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High tech patient education in a value based world: a low-cost production method for 3D printing kidney models
Upper Lobby
High tech patient education in a value based world: a low-cost production method for 3D printing kidney models
IntroductionEmpowering patients to make informed decisions about their health is foundational in the transition to value based care. Patients with small kidney cancers face a spectrum of treatment options... Read more

Description

Introduction
Empowering patients to make informed decisions about their health is foundational in the transition to value based care. Patients with small kidney cancers face a spectrum of treatment options ranging from surveillance to radical nephrectomy, with important tradeoffs in terms of survival, risks, and renal dysfunction. Our previous work has found that patients lack basic anatomic knowledge that in a crucial component of making informed decisions when faced with this choice. 3D printing provides an exciting avenue to educate patients about their disease with individualized physical models that they can examine in the office setting. Until recently this technology has been expensive, ($750/model), precluding routine use in the clinical setting. We developed a low-cost, open source method to print 3D kidney models for use in patient education.

Methods
An open source program used for CT visualization and medical image computing (3D Slicer) was modified with an algorithm used for identification of necrotic nodes on PET imaging. The tumor and the normal renal architecture were extracted in series using this modification. The resulting file underwent Laplacian smoothing to remove artifact and was scaled and repaired using two additional open source programs designed for processing and editing of unstructured 3D triangular meshes (Netfabb, MeshLab). The resulting model was sliced and printed using an open source printer driver and a budget, dual extruder 3D printer (MakerBot Desktop, FlashForge Creator Pro).

Results
3D models of several sizes and tumor configuration were printed. The normal kidney parenchyma was printed in clear, with the tumor in red. The extraction and creation of a printable file took on average 30 minutes. A 1/3 scale kidney and tumor took on average 1 hour to print, while the print time for a full size model averaged 3 hours. The definition and quality of the model was excellent, and the detail suitable for patient education. The models were printed in biodegradable thermoplastics, and materials cost for a full size model averaged $6.25.

Conclusions
While the use of 3D printing in healthcare has been limited, it provides an exciting avenue for expedited production of patient-specific educational tools. Previous methods for printing have utilized industry-specific computer programs to extract data from CT and MRI imaging, as well as industrial quality printing. By modification of existing open-source programs and use of a low-cost printer, these models can be produced for $6.25 and with minimal labor. This method has the potential for application across multiple organ and tumor types, thus providing myriad clinicians and patients access to this innovative educational tool.

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