St. Louis Children's Hospital, one of the premier children's hospitals in the United States, recently opened a new medical 3D printing center at the BJC Institute of Health at Washington University School of Medicine (425 South Euclid Avenue, Suite 4301), located next to St. Louis Children's Hospital (SLCH) in the Central West End. St. Louis Children's Hospital Foundation provided the funds.
Located at the BJC Institute of Health on the Washington University medical campus, the Medical 3D Printing Center offers a wide range of 3D printing services to researchers and clinicians in the medical community at Washington University and in the midwest region.
Gautam Singh, MD, and Pamela Woodard, MD, discuss how at St. Louis Children's Hospital we work with our clients to develop accurate, high-quality models that will support your surgical, research or medical needs at this exciting Medical 3-D Printing Center.
Selected Podcast
Medical 3-D Printing Center at St. Louis Children's Hosptial
Featured Speaker:
Learn more about Gautam Singh, MD
Dr. Pamela Woodard, MD, Professor of Radiology and Biomedical Engineering at the Mallinckrodt Institute of Radiology, Washington University.
Learn more about Pamela Woodard, MD
Gautam Singh, MD & Pamela Woodard, MD
Gautam Singh, MD, is a Washington University Pediatric Cardiologist at St. Louis Children's Hospital.Learn more about Gautam Singh, MD
Dr. Pamela Woodard, MD, Professor of Radiology and Biomedical Engineering at the Mallinckrodt Institute of Radiology, Washington University.
Learn more about Pamela Woodard, MD
Transcription:
Melanie Cole (Host): 3D printing is a relatively new, rapidly expanding method of manufacturing that has found numerous applications in the healthcare sector. St. Louis Children’s Hospital, one of the premier children’s hospitals in the United States, recently opened a new medical 3D printing center at the BJC Institute of Health at Washington University School of Medicine. My guests to tell us about that exciting center today are Dr. Gautam Singh, he’s Washington University’s pediatric cardiologist at St. Louis Children’s Hospital, and Dr. Pamela Woodard. She’s a professor of radiology and biomedical engineering at the Mallinckrodt Institute of Radiology of Washington University. Welcome to the show Doctors. Dr. Woodard, I’d like to start with you. How does 3D printing work? Explain a little bit for the listeners about the evolution of it. What really is it?
Dr. Pamela Woodard (Guest): Okay, 3D printing can be traced back to 1986 when initially people started using this to manufacture parts. It wasn’t a medical use at that point, but over the course of the last several years, it’s been adopted to take our 2 dimensional images, which we obtain from CT and MRI and to create objects that a physician can hold in their hand, so if you can see a bone or a heart on a CT scan or an MRI scan, then we can actually take that, and using printing substances, print a 3 dimensional object that the surgeon can hold and use for surgical planning or that a referring physician can use for procedural planning.
Melanie: Dr. Singh, before we get into some of the benefits of 3D printing, and really this expanding use in healthcare, tell us a little bit about the history of the 3D printing at St. Louis Children’s Hospital, how did that come about?
Dr. Gautam Singh (Guest): So the 3D printing came first, it was utilized in our pediatric plastic surgery arena. One of our surgeons wanted to see if he can print some exact replica of certain segments of the bones or facial structure and he brought in the first 3D printer in 2014. That’s the time when we started printing these 3D models of the different segments of the body, especially the face and craniofacial structure. I might just add to that, what Dr. Woodard explained, is that 3D printing was utilized in aerospace industry much earlier, Boeing over here at St. Louis, they started using in the airfield way back in the 1990s for their Dreamliner when they started working on this new airplane. We knew about 3D printing for quite some time, but we didn’t really apply it, but we felt the need particularly in out surgical fields, congenital heart disease and cardiac defects, that it would have been the most useful and very helpful technology that would have helped in designing and aiding to the complex cardiac surgery that we performed, that our surgeons performed for complex heart defects. So it started in 2014 here, but it rapidly evolved, and since last year, we actually for the first time, we installed the 3D printing, which became fully functional at the beginning of this year, in April of this year. So this is a rather short history but it’s proving very, very useful for surgical planning and evolving surgical technique that it is applied over there.
Melanie: So, Dr. Woodard, tell us about some of the benefits of 3D printing in the healthcare field, it must really be unending, and while you’re telling other providers about some of the uses that you can use these for, also touch on whether or not you think that it’s eventually maybe going to be used in things like transplant or to help create some biologic organs. Tell us about the uses.
