Phantom Training Method Could Improve Vascular Interventions

By allowing physicians to first perform the planned treatment on a phantom under standard operating procedures, interventionists can gain thorough familiarity with their patients’ unique vasculature. 

Under the mentorship of Ciprian N. Ionita, PhD, research assistant professor of biomedical engineering, and Stephen Rudin, PhD, SUNY Distinguished Professor of radiology, Russ studied how this training method can help prevent post-procedure complications. 

The research demonstrated that 3-D printing can be used in hospitals to adjust treatment plans before procedures. This extra preparation can reduce the risk of perioperative complications or delays. 

Minimally invasive endovascular image-guided interventions (EIGIs) are the preferred treatment for a wide range of vascular disorders.

EIGIs offer reduced trauma and recovery time compared to other methods, but there are some challenges associated with EIGIs. For instance, remote catheter actuation and challenging anatomical morphology may lead to erroneous endovascular device selections, delays or even complications such as vessel injury. 

The researchers began the manufacturing process by acquiring 3-D reconstructed imaging data from scans — such as CT, cone beam CT or MRI scans — of patients’ anatomy.

They separated the geometry of the vasculature from the rest of the anatomy and excluded bone, muscle, nerve and peripheral vasculature; then they manipulated the vasculature design using modeling software.

Once the 3-D design is complete, it can be exported as a stereolithography file to be read by the 3-D printer and printed in successive layers.

Using CT angiography, which allows segmentation and stereolithographic files to be exported, the researchers created phantoms.

“We made patient-specific phantoms — models printed in the form of an individual’s vasculature — and phantoms presenting a wide range of challenging geometrics,” said Russ.

For their first preoperative practice procedure on a patient, Ionita worked with two graduate students: Richard Izzo and Ryan O’Hara. Together they designed a patient-specific heart phantom that contained realistic calcification.

Using the first phantom, they practiced a transcatheter mitral valve replacement. 

The phantoms were tested for ischemic stroke treatment, distal catheter navigation, aneurysm stenting and cardiac imaging under angiographic guidance.

Out of 51 submissions at the SPIE Medical Imaging 2015 conference, Russ — along with her faculty mentors and fellow researchers — received the first-place cum laude award.

The presentation, “Treatment Planning for Image-Guided Neurovascular Interventions Using Patient-Specific 3-D Printed Phantoms,” was also displayed at the SPIE Biomedical Applications in Molecular, Structural and Functional Imaging conference. 

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