Individualized Intracranial Tumor Models Created with 3D Printer, an Early Clinical Experience

Yıl 2020, Cilt: 2 Sayı: 1, 97 - 102, 15.06.2020

Orhan Kalemci Ceren Kızmazoğlu , Ege Coşkun , R. Bugra Husemoglu , Murat Atar , Gündüz Kadir İstan Bilal Kılıçarslan Beyza Alkış Hasan Aydın

Öz

Intracranial tumors located at an eloquent cortical site have challenges during a radical resection and may cause serious morbidity. Several techniques are used to prevent such morbidity and recently addition of 3D printer technology provides the surgeon to plan the surgery on a model preoperatively, thus helps lowering morbidity. 9 patients with cortically located tumors were operated in our institutions planned preoperatively on a 3D printed model. Individualized 3D printed models for preoperative planning in patients with cortically located tumors were created successfully throughout this study. Most of the previous studies regarding utilization of 3D printers in neurosurgery focused on cranial deformities and intracranial aneurysm models. Tumors invading normal glial tissue set a challenge for creating 3D printed models for the disease. Future prospective studies are essential to prove the efficiency of the model in terms of reduced morbidity and better surgical outcome.

Anahtar Kelimeler

Intracranial tumor, 3D printer, Neurosurgery education

3 Boyutlu Yazıcı ile Kişiye Özel Beyin Tümörü Modelleri, Erken Klinik Deneyim

Öz

Değerli ve fonksiyonel kortikal bölgelerde yer alan intrakranial tümörlerin radikal rezeksiyonu esnasında çeşitli güçlüklerle karşılaşılabilir ve bu ciddi morbiditeye sebep olabilir. Bu tarz bir morbiditenin önüne geçmek için farklı yöntemler kullanılabilir. Yakın bir geçmişte 3 boyutlu yazıcı teknolojisinin eklenmesi ile cerrah, preoperatif olarak model üzerinde planlama yapabilir. Böylece morbiditenin azaltılmasına yardımcı olunabilir. Kliniklerimizde kortikal yerleşimli tümörleri olan 9 hasta, 3 boyutlu (3B) model üzerinde preoperatif hazırlık yapılarak opere edildiler. Nöroşirurjide 3B yazıcılarla ilgili bundan önceki çalışmaların birçoğunda kranial deformite cerrahileri ve anevrizmal modelleri üzerinde durulmuştu. Normal glial dokulara invazyon gösteren tümörlerin modellenmesi görece zor olup, bu tarz modellemelerin daha iyi cerrahi sonuçlar sağlayabileceğinin değerlendirilmesi açısından prospektif çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

İntrakranial tümör, 3 boyutlu yazıcı, Nöroşirurji eğitimi

Kaynakça

• 1. McNeill KA. Epidemiology of Brain Tumors. Neurol Clin. 2016 Nov;34(4):981–98.
• 2. Duffau H. Is non-awake surgery for supratentorial adult low-grade glioma treatment still feasible? Neurosurg Rev. 2018 Jan;41(1):133–9.
• 3. Wang L, Ye X, Hao Q, Chen Y, Chen X, Wang H, et al. Comparison of Two Three-Dimensional Printed Models of Complex Intracranial Aneurysms for Surgical Simulation. World Neurosurg [Internet]. 2017;103:671–9. Available from: http://www.sciencedirect.com/science/article/pii/S187887501730606X
• 4. Ploch CC, Mansi CSSA, Jayamohan J, Kuhl E. Using 3D Printing to Create Personalized Brain Models for Neurosurgical Training and Preoperative Planning. World Neurosurg [Internet]. 2016;90:668–74. Available from: http://www.sciencedirect.com/science/article/pii/S1878875016003260
• 5. Park S, Park E-K, Shim K-W, Kim D-S. Modified Cranioplasty Technique Using 3-Dimensional Printed Implants in Preventing Temporalis Muscle Hollowing. World Neurosurg [Internet]. 2019;126:e1160–8. Available from: http://www.sciencedirect.com/science/article/pii/S187887501930703X
• 6. Randazzo M, Pisapia JM, Singh N, Thawani JP. 3D printing in neurosurgery: A systematic review. Surg Neurol Int. 2016;7(Suppl 33):S801–9.
• 7. Trimble G, McStravick C, Farling P, Megaw K, McKinstry S, Smyth G, et al. Awake craniotomy for glioma resection: Technical aspects and initial results in a single institution. Br J Neurosurg. 2015;29(6):836–42.
• 8. Okonogi S, Kondo K, Harada N, Masuda H, Nemoto M, Sugo N. Operative simulation of anterior clinoidectomy using a rapid prototyping model molded by a three-dimensional printer. Acta Neurochir (Wien). 2017 Sep;159(9):1619–26.
• 9. Oishi M, Fukuda M, Yajima N, Yoshida K, Takahashi M, Hiraishi T, et al. Interactive presurgical simulation applying advanced 3D imaging and modeling techniques for skull base and deep tumors. J Neurosurg. 2013 Jul;119(1):94–105.
• 10. Lan Q, Chen A, Zhang T, Li G, Zhu Q, Fan X, et al. Development of Three-Dimensional Printed Craniocerebral Models for Simulated Neurosurgery. World Neurosurg [Internet]. 2016;91:434–42. Available from: http://www.sciencedirect.com/science/article/pii/S1878875016301966
• 11. Van de Belt TH, Nijmeijer H, Grim D, Engelen LJLPG, Vreeken R, van Gelder MMHJ, et al. Patient-Specific Actual-Size Three-Dimensional Printed Models for Patient Education in Glioma Treatment: First Experiences. World Neurosurg. 2018 Sep;117:e99–105.
• 12. Lin J, Zhou Z, Guan J, Zhu Y, Liu Y, Yang Z, et al. Using Three-Dimensional Printing to Create Individualized Cranial Nerve Models for Skull Base Tumor Surgery. World Neurosurg. 2018 Dec;120:e142–52.
• 13. Damon A, Clifton W, Valero-Moreno F, Quinones-Hinojosa A. A Cost-Effective Method for 3D Printing Dynamic Multi-Object and Patient-Specific Brain Tumor Models: Technical Note. World Neurosurg. 2020 Apr.
• 14. Thawani JP, Singh N, Pisapia JM, Abdullah KG, Parker D, Pukenas BA, et al. Three-Dimensional Printed Modeling of Diffuse Low-Grade Gliomas and Associated White Matter Tract Anatomy. Neurosurgery. 2017 Apr;80(4):635–45.