Abstract Details

We propose using 3D printing to improve epilepsy care and education in the patients with medication refractoryepilepsies (MRE).

Approximately ? of patients with seizures have medication refractory epilepsy (MRE). Recently, 3D printing has gained substantial grounds in many fields, including medicine. We propose using 3D printing to improve epilepsy care and education in this population. Accurate pre-surgical workup is an important factor in the success of surgery in MRE. Intracranial electrodes (IE) can beused to identify the epileptogenic zone (EZ); their optimal placement and actual anatomical localization are critical. We generate personalized 3D printed brain models (with or without the intracranial electrodes), or other anatomical regions of interestfor improved visualization.  

Source image data are used to produce multiplane reformations and 3D views of the anatomy, which are then transformed into a physical model. The workflow consists of 4 major steps: 1) Image acquisition: pre-implantation MRI, post-implantation CT, 2) Image post-processing: (CT / MR) segmentation and registration, 3) 3D design of CAD model, 4) 3D printing. TeraRecon Aquarius was used to segmentand fuse the MR and CT images. 

Three examplemodels of the brain were printed in Stanford 3D and Quantitative Imaging Laboratory. (1) Elastomeric:A simple model that is primarily for planning subdural grid placement, depth electrode data interpretation and surgical planning. (2) Rigid transparent: Printed in 3 pieces which were held together using magnets. The electrodes are printed with a dark material to highlight their paths. (3) Rigid transparent: Includes colored white matter tracts derived from DTI, demonstrating their location relative to the lesion of interest. 

3D printing has become standard in our clinical practice: models are ordered directly in Electronic Health Records (Epic). We hypothesize that 3D printed models can help improve surgical planning and education in epilepsy as well as other specialties through more intuitive visualization of complex brain anatomy.