Customized Procedural Phantoms from 3D Medical Images:
Curriculum-driven, High-fidelity, in-situ Procedural Simulation
“Time for learning curves on patients has passed.” Yet most first procedures are still performed on patients.
3D image processing and micromanufacturing systems now allow development of high-fidelity phantoms based on real anatomy
- Tailored to specific curriculum and educational objectives.
- Wide range of normal and pathologic variants based on real cases.
- Low-cost and repairable – high wear parts easily replaced or refreshed.
- Accessible in large numbers for group teaching and deployments across distributed teaching sites.
- Open-source collaboration and sharing of designs and anatomic atlases across academic centers.
From Medical Image to Phantom: Workflows
CT Data. Segmented with ITK-Snap. Raw 3D model exported as triangle mesh in STL format. Enclosure created in OpenSCAD. Final mesh file converted to printer code (g-code) by Slic3r and printed using FDM with PETG.Thecal sac made using silicone tubing. Ligamentum flavum simulated with dense silicone. Soft tissue ballistic gel. Needle holes can be treated with heat-gun.
Echocardiography Simulator & Anatomical Teaching Models
Everything illustrated here was derived from a single Cardiac CT. The digital 3D models derived from the CT have been used to create renderings, animations, 3D prints of the myocardium, and blood pools, interactive rendering of all structures and three simulators: web-based, virtual-reality and physical echogenic phantom produced using 3D printing and gel casting techniques. See also: https://doi.org/10.1053/j.jvca.2020.07.008
Our Approach: curriculum-based Technology Development
Ideally simulators are developed as part of a need-driven curriculum (“Nail-First Approach”)
- Identify task elements and steps and corresponding learning objectives
- Set-Up; Positioning; Landmarking; Ultrasound Anatomy; Eye-Hand-Needle Coordination; Tactile Feedback
- Identify learning stages and organize objectives by stage
- Identify type (tactile, visual, ultrasound) & optimal level of fidelity required for each stage
- Live tissue is not always the gold standard!
- Identify required interactions & best modalities for each stage:
- 2D, 3D print / Render / VR / AR / Banana / Chicken
- Cost, Accessibility, Usability, Interactions, Storage