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      3D printing of radioactive phantoms for nuclear medicine imaging

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          Abstract

          Background

          For multicenter clinical studies, PET/CT and SPECT/CT scanners need to be validated to ensure comparability between various scanner types and brands. This validation is usually performed using hollow phantoms filled with radioactive liquids. In recent years, 3D printing technology has gained increasing popularity for manufacturing of phantoms, as it is cost-efficient and allows preparation of phantoms of almost any shape. So far, however, direct 3D printing with radioactive building materials has not yet been reported. The aim of this work was to develop a procedure for preparation of 99mTc-containing building materials and demonstrate successful application of this material for 3D printing of several test objects.

          Method

          The desired activity of a [ 99mTc]pertechnetate solution eluted from a 99Mo/ 99mTc-generator was added to the liquid 3D building material, followed by a minute amount of trioctylphosphine. The resulting two-phase mixture was thoroughly mixed. Following separation of the phases and chemical removal of traces of water, the radioactive building material was diluted with the required volume of non-radioactive building material and directly used for 3D printing.

          Results

          Using our optimized extraction protocol with trioctylphosphine as complex-forming phase transfer agent, technetium-99m was efficiently transferred from the aqueous 99Mo/ 99mTc-generator eluate into the organic liquid resin monomer. The observed radioactivity concentration ratio between the organic phase and the water phase was > 2000:1. The radioactivity was homogeneously distributed in the liquid resin monomer. We did not note differences in the 3D printing behavior of the radiolabeled and the unlabeled organic liquid resin monomers. Radio-TLC and SPECT studies showed homogenous 2D and 3D distribution of radioactivity throughout the printed phantoms. The radioactivity was stably bound in the resin, apart from a small amount of surface-extractable radioactivity under harsh conditions (ethanol at 50 °C).

          Conclusions

          3D printing of radioactive phantoms using 99mTc-containing building materials is feasible. Compared to the classical fillable phantoms, 3D printing with radioactive building materials allows manufacturing of phantoms without cold walls and in almost any shape. Related procedures with longer-lived radionuclides will enable production of phantoms for scanner validation and quality control.

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          Most cited references22

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          Three-Dimensional Printing: Basic Principles and Applications in Medicine and Radiology

          The advent of three-dimensional printing (3DP) technology has enabled the creation of a tangible and complex 3D object that goes beyond a simple 3D-shaded visualization on a flat monitor. Since the early 2000s, 3DP machines have been used only in hard tissue applications. Recently developed multi-materials for 3DP have been used extensively for a variety of medical applications, such as personalized surgical planning and guidance, customized implants, biomedical research, and preclinical education. In this review article, we discuss the 3D reconstruction process, touching on medical imaging, and various 3DP systems applicable to medicine. In addition, the 3DP medical applications using multi-materials are introduced, as well as our recent results.
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            Recent advances on the development of phantoms using 3D printing for imaging with CT, MRI, PET, SPECT, and ultrasound

            Purpose Printing technology, capable of producing three‐dimensional (3D) objects, has evolved in recent years and provides potential for developing reproducible and sophisticated physical phantoms. 3D printing technology can help rapidly develop relatively low cost phantoms with appropriate complexities, which are useful in imaging or dosimetry measurements. The need for more realistic phantoms is emerging since imaging systems are now capable of acquiring multimodal and multiparametric data. This review addresses three main questions about the 3D printers currently in use, and their produced materials. The first question investigates whether the resolution of 3D printers is sufficient for existing imaging technologies. The second question explores if the materials of 3D‐printed phantoms can produce realistic images representing various tissues and organs as taken by different imaging modalities such as computer tomography (CT), positron emission tomography (PET), single‐photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), ultrasound (US), and mammography. The emergence of multimodal imaging increases the need for phantoms that can be scanned using different imaging modalities. The third question probes the feasibility and easiness of “printing” radioactive or nonradioactive solutions during the printing process. Methods A systematic review of medical imaging studies published after January 2013 is performed using strict inclusion criteria. The databases used were Scopus and Web of Knowledge with specific search terms. In total, 139 papers were identified; however, only 50 were classified as relevant for this paper. In this review, following an appropriate introduction and literature research strategy, all 50 articles are presented in detail. A summary of tables and example figures of the most recent advances in 3D printing for the purposes of phantoms across different imaging modalities are provided. Results All 50 studies printed and scanned phantoms in either CT, PET, SPECT, mammography, MRI, and US—or a combination of those modalities. According to the literature, different parameters were evaluated depending on the imaging modality used. Almost all papers evaluated more than two parameters, with the most common being Hounsfield units, density, attenuation and speed of sound. Conclusions The development of this field is rapidly evolving and becoming more refined. There is potential to reach the ultimate goal of using 3D phantoms to get feedback on imaging scanners and reconstruction algorithms more regularly. Although the development of imaging phantoms is evident, there are still some limitations to address: One of which is printing accuracy, due to the printer properties. Another limitation is the materials available to print: There are not enough materials to mimic all the tissue properties. For example, one material can mimic one property—such as the density of real tissue—but not any other property, like speed of sound or attenuation.
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              A Review on the 3D Printing of Functional Structures for Medical Phantoms and Regenerated Tissue and Organ Applications

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                Author and article information

                Contributors
                tilman.laeppchen@insel.ch
                Journal
                EJNMMI Phys
                EJNMMI Phys
                EJNMMI Physics
                Springer International Publishing (Cham )
                2197-7364
                22 April 2020
                22 April 2020
                December 2020
                : 7
                : 22
                Affiliations
                Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
                Article
                292
                10.1186/s40658-020-00292-0
                7176799
                32323035
                f380f88e-ca50-4def-821c-9390db0d3cef
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 14 December 2019
                : 27 March 2020
                Categories
                Original Research
                Custom metadata
                © The Author(s) 2020

                3d printing,spect,technetium-99m,resin monomer,printer ink,phantom,scanner validation

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