Imagine being able to see inside a patient’s heart with just a pair of glasses and a handheld device. Or being able to create a physical replica of their heart that you can hold in your hands and examine from every angle. These are not science fiction scenarios, but real possibilities thanks to emerging technologies such as mixed reality (MR) and 3D printing. These technologies have the potential to revolutionize the diagnosis and treatment of congenital heart disease (CHD), a group of conditions that affect the structure and function of the heart from birth. CHD is one of the most common birth defects, affecting about 1% of newborns worldwide. It is also one of the most complex and diverse, with more than 40 different types and subtypes. It is a complex and challenging condition to treat, often requiring a multidisciplinary team of healthcare professionals, including cardiologists, cardiac surgeons, radiologists, and anesthetists. Some CHD cases are mild and asymptomatic, while others are severe and life-threatening, requiring multiple surgeries or interventions throughout life. However, understanding the anatomical features and generating realistic three-dimensional (3D) visualization of CHD is always challenging due to its complexity and variability. Conventional 2D and 3D imaging modalities such as echocardiography, magnetic resonance imaging (MRI), or cardiac computed tomography angiography (CCTA) have limitations in providing adequate spatial resolution, depth perception, or interactivity for visualizing CHD anatomy and pathology. This can lead to difficulties in diagnosis, communication, education, planning, guidance, simulation, or training for CHD management. To overcome these limitations, researchers have been exploring the use of MR and 3D printing as novel technologies that can create realistic 3D models of CHD based on CCTA scans. MR is a technology that combines virtual and real-world elements to create a new immersive environment. In the context of CHD, MR can be used to create realistic 3D models of the heart that can be viewed and manipulated in real-time by the medical team. This technology allows clinicians to see the heart in greater detail and from different perspectives, which can be especially useful for complex cases where traditional imaging methods may not provide enough information. For example, MR may be used to simulate the flow of blood through the heart, allowing clinicians to assess the impact of different treatment options before performing surgery. Another important technology in the context of CHD is 3D printing. 3D printing involves creating physical objects from digital models by layering material on top of each other. In the context of CHD, 3D printing can be used to create highly detailed models of the heart that can be used to plan surgical procedures. These models can also be used to train medical professionals and to educate patients and their families about the condition.
In a new study published in the journal Biomolecules, Australian researchers: Ivan Lau, Dr. Ashu Gupta, Dr. Abdul Ihdayhid, and Professor Zhonghua Sun from Curtin University in collaboration with Fiona Stanley Hospital, Australia evaluated the value of MR and 3D printing in the diagnosis, medical education, preoperative planning, and intraoperative guidance of CHD surgeries. They compared these advanced technologies with the traditional visualization technique and gathered feedback from cardiac specialists and physicians.
The research team evaluated the effectiveness of different modalities in demonstrating and communicating complex congenital heart disease (CHD) lesions. Two cardiac computed tomography angiography scans were used to create 3D-printed heart models (3DPHM) and MR models, which were then evaluated by 34 cardiac specialists and physicians. The study found that MR models were the best modality for demonstrating complex CHD lesions, enhancing depth perception, portraying spatial relationships between cardiac structures, serving as a learning tool for pathology, and facilitating pre-operative planning. On the other hand, 3DPHM were found to be the best modality for communicating with patients. The MR models were significantly better than original DICOM images in demonstrating complex CHD lesions, enhancing depth perception, and portraying spatial relationships between cardiac structures. They were also found to be significantly better as a learning tool for the pathology and in facilitating pre-operative planning. On the other hand, 3DPHM were significantly better than DICOM images in facilitating communication with patients. This finding is particularly relevant as effective communication is critical in ensuring that patients understand their condition and the recommended treatment plan. Overall, the study highlights the potential of 3D printing and MR imaging in enhancing the understanding and communication of complex CHD lesions. The findings also suggest that a combination of different modalities may be necessary to effectively communicate with both medical professionals and patients.
To sum up, Professor Zhonghua Sun and colleagues revealed that MR models were considered the preferred tool for demonstrating complex CHD lesions, improving depth perception, representing the spatial relationship between cardiac structures, aiding in pathology education, and supporting pre-operative planning. Meanwhile, 3DPHM were ranked as the preferred tool for communicating with patients, improving depth perception, and supporting pathology education. Both MR and 3DPHM can be used in conjunction with the current image visualization method to provide additional information that can assist in the diagnostic assessment of patients with CHD. As these technologies continue to evolve, they hold great promise for the future of CHD diagnosis and treatment.
Lau I, Gupta A, Ihdayhid A, Sun Z. Clinical Applications of Mixed Reality and 3D Printing in Congenital Heart Disease. Biomolecules. 2022;12(11):1548.