3D Printing in Medicine

, 2:5 | Cite as

Medical 3D printing for vascular interventions and surgical oncology: a primer for the 2016 radiological society of North America (RSNA) hands-on course in 3D printing

  • Leonid Chepelev
  • Taryn Hodgdon
  • Ashish Gupta
  • Aili Wang
  • Carlos Torres
  • Satheesh Krishna
  • Ekin Akyuz
  • Dimitrios Mitsouras
  • Adnan Sheikh
Technical Note


Medical 3D printing holds the potential of transforming personalized medicine by enabling the fabrication of patient-specific implants, reimagining prostheses, developing surgical guides to expedite and transform surgical interventions, and enabling a growing multitude of specialized applications. In order to realize this tremendous potential in frontline medicine, an understanding of the basic principles of 3D printing by the medical professionals is required. This primer underlines the basic approaches and tools in 3D printing, starting from patient anatomy acquired through cross-sectional imaging, in this case Computed Tomography (CT). We describe the basic principles using the relatively simple task of separation of the relevant anatomy to guide aneurysm repair. This is followed by exploration of more advanced techniques in the creation of patient-specific surgical guides and prostheses for a patient with extensive pleomorphic sarcoma using Computer Aided Design (CAD) software.


3D Printing Aneurysm repair Cancer Segmentation Computer-aided design Orthopedic Surgery Implant Surgical Guide Radiological Society of North America Precision Medicine 



Three dimensional


Anterior superior iliac spine


Computer-aided design


Computed tomography


Digital imaging and communications in medicine


United States Food and Drug Administration


Hounsfield units


Magnetic resonance imaging


Region of interest


Radiological Society of North America


Standard Tessellation Language



No funding sources to declare for this study.

Authors’ contributions

AS and LC conceived the design, analyzed the data, drafted, edited and critically revised the manuscript. AG and TH contributed significant portions of the manuscript. AW provided customized illustrations. LC carried out data collection and analysis. AS, AG, AW, CT, SK, EA, DM, LC interpreted the data and drafted the manuscript. All authors have read and have given final approval of the version to be published. All authors read and approved the final manuscript.

Competing interests

The authors declare that they have no competing interests.

Consent for publication

The DICOM patient images used this this publication are obtained from open anonymized online repositories publishing patient data with patient consent. Statements to this effect are available on the respective websites of the OsiriX Image Library [17] and the Cancer Imaging Archive [16].

Supplementary material

41205_2016_8_MOESM1_ESM.docx (1 mb)
Additional file 1: Printing a 3D Model with Polyjet Studio. (DOCX 1049 kb)
41205_2016_8_MOESM2_ESM.docx (194 kb)
Additional file 2: Creating Holes and Labeling. (DOCX 193 kb)