Dr. Woodard: Sure, so right now the uses are printing from CT and MRI images, allowing the surgeons to take what we often see 2 dimensionally and actually hold the structure in their hands. So we have children who have very complex congenital heart disease, essentially where parts of their hearts are in places where in normal people they usually aren’t, and the surgeons have to go in and correct pathways for the blood progression, and so by having something that they can hold in their hand prior to going into surgery, it allows them to visually see what their going to see in the operating room. So, for these congenital heart patients, taking what we image and making 3 dimensional structures has been very useful to them and their presurgical planning. In plastic surgery, our plastic surgeons have found that taking the bones and being able to assess them as 3 dimensional objects, structures that they can hold prior to going into the OR, allow them to plan before they go into surgery. They can also take the structures that they see, and if they need to put in prosthetic devices or plates, they can form fit them before they get into the OR and have what they need ready to go, shortening the operative time. So those are some of the very practical current applications. In addition, with prosthetic devices, we’ve made artificial hands and limbs. These can be printed as well. They involved electronic components, but for people who need prostheses, 3D printing is often a way to go to make the device actually fit and fit accustomed to their own physical structures, so to personalize the device. In the future, you mentioned transplants. And there are new techniques. They are very, very new, but printing with cellular materials, so that you could print portions of liver tissue or splenic tissue or pancreatic tissue or renal tissue to perform certain functions is on the horizon, and so these aren’t available yet, but with certain types of printers and different cellular materials, people in the laboratory are printing hepatic tissue that can allow certain functions of the liver to occur without the organ itself.
Melanie: Dr. Singh, how can a pediatrician, utilize this information and this amazing technology that you’re using there at St. Louis Children’s Hospital and tell them how they would get involved, what it is you want them to know about looking into this and exploring the options.
Dr. Singh: So the 3D printing has provided and is getting into what’s now called personalized medicine and precision medicine, so one appliance or one apparatus doesn’t fit all and this has led to a situation where a patient specific computer designed material can be printed to precise dimensions for that patient, and if the pediatricians are looking into some kind of providing a very specific therapy for certain conditions, 3D printed segments of the body can be useful to provide and aid to really realistic specific kind of surgery that can be done. So they can reach out to their basis care provider and asking if a 3D printing prosthesis or appliance or anything that can be helpful in designing and developing a very patient specific surgery or intervention that could be designed actually. I will just give you one example, now with the advent of a noninvasive catheter based prosthetic valve implantation in heart, it is feasible to decide whether that valve implant can work and the heart where it is going to be implanted can accommodate. We can print the heart, and then give it a trial that a particular type of prosthetic valve can be accommodated and can be implanted even before we do that in real time, and thereby we can be certain whether it’s a feasible intervention to perform on that specific patient for that specific reason, so I think these are some of the things that can be utilized and realized at this time, and pediatricians can reach out to their care provider of the patients to see if this technology can be an application for precision medicine or precision technique treatment for the patient.
Melanie: Dr. Woodard, as we wrap up, what does this mean for the future of healthcare as far as diagnosis, treatment, and what else would a referring pediatrician need to know about medical 3D printing? What can they expect from your team after referral insofar as your communication with the physician and your team approach?
Dr. Woodard: Sure, let me answer your last question first. In terms of what they could expect. What they’ll be able to expect is excellent presurgical planning, a printed roadmap essentially for the surgeons who are working here at St. Louis Children’s Hospital, a method of determining exactly what the best surgical procedure is for their child. Follow up, the surgeons will often take these models and show the family exactly what they’re planning to do. The models help in understanding both for the surgical team, but also for the patient and those caring for them in terms of relatives. In terms of what the future holds, the future holds enumerable possibilities. As we discussed printing tissues specific to the patient themselves, printing prosthetic devices that Dr. Singh just mentioned, that are personalized so that they fit the patient specifically. Essentially 3D printing opens up a world of opportunities for us as physicians in terms of treating our patients.
Melanie: What an amazing center and what a fascinating topic. Dr. Singh, last word to you. Tell us about developing these accurate high quality models, and what your team has produced models for. Kind of wrap it up with your best information for other providers about this surgical research or medical needs that they might have.
