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Use of patient specific 3D printed neurovascular phantoms to evaluate the clinical utility of a high resolution x-ray imager

机译:使用患者特定的3D打印的神经血管模型来评估高分辨率X射线成像仪的临床实用性

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摘要

Modern 3D printing technology can fabricate vascular phantoms based on an actual human patient with a high degree of precision facilitating a realistic simulation environment for an intervention. We present two experimental setups using 3D printed patient-specific neurovasculature to simulate different disease anatomies.To simulate the human neurovasculature in the Circle of Willis, patient-based phantoms with aneurysms were 3D printed using a Objet Eden 260V printer. Anthropomorphic head phantoms and a human skull combined with acrylic plates simulated human head bone anatomy and x-ray attenuation. For dynamic studies the 3D printed phantom was connected to a pulsatile flow loop with the anthropomorphic phantom underneath. By combining different 3D printed phantoms and the anthropomorphic phantoms, different patient pathologies can be simulated. For static studies a 3D printed neurovascular phantom was embedded inside a human skull and used as a positional reference for treatment devices such as stents. To simulate tissue attenuation acrylic layers were added. Different combinations can simulate different patient treatment procedures.The Complementary-Metal-Oxide-Semiconductor (CMOS) based High Resolution Fluoroscope (HRF) with 75μm pixels offers an advantage over the state-of-the-art 200 μm pixel Flat Panel Detector (FPD) due to higher Nyquist frequency and better DQE performance. Whether this advantage is clinically useful during an actual clinical neurovascular intervention can be addressed by qualitatively evaluating images from a cohort of various cases performed using both detectors. The above-mentioned method can offer a realistic substitute for an actual clinical procedure. Also a large cohort of cases can be generated and used for a HRF clinical utility determination study.
机译:现代3D打印技术可以根据实际的人类患者制造血管模型,具有很高的精度,从而为干预提供了逼真的模拟环境。我们提供了两种使用3D打印的患者特定神经脉管系统模拟不同疾病解剖结构的实验装置。为了模拟Willis环中的人类神经脉管系统,使用Objet Eden 260V打印机3D打印基于患者的动脉瘤体模。拟人化的头部幻像和人类的头颅与丙烯酸板相结合,模拟了人类头部的骨骼解剖和X射线衰减。为了进行动态研究,将3D打印体模连接到脉动流环,并在其下方具有拟人化体模。通过组合不同的3D打印体模和拟人体模,可以模拟不同的患者病状。对于静态研究,将3D打印的神经血管幻影嵌入到人类头骨内,并用作诸如支架之类的治疗设备的位置参考。为了模拟组织衰减,添加了丙烯酸层。不同的组合可以模拟不同的患者治疗程序。基于互补金属氧化物半导体(CMOS)的高分辨率荧光镜(HRF)像素为75μm,相对于最新的200μm像素平板探测器(FPD)具有优势)的原因在于更高的奈奎斯特频率和更好的DQE性能。可以通过定性评估使用两个检测器执行的各种病例队列中的图像来解决这种优势在实际的临床神经血管介入治疗过程中是否在临床上有用的问题。上述方法可以为实际的临床程序提供现实的替代。还可以生成大量病例,并将其用于HRF临床效用确定研究。

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