Use of Individualized 3D Printed Models in the Diagnosis and Treatment Planning of Cervical Cancer

Supplementing Complex Tumor Visualization

Cervical cancer is the fourth most common cancer in women worldwide. Treatment options depend primarily on the size of the tumor, its spread, and the overall health of the patient. Choosing the appropriate treatment typically involves a multidisciplinary team and requires detailed information about the cancer.

Currently, this information comes from CT and MRI scans, whose outputs are limited to two-dimensional projections on a monitor. Moreover, interpreting a large number of 2D slices is time-consuming and depends on the examiner's experience. The use of 3D printed models based on segmented scans could supplement the comprehensive visualization of cancer in a specific patient.

The research team, led by Anne Cathrine Scherer-Quenzer from the Department of Obstetrics and Gynecology at the University Hospital in Würzburg, wanted to find out if personalized 3D models could help in diagnostics, treatment planning, interdisciplinary communication, and more informed discussions with patients.

Creation and Evaluation of Personalized 3D Models

Findings from five patients aged between 27 and 47 years, who had undergone magnetic resonance imaging of the pelvic region with several imaging modalities, were used. The data were then segmented and processed using a specially designed algorithm for 3D modeling.

Five virtual models were then printed on conventional 3D printers Prusa MK3s and Prusa Mini at a 1:1 scale. For better clarity, they consisted of several color-differentiated parts that could be disassembled and reassembled, allowing for better identification of affected tissues.

The evaluation of the models' quality and usability was based on a survey involving doctors from relevant specialties with at least five years of experience: surgery, pathology, radiology, and radiotherapy (at least three representatives from each specialty).

For each specialty, an individualized form consisting of 12 questions divided into three groups was designed. The first group pertained to the analysis of specific models, the second monitored the possibilities of their practical use in the relevant fields, and the third gathered general experiences of doctors with the use of 3D printing. Responses were given by doctors on a 5-point scale or dichotomously (yes/no).

From the survey, the research team compiled a comprehensive picture of how doctors across specialties perceive 3D models of cervical cancer. The responses were then grouped into four thematic blocks: anatomical accuracy of the models, use in interdisciplinary communication, treatment planning, and educational potential.

Radiation Therapists Most Enthusiastic

Doctors rated the models' accuracy in depicting tumor anatomy between 3 and 4.3 points out of 5. The usefulness in identifying specific structures was rated between 4 and 5 points, depending on the specialty. The basic condition of accurate and comprehensible depiction of carcinoma anatomy was thus met.

Another aspect examined was the models' potential to improve interdisciplinary communication. Opinions across specialties varied considerably in this case. Radiation therapists and radiologists greatly appreciated the facilitation of information exchange between medical professions (4.7 and 4.3 points out of 5, respectively), while surgeons and pathologists saw only limited usefulness (3.3 points out of 5).

Similar responses came from the section on the potential of 3D models in the diagnostic and treatment process. Surgeons and radiation therapists valued this the most (4 points out of 5), while pathologists and radiologists were more reserved (3.0 and 3.3 points out of 5, respectively). Since radiologists and pathologists are not usually directly involved in treatment planning, this is not surprising according to the authors of the study. However, the high interest from surgeons and radiation therapists indicates great potential for increasing treatment accuracy.

There was consensus among all consulted specialties about the possibilities of using 3D models for educational purposes and patient education. Radiation therapists expressed the greatest enthusiasm for the educational value, rating it 5 points out of 5.

In response to whether they would use a personalized 3D model in their future practice, all specialties rated this possibility 4 out of 5.

In conclusion, the authors of the research state that 3D printed models specific to individual patients have significant potential in translational oncology, where they can enhance the quality of clinical diagnostics and treatment planning. The wide availability of 3D printers moreover makes them an effective tool for regular use. However, the full utilization of their potential will also depend on their adaptation to the specific needs of individual medical specialties.

Editorial Team, Medscope.pro

Source: Scherer-Quenzer, A.C., Beyers, I., Kalisz, A. et al. Evaluating the value of individualized 3D printed models for examination, diagnosis, and treatment planning of cervical cancer. 3D Print Med 10, 25 (2024), doi: 10.1186/s41205-024-00229-8.