Dr. Singh: So far in a very short period of time since we have established a full functioning 3D printing center, the 3D model has been printed for a wide range of applications, in plastic surgery, in orthopedic surgery, in craniofacial surgery and of course for cardiac surgery or specifically for congenital heart surgeries. So far in a six month short period, we have printed about 76 cardiac models for patient’s education, device implantation, and of course surgical planning. The plastic surgeons who have been using it since 2014 when the first 3D printer was installed, they have been using and we have more than 200 applications and models printed in that field, so I think we are on the verge of providing even a wider range of services. Recently we printed an entire spinal vertebral column for a patient who has a very complex defect of the vertebral spinal column and it proved very useful in providing what precise surgery would be needed, so I think there is a wide arena, and as Dr. Woodard said, scope and potential for application is very, very wide and it will certainly take a lot of effort and resources to develop it further, but we are very much excited about providing services for our patients, for people in this state, and if required in the Midwest, as there are only a few of the centers that have this capability of doing 3D printing.
Melanie: Amazing, thank you both for joining us today. What a fascinating topic. Thank you again for all the work that you are doing. A physician can refer a patient by calling Children’s direct physician access line at 1-800-678-HELP, that’s 1-800-678-4357. You’re listening to Radio Rounds with St. Louis Children’s Hospital. For more information on resources available at St. Louis Children’s Hospital, you can go to stlouischildrens.org, that’s stlouischildrens.org. This is Melanie Cole, thank you so much for listening.
Melanie Cole (Host): 3D printing is a relatively new, rapidly expanding method of manufacturing that has found numerous applications in the healthcare sector. St. Louis Children’s Hospital, one of the premier children’s hospitals in the United States, recently opened a new medical 3D printing center at the BJC Institute of Health at Washington University School of Medicine. My guests to tell us about that exciting center today are Dr. Gautam Singh, he’s Washington University’s pediatric cardiologist at St. Louis Children’s Hospital, and Dr. Pamela Woodard. She’s a professor of radiology and biomedical engineering at the Mallinckrodt Institute of Radiology of Washington University. Welcome to the show Doctors. Dr. Woodard, I’d like to start with you. How does 3D printing work? Explain a little bit for the listeners about the evolution of it. What really is it?
Dr. Pamela Woodard (Guest): Okay, 3D printing can be traced back to 1986 when initially people started using this to manufacture parts. It wasn’t a medical use at that point, but over the course of the last several years, it’s been adopted to take our 2 dimensional images, which we obtain from CT and MRI and to create objects that a physician can hold in their hand, so if you can see a bone or a heart on a CT scan or an MRI scan, then we can actually take that, and using printing substances, print a 3 dimensional object that the surgeon can hold and use for surgical planning or that a referring physician can use for procedural planning.
Melanie: Dr. Singh, before we get into some of the benefits of 3D printing, and really this expanding use in healthcare, tell us a little bit about the history of the 3D printing at St. Louis Children’s Hospital, how did that come about?
Dr. Gautam Singh (Guest): So the 3D printing came first, it was utilized in our pediatric plastic surgery arena. One of our surgeons wanted to see if he can print some exact replica of certain segments of the bones or facial structure and he brought in the first 3D printer in 2014. That’s the time when we started printing these 3D models of the different segments of the body, especially the face and craniofacial structure. I might just add to that, what Dr. Woodard explained, is that 3D printing was utilized in aerospace industry much earlier, Boeing over here at St. Louis, they started using in the airfield way back in the 1990s for their Dreamliner when they started working on this new airplane. We knew about 3D printing for quite some time, but we didn’t really apply it, but we felt the need particularly in out surgical fields, congenital heart disease and cardiac defects, that it would have been the most useful and very helpful technology that would have helped in designing and aiding to the complex cardiac surgery that we performed, that our surgeons performed for complex heart defects. So it started in 2014 here, but it rapidly evolved, and since last year, we actually for the first time, we installed the 3D printing, which became fully functional at the beginning of this year, in April of this year. So this is a rather short history but it’s proving very, very useful for surgical planning and evolving surgical technique that it is applied over there.
Melanie: So, Dr. Woodard, tell us about some of the benefits of 3D printing in the healthcare field, it must really be unending, and while you’re telling other providers about some of the uses that you can use these for, also touch on whether or not you think that it’s eventually maybe going to be used in things like transplant or to help create some biologic organs. Tell us about the uses.
