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{\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/53\\\/11\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;14\\\/53\\\/11\u0022}],\u0022ac\u0022:{\u0022spmdc;14\\\/53\\\/11\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;14\\\/53\\\/11\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EGood quality images are determined by number of dimensions, spatial resolution, signal-to-noise ratio, image contrast, and the presence of artifacts. This article presents an overview of 3D image acquisition with computed tomography and magnetic resonance from the perspective of obtaining accurate images suitable for 3D printing. Other topics include a review of the art of 3D visualization vs 3D printing, as well as the role of rapid prototyping using 3D printing technologies to assist surgeons in optimizing surgical decisions.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eimaging\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ethree dimensional\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EKarin E. Dill, MD, University of Chicago, Chicago, Illinois, USA, presented an overview of 3D image acquisition with computed tomography (CT) and magnetic resonance (MR) from the perspective of obtaining accurate images suitable for 3D printing. Good quality images are determined by number of dimensions, spatial resolution, signal-to-noise ratio, image contrast, and the presence of artifacts.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003ETypical MR slices are 1 to 10 mm thick and CT slices range from 0.5 to 5 mm. The anatomic structure may not be perfectly homogeneous across each slice. Two-dimensional imaging, therefore, should be considered an average of the image information. Two-dimensional images are representative of tissue slices, while 3D images reflect a volume rather than a slice.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EDuring CT, cross sections of the body are irradiated. CT generates 2D radiographic images taken around a single axis of rotation, obtained in an arc in the transverse plane. They provide one channel of spatial data.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EThree-dimensional images can be generated in the axial plane, perpendicular to the z-axis plane. Multisection CT scans with multiple rows of detectors along the longitudinal (z) axis of the patients can generate stacks of data for 3D images. Further, 3D imaging offers a more complete representation of all the tissue in a given region, the ability to postprocess and reformat images into any slice plane, and a better representation of tissue geometry and relationships between structures.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003ESpatial resolution is related to the ratio of field of view and number of voxels in the image or matrix. Voxels that are the same size in all 3 dimensions (x, y, z) are referred to as isotropic voxels. Spatial resolution defines the smallest features that may be detected in the image. This can be complicated by the signal-to-noise ratio, which determines the ratio of the useful data to the nonuseful data, and must be adequate for tissue signals in routine CT and MR scans.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EMichael L. Steigner, MD, Brigham and Women\u0027s Hospital and Harvard Medical School, Boston, Massachusetts, USA, reviewed the art of 3D visualization vs 3D printing.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EUntil recently, heart imaging focused mainly on retrospectively gated computed tomography angiography (CTA). A new technique, prospective gating, has gained attention as a way to reduce radiation dose in addition to improving image quality. With prospective gating, CT data acquisition is synchronized with the cardiac cycle. Images reconstructed during the cardiac phases with minimum motion are of higher quality and have less motion artifact (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). For instance, a study that assessed the relationship between the phase window width and image quality in prospectively electrocardiogram-gated 320-detector row coronary CTA showed that a phase window width of 10% reduces patient radiation and yields diagnostic images in \u0026gt; 90% of patients [Steigner ML et al. \u003Cem\u003EInt J Cardiovasc Imaging.\u003C\/em\u003E 2009]. Further, heart rate control was found to be an important component of 320-detector row prospectively gated CT dose reduction.\u003C\/p\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/53\/11\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Three-Dimensional Volume Rendered on Multiple-Detector Computed Tomography\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1839249083\u0022 data-figure-caption=\u0022Three-Dimensional Volume Rendered on Multiple-Detector Computed Tomography\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/53\/11\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/53\/11\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/53\/11\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16390\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-9\u0022 class=\u0022first-child\u0022\u003EThree-Dimensional Volume Rendered on Multiple-Detector Computed Tomography\u003C\/p\u003E\n            \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from ML Steigner, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EColor correction of the scan can be performed using the Color Look Up Table, which renders objects that may normally be hidden. Dr Steigner described the use of 3D visualization for detecting bend relief disconnection in patients implanted with left ventricular assist devices (\u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E) [Waller AH et al. \u003Cem\u003ECirc Cardiovasc Imaging.\u003C\/em\u003E 2014].\u003C\/p\u003E\n         \u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/53\/11\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Three-Dimensional Visualization of Bend Relief Disconnection of Implanted Left Ventricular Assist Device\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1839249083\u0022 data-figure-caption=\u0022Three-Dimensional Visualization of Bend Relief Disconnection of Implanted Left Ventricular Assist Device\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 2.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/53\/11\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/53\/11\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 2.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/53\/11\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16483\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 2.\u003C\/span\u003E \n               \u003Cp id=\u0022p-11\u0022 class=\u0022first-child\u0022\u003EThree-Dimensional Visualization of Bend Relief Disconnection of Implanted Left Ventricular Assist Device\u003C\/p\u003E\n            \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EArrow demonstrates a complete disconnection of the bend relief from the sealed outflow graft.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-3\u0022\u003EReproduced from Waller AH et al. Evaluation of bend relief disconnection in patients supported by a HeartMate II left ventricular assist device. \u003Cem\u003ECirc Cardiovasc Imaging.\u003C\/em\u003E 2014;7(5):844\u2013848. With permission from American Heart Association, Inc.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-12\u0022\u003EOnce a good image that reflects the anatomic structure in question has been captured, postprocessing software is used to render the image into a 3D object. The 3D data set can be reformatted using several types of postprocessing algorithms. This might include volume rendering, multiplanar reformation, thin-slab maximum intensity projection, curved multiplanar reformation, angiographic view, and plaque-loaded angiographic view. The interpreter should know the advantage and disadvantage of each postprocessing 2D and 3D image and renderings before the final printing. Multidetector CT is a first-line modality for pretreatment planning and imaging to detect hidden deformities. Proper data collection, surface rendering, and stereolithographic editing can produce detailed skeletal and soft tissue structures from CT and MRI data that cannot be adequately conveyed through a computer screen.\u003C\/p\u003E\n         \u003Cp id=\u0022p-13\u0022\u003EShi-Joon Yoo, MD, University of Toronto, Toronto, Ontario, Canada, discussed the role of rapid prototyping using 3D printing technologies to assist surgeons in optimizing surgical decisions. Physical heart replicas can fill the gap between the imagination of the medical images and reality, as well as simulate the intended procedures to improve accuracy and reduce procedure and anesthesia time.\u003C\/p\u003E\n         \u003Cp id=\u0022p-14\u0022\u003ERapid prototyping includes multiple technologies, methods, and materials. Three-dimensional technologies such as selective laser sintering, electron beam melting, inkjet technology, stereolithography (STL), fused deposition modeling, laminated object manufacturing, and 3D microfabrication are routinely being employed for this process.\u003C\/p\u003E\n         \u003Cp id=\u0022p-15\u0022\u003EOnce the imaging is complete, the multislice digital images are partitioned into multiple segments that locate objects and boundaries, creating a set of contours that defines the structure. Image segmentation is then used to create a 3D reconstruction using a Digital Imaging and Communications in Medicine (DICOM) data set. DICOM supports the distribution and viewing of medical images from CT, MRI, and other medical modalities. The DICOM data are converted STL for manufacturing with resin and solidification with UV light.\u003C\/p\u003E\n         \u003Cp id=\u0022p-16\u0022\u003ERapid prototyping of vessel and heart deformities as 3D replicas is feasible and can aid in planning procedural time, dosing, and cost. In congenital heart disease surgery, the replicas are of tremendous help for making surgical decisions.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/53\/11.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzlseq\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlseq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}