.2 Recent Advances in 3D Bioprinting Research
14.2.1 Placenta-on-a-Chip
14.2.2 3D Bioprinted Outer-Blood-Retina for Anti-Zika Small-Molecules Discovery
14.2.3 Bone Regeneration with 3D Bioprinting
14.2.4 Bioprinted Autologous Heart Valve Implants with Regenerative Capabilities and Life-Long Durability
14.3 3D Bioprinting and Fetal Medicine
14.4 Considerations
References