3D Printing: Proceed with Caution

May 12, 2016
Ronald Schilling, PhD

3D printing has a promising future in radiology, if we take our time and manage expectations.

Many surgeons and imaging specialists have recognized the incredible potential of 3D printing. Using 3D printers, we can turn real patient data into actionable, physical objects. The applications are numerous - from custom size prosthetics to surgical models to sizing implants.

Companies and medical professionals are looking at a range of opportunities. Stratasys and Vital Imaging announced a partnership last year to offer a “print on demand” service. And at RSNA last year, you could hardly go 30 minutes without overhearing an excited conversation about 3D printing.

There have been incredible successes. Nicklaus Children’s Hospital in Miami has been one of the strongest early adopters in 3D printing. In October, they made headlines for a surgical operation on a rare congenital heart defect in a five-year-old girl. The surgeons printed a 3D model of her heart in order to fully understand its unusual anatomical structures and prepare for a successful operation.

Despite success stories like this, many questions remain about the road to mass adoption of 3D printing. Printers are expensive to buy and maintain, and the technology is always evolving. By buying now, hospitals run the risk of purchasing technology that will soon become outdated. And I don’t think the industry has determined exactly how 3D printing fits into everyday medical workflows. Nevertheless, hospitals are moving quickly to spend large amounts of money on printers.

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In a way, this whole situation reminds me of the 1990s, when hospitals were beginning to adopt PACS. Here was an exciting new technology, promising huge return on investment. People couldn’t stop talking about PACS, and the money followed the hype.

Hospitals spent millions on these systems, but they largely failed to address the workflow question. Following the investment in infrastructure, hospitals failed to invest in training and onboarding. Many CIOs refused to deal with PACS, and the systems frequently sat unused.

As a result, the whole market crashed, and it took years to recover. It wasn’t a problem with the technology, but with the timing and method of its adoption.

I worry that the same could happen with 3D printing. If you could print a model directly in the office, in a matter of minutes - that would be a tremendous asset. But 3D printing is notoriously slow. Creating a model makes sense for exceptional cases - like the heart surgery at Nicklaus - but perhaps not for everyday operations. There’s often too much effort for the output.

This begs the question: if hospitals spend millions on 3D printers, will doctors actually use them? Are there other ways to deliver some of the benefits of 3D printing, at faster speeds and without spending so much money on a piece of equipment that could soon be outdated?

Another Option: Advanced Imaging Technologies
There’s another option that offers many of the same advantages to medical professionals, at much less cost. New imaging systems are emerging that create true volumetric images of patient anatomy. We call these virtual reality (VR) systems. Unlike today’s “3D” imaging, this is not a 3D view on a flat screen. Rather, it is a real-size interactive image (similar to a hologram) of a patient’s body part projected into open space.

Like a 3D printer, an interactive VR system can create a workable model from actual patient data. These help medical professionals understand anatomy, and even practice their operations. It also allows radiologists to provide a better product to surgeons - to communicate more intelligently, in a language (3D anatomy) that they both understand.

There are advantages to both technologies. Printed models have a physical consistency that more closely resembles body parts - you can hold them, and they provide resistance to incisions. But unlike prints, 3D images can be generated instantly, and with no cost for materials. In many cases, they can provide the same quality of information as 3D models. For example, doctors have seen huge success correctly sizing medical devices using VR systems.

Imaging systems also offer data analytics and feedback that you can’t obtain with a static model. A surgeon could practice an operation over and over again with virtual reality, with detailed feedback, and without needing to generate additional models. They can help radiologists communicate more effectively with surgeons, by letting them label patient anatomy and structures from multiple angles, at each step of the procedure.

They can also be dynamic - allowing doctors to visualize blood flow, for example, or to view anatomy from multiple angles. And they allow professionals to view and study many different models quickly and easily.

The Right Tool for the Right Situation
Ultimately, doctors will use both technologies; it’s a matter of choosing the right tool for the right situation. If adopted correctly, 3D printers and VR systems will bring tremendous benefit to the busy workflows of medical professionals. But let’s make sure 3D printing doesn’t become the latest technology to flounder due to poor timing and adoption strategy. As always, hospitals should carefully consider workflow, training, and all available options before rushing to buy.