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Planning and practising invasive paediatric procedures in advance using 3D models

Comprehensive Center for Pediatrics of MedUni Vienna and University Hospital Vienna develops customised patient simulation models using 3D printing
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Patient-specific simulation training to relieve pneumothorax in the chest model of a premature baby

(Vienna, 16 June 2020) 3D models based on medical imaging enable doctors to plan, simulate and practice invasive and/or surgical procedures on children in advance. In a MedUni Vienna interdisciplinary research project, the anatomies and individual pathologies of children are accurately replicated using 3D printing. This allows procedures to be planned in detail and increases the safety of the young patients.

As well as excellent expert knowledge, invasive procedures also require the best possible insight into the individual circumstances of the patients being treated, keyword precision medicine. In a joint project led by Michael Wagner and Tobias Werther from the Department of Pediatrics and Adolescent Medicine/Comprehensive Center for Pediatrics, Ewald Unger and Gunpreet Oberoi, collaborators in the FFG-funded infrastructure project M3dRES (Francesco Moscato) at the Center for Medical Physics and Biomedical Engineering, together with Gregor Kasprian from the Department of Radiology and Christian Dorfer from the Department of Neurosurgery of MedUni Vienna within University Hospital Vienna, have reconstructed detailed digital models using 3D ultrasound, CT and MRI scans and converted them into anatomical models by additive manufacturing (3D printing).

3D model with a brain, skull bone and side ventricle of a premature baby (cut off for a better view)

These models can be used, for example, to plan, simulate and practice surgical procedures in detail, for example operations following brain haemorrhage in premature babies. "At the Department of Pediatrics and Adolescent Medicine, we are able to use 3D ultrasound to quickly and easily generate a map of the brain structures," says neonatologist Michael Wagner, explaining the process, "this data is then used to produce an accurate model of the affected area, for example the ventricular system in the brain, using 3D printing. This model then provides the treating neurosurgeon with a template for planning the most effective and conservative operation."

This project, which is being funded by a starter grant from the Comprehensive Center for Pediatrics (CCP) of MedUni Vienna and Vienna General Hospital, will now be followed by further steps in the context of an interdisciplinary "CCP Innovation Labs".

Precision medicine thanks to customised models
In the spirit of precision medicine, further 3D models of child anatomy are now being produced for the purposes of simulation and training and are to be used, in future, alongside printed models with the aid of Virtual/Augmented Reality for simplified interactions. In addition to the standard commercial models available, doctors and students can practice on the more complex, customised and, hence, more informative models that are essential to a university department, for example thoracic models to practice relieving pneumothorax in premature babies weighing less than 1000g. This project is currently being funded by an international INSPIRE Innovation Funding Award obtained by Michael Wagner. "We are able to practice the treatment of actual complex cases in advance and we are also able to simulate realistic interventions for a specific anatomy or pathology for training purposes," explains Angelika Berger, Head of the Comprehensive Center for Pediatrics and the Division of Neonatology, Intensive Care Medicine and Neuropediatrics, "that gives the treating doctors more confidence and practice, thereby increasing patient safety."