GOODNEWS

It was summer 2016 when Narutoshi Hibino began collaborating with graduate student Sarah Chen on a peculiar puzzle: Could they produce a three-dimensional model of a baby’s heart?
A cardiac surgeon at the Johns Hopkins Hospital and assistant professor of surgery at the Johns Hopkins University School of Medicine, Hibino’s surgical experience is in treating adult and pediatric patients with congenital heart diseases. One such disease is hypoplastic left heart syndrome, a birth defect that affects normal blood flow and usually requires repairing the blood vessels coming out of the heart. Congenital diseases are tricky in that no two hearts are alike; the heart and vessels of each patient are unique. Hibino wanted a pediatric heart model created to mimic a patient’s exact anatomy.
In early 2017, Hibino teamed up with Juan Garcia, director of the hospital’s new 3-D print facility. Their collaboration combined surgical expertise, medical illustration, and cutting edge engineering to devise a solution. They received a Johns Hopkins Hospital Women’s Board grant to take 3-D printed models from concept to clinical reality.
“It started off as a research effort,” Garcia recalls. “But the 3-D print facility envisions a service around creating clinical prints, especially for surgical planning.” An associate professor in the Department of Art as Applied to Medicine and a medical artist by training, Garcia has been applying advanced technologies since 2003, such as 3-D scanning and printing for facial prosthetics in clinical cases. With the new grant, the 3-D print facility was able to purchase what was needed to produce models from CT or MRI imaging data, using state-of-the-art software.
“The CT or MRI data can be visualized using virtual reality software and quickly converted to a high-quality 3-D print,” says Garcia.
Through 3-D printing, a model is built with layers of molten or light-cured plastic resin. Large companies, like Ford and General Electric, use 3-D printing to make intricate parts that cannot be made through traditional manufacturing. But 3-D printing can also be used in healthcare to produce accurate, scaled models of human organs that are rigid or flexible, colorized or clear. What’s more, with virtual reality, users can interact with 3-D data, rotating and viewing cross-sections of some of the anatomical models to quickly convert 3-D images to a form that’s ready to print.
Over the last few years, 3-D printing and virtual reality visualization have become popular topics in the medical field, particularly for preplanning surgeries.
“This is a very hot topic in radiology and surgery,” says Jeffrey Siewerdsen, professor of biomedical engineering and co-director of the Carnegie Center for Surgical Innovation, which houses the new 3-D print facility. “And it is great to see the technology put to meaningful use for clinicians.”
But it wasn’t until February 2016, with the purchase of the facility’s first printer, that the Johns Hopkins Hospital could produce complex 3-D prints in-house. The impetus came from the clinic, specifically, the Department of Neurosurgery. With support from a patient’s generous donation, neurosurgeons and biomedical engineers set out to create new capabilities for 3-D printing at Johns Hopkins. The patient’s donation was matched with support from the Johns Hopkins Institute for Clinical and Translational Research and the printer’s manufacturer, Stratasys.
The genesis of the new 3-D print facility at Johns Hopkins illustrates just how transformational 3-D printing can be, putting patient-specific organ models into the hands of surgeons, and giving patients a better understanding of their own medical condition.
“Patients gain a better understanding of their condition when they hold a model of their heart or brain tumor,” says Siewerdsen. “It gives an entirely different level of understanding than just looking at an MRI scan.”
Garcia says the facility is now assembling the assets it needs to serve surgeons and clinicians at Johns Hopkins Hospital. He plans to work with physicians and researchers across departments, including Surgery, Otolaryngology, and Radiation Oncology in order to bring 3-D printing into the mainstream of modern medicine through patient education, surgical planning, and surgical simulation.
– Andrew Zaleski