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      Making three-dimensional echocardiography more tangible: a workflow for three-dimensional printing with echocardiographic data

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          Abstract

          Three-dimensional (3D) printing is a rapidly evolving technology with several potential applications in the diagnosis and management of cardiac disease. Recently, 3D printing (i.e. rapid prototyping) derived from 3D transesophageal echocardiography (TEE) has become possible. Due to the multiple steps involved and the specific equipment required for each step, it might be difficult to start implementing echocardiography-derived 3D printing in a clinical setting. In this review, we provide an overview of this process, including its logistics and organization of tools and materials, 3D TEE image acquisition strategies, data export, format conversion, segmentation, and printing. Generation of patient-specific models of cardiac anatomy from echocardiographic data is a feasible, practical application of 3D printing technology.

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          Most cited references13

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          Three-Dimensional Printing and Medical Imaging: A Review of the Methods and Applications.

          The purpose of this article is to review recent innovations on the process and application of 3-dimensional (3D) printed objects from medical imaging data. Data for 3D printed medical models can be obtained from computed tomography, magnetic resonance imaging, and ultrasound using the Data Imaging and Communications in Medicine (DICOM) software. The data images are processed using segmentation and mesh generation tools and converted to a standard tessellation language (STL) file for printing. 3D printing technologies include stereolithography, selective laser sintering, inkjet, and fused-deposition modeling . 3D printed models have been used for preoperative planning of complex surgeries, the creation of custom prosthesis, and in the education and training of physicians. The application of medical imaging and 3D printers has been successful in providing solutions to many complex medical problems. As technology advances, its applications continue to grow in the future.
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            European Association of Echocardiography recommendations for standardization of performance, digital storage and reporting of echocardiographic studies.

            In view of the European Association of Echocardiography (EAE) mission statement "To promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular ultrasound in Europe" and the increasing demand for standardization and quality control, the EAE have established recommendations and guidelines for standardization of echocardiography performance, data acquisition (images, measurements and morphologic descriptors), digital storage and reporting of echocardiographic studies. The aim of these recommendations is to provide a European consensus document on the minimum acceptable requirements for the clinical practice of echocardiography today and thus improve the quality and consistency of echocardiographic practice in Europe.
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              Three-dimensional printing of intracardiac defects from three-dimensional echocardiographic images: feasibility and relative accuracy.

              With the advent of three-dimensional (3D) printers and high-resolution cardiac imaging, rapid prototype constructions of congenital cardiac defects are now possible. Typically, source images for these models derive from higher resolution, cross-sectional cardiac imaging, such as cardiac magnetic resonance imaging or computed tomography. These imaging methods may involve intravenous contrast, sedation, and ionizing radiation. New echocardiographic transducers and advanced software and hardware have optimized 3D echocardiographic images for this purpose. Thus, the objectives of this study were to confirm the feasibility of creating cardiac models from 3D echocardiographic data and to assess accuracy by comparing 3D model measurements with conventional two-dimensional (2D) echocardiographic measurements of cardiac defects.
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                Author and article information

                Journal
                Echo Res Pract
                Echo Res Pract
                echo
                Echo Research and Practice
                Bioscientifica Ltd (Bristol )
                2055-0464
                December 2016
                14 December 2016
                : 3
                : 4
                : R57-R64
                Affiliations
                [1 ]Department of Anesthesia and Pain Management , Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada
                [2 ]Department of Anesthesia , Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
                [3 ]Division of Cardiac Surgery , Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
                [4 ]Department of Anesthesiology , University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
                Author notes
                Correspondence should be addressed to M Montealegre-Gallegos; Email: mmonteal@ 123456bidmc.harvard.edu
                Article
                ERP160036
                10.1530/ERP-16-0036
                5302065
                27974356
                633f16b9-7d8e-4f62-a6e3-25b66b1dda3d
                © 2016 The authors

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License .

                History
                : 2 December 2016
                : 14 December 2016
                Categories
                Review

                rapid prototyping,3d printing,transesophageal echocardiography,patient-specific models

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