  1. 1.
    Giannopoulos AA, Leonid C, Adnan S, Aili W, Wilfred D, Ekin A, Chris H, Nicole W, Todd P, Dydynski PB, Rybicki DMFJ. 3D printed ventricular septal defect patch: a primer for the 2015 Radiological Society of North America (RSNA) hands-on course in 3D printing. 3D Printing in Medicine. 2015;1:3.CrossRefGoogle Scholar
  2. 2.
    Mitsouras D, Liacouras P, Imandzadeh A, Giannopoulos A, Cai T, Kumamaru K, et al. Medical 3D printing for the radiologist. Radiographics. 2015;35(7):1965–88.CrossRefGoogle Scholar
  3. 3.
    United States Food and Drug Administration. Technical Considerations for Additive Manufactured Devices. Draft Guidance for Industry and Food and Drug Administration Staff. Accessed 8 Oct 2016.
  4. 4.
    Brunkwall J, Hauksson H, Bengtsson H, et al. Solitary aneurysms of the iliac arterial system: an estimate of their frequency of occurrence. J Vasc Surg. 1989;10:381–4.CrossRefGoogle Scholar
  5. 5.
    Ferreira J, Canedo A, Brandão D, Maia M, Braga S, Chaparro M, Barreto P, Vaz G. Isolated iliac artery aneurysms: six-year experience. Interact Cardiovasc Thorac Surg. 2010;10(2):245–8.CrossRefGoogle Scholar
  6. 6.
    Huang Y, Gloviczki P, Duncan AA, Kalra M, Hoskin TL, Oderich GS, McKusick MA, Bower TC. Common iliac artery aneurysm: expansion rate and results of open surgical and endovascular repair. J Vasc Surg. 2008;47(6):1203–10.CrossRefGoogle Scholar
  7. 7.
    McCready RA, Pairolero PC, Gilmore JC, Kazimer FJ, Cherry Jr KJ, Hollier LH. Isolated iliac artery aneurysms. Surgery. 1983;93:688–93.PubMedGoogle Scholar
  8. 8.
    Santilli SM, Wernsing SE, Lee ES. Expansion rates and outcomes for iliac artery aneurysms. J Vasc Surg. 2000;31:114–21.CrossRefGoogle Scholar
  9. 9.
    Patel NV, Long GW, Cheema ZF, Rimar K, Brown OW, Shanley CJ. Open vs. endovascular repair of isolated iliac artery aneurysms: A 12-year experience. J Vasc Surg. 2009;49(5):1147–53.CrossRefGoogle Scholar
  10. 10.
    Albertini JN, Favre JP, Bouziane Z, Haase C, Nourrissat G, Barral X. Aneurysmal extension to the iliac bifurcation increases the risk of complications and secondary procedures after endovascular repair of abdominal aortic aneurysms. Ann Vasc Surg. 2010;24(5):663-9.CrossRefGoogle Scholar
  11. 11.
    Nascimento AF, Raut CP. Diagnosis and management of pleomorphic sarcomas (so-called “MFH”) in adults. J Surg Oncol. 2008;97(4):330–9.CrossRefGoogle Scholar
  12. 12.
    Matushansky I, Charytonowicz E, Mills J, Siddiqi S, Hricik T, Cordon-Cardo C. MFH classification: differentiating undifferentiated pleomorphic sarcoma in the 21st Century. Expert Rev Anticancer Ther. 2009;9(8):1135–44.CrossRefGoogle Scholar
  13. 13.
    Le Doussal V, Coindre JM, Leroux A, Hacene K, Terrier P, Bui NB, Bonichon F, Collin F, Mandard AM, Contesso G. Prognostic factors for patients with localized primary malignant fibrous histiocytoma: a multicenter study of 216 patients with multivariate analysis. Cancer. 1996;77(9):1823–30.CrossRefGoogle Scholar
  14. 14.
    Salo JC, Lewis JJ, Woodruff JM, Leung DH, Brennan MF. Malignant fibrous histiocytoma of the extremity. Cancer. 1999;85(8):1765–72.CrossRefGoogle Scholar
  15. 15.
    Zagars GK, Mullen JR, Pollack A. Malignant fibrous histiocytoma: outcome and prognostic factors following conservation surgery and radiotherapy. Int J Radiat Oncol Biol Phys. 1996;34(5):983–94.CrossRefGoogle Scholar
  16. 16.
    Clark K, Vendt B, Smith K, Freymann J, Kirby J, Koppel P, Moore S, Phillips S, Maffitt D, Pringle M, Tarbox L, Prior F. The Cancer Imaging Archive (TCIA): maintaining and operating a public information repository. J Digit Imaging. 2013;26(6):1045–57.CrossRefGoogle Scholar
  17. 17.
    OsiriX DICOM Image Library. Accessed 8 Oct 2016.

Copyright information

© The Author(s) 2016

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Authors and Affiliations

  1. 1.The Ottawa Hospital Research Institute and the Department of RadiologyUniversity of OttawaOttawaCanada
  2. 2.Faculty of MedicineUniversity of OttawaOttawaCanada
  3. 3.Department of Radiology, Applied Imaging Science LabBrigham and Women’s HospitalBostonUSA

Personalised recommendations