Dr. Woodard: Sure, so right now the uses are printing from CT and MRI images, allowing the surgeons to take what we often see 2 dimensionally and actually hold the structure in their hands. So we have children who have very complex congenital heart disease, essentially where parts of their hearts are in places where in normal people they usually aren’t, and the surgeons have to go in and correct pathways for the blood progression, and so by having something that they can hold in their hand prior to going into surgery, it allows them to visually see what their going to see in the operating room. So, for these congenital heart patients, taking what we image and making 3 dimensional structures has been very useful to them and their presurgical planning. In plastic surgery, our plastic surgeons have found that taking the bones and being able to assess them as 3 dimensional objects, structures that they can hold prior to going into the OR, allow them to plan before they go into surgery. They can also take the structures that they see, and if they need to put in prosthetic devices or plates, they can form fit them before they get into the OR and have what they need ready to go, shortening the operative time. So those are some of the very practical current applications. In addition, with prosthetic devices, we’ve made artificial hands and limbs. These can be printed as well. They involved electronic components, but for people who need prostheses, 3D printing is often a way to go to make the device actually fit and fit accustomed to their own physical structures, so to personalize the device. In the future, you mentioned transplants. And there are new techniques. They are very, very new, but printing with cellular materials, so that you could print portions of liver tissue or splenic tissue or pancreatic tissue or renal tissue to perform certain functions is on the horizon, and so these aren’t available yet, but with certain types of printers and different cellular materials, people in the laboratory are printing hepatic tissue that can allow certain functions of the liver to occur without the organ itself.
Melanie: Dr. Singh, how can a pediatrician, utilize this information and this amazing technology that you’re using there at St. Louis Children’s Hospital and tell them how they would get involved, what it is you want them to know about looking into this and exploring the options.
Dr. Singh: So the 3D printing has provided and is getting into what’s now called personalized medicine and precision medicine, so one appliance or one apparatus doesn’t fit all and this has led to a situation where a patient specific computer designed material can be printed to precise dimensions for that patient, and if the pediatricians are looking into some kind of providing a very specific therapy for certain conditions, 3D printed segments of the body can be useful to provide and aid to really realistic specific kind of surgery that can be done. So they can reach out to their basis care provider and asking if a 3D printing prosthesis or appliance or anything that can be helpful in designing and developing a very patient specific surgery or intervention that could be designed actually. I will just give you one example, now with the advent of a noninvasive catheter based prosthetic valve implantation in heart, it is feasible to decide whether that valve implant can work and the heart where it is going to be implanted can accommodate. We can print the heart, and then give it a trial that a particular type of prosthetic valve can be accommodated and can be implanted even before we do that in real time, and thereby we can be certain whether it’s a feasible intervention to perform on that specific patient for that specific reason, so I think these are some of the things that can be utilized and realized at this time, and pediatricians can reach out to their care provider of the patients to see if this technology can be an application for precision medicine or precision technique treatment for the patient.
Melanie: Dr. Woodard, as we wrap up, what does this mean for the future of healthcare as far as diagnosis, treatment, and what else would a referring pediatrician need to know about medical 3D printing? What can they expect from your team after referral insofar as your communication with the physician and your team approach?
Dr. Woodard: Sure, let me answer your last question first. In terms of what they could expect. What they’ll be able to expect is excellent presurgical planning, a printed roadmap essentially for the surgeons who are working here at St. Louis Children’s Hospital, a method of determining exactly what the best surgical procedure is for their child. Follow up, the surgeons will often take these models and show the family exactly what they’re planning to do. The models help in understanding both for the surgical team, but also for the patient and those caring for them in terms of relatives. In terms of what the future holds, the future holds enumerable possibilities. As we discussed printing tissues specific to the patient themselves, printing prosthetic devices that Dr. Singh just mentioned, that are personalized so that they fit the patient specifically. Essentially 3D printing opens up a world of opportunities for us as physicians in terms of treating our patients.
Melanie: What an amazing center and what a fascinating topic. Dr. Singh, last word to you. Tell us about developing these accurate high quality models, and what your team has produced models for. Kind of wrap it up with your best information for other providers about this surgical research or medical needs that they might have.
Dr. Singh: So far in a very short period of time since we have established a full functioning 3D printing center, the 3D model has been printed for a wide range of applications, in plastic surgery, in orthopedic surgery, in craniofacial surgery and of course for cardiac surgery or specifically for congenital heart surgeries. So far in a six month short period, we have printed about 76 cardiac models for patient’s education, device implantation, and of course surgical planning. The plastic surgeons who have been using it since 2014 when the first 3D printer was installed, they have been using and we have more than 200 applications and models printed in that field, so I think we are on the verge of providing even a wider range of services. Recently we printed an entire spinal vertebral column for a patient who has a very complex defect of the vertebral spinal column and it proved very useful in providing what precise surgery would be needed, so I think there is a wide arena, and as Dr. Woodard said, scope and potential for application is very, very wide and it will certainly take a lot of effort and resources to develop it further, but we are very much excited about providing services for our patients, for people in this state, and if required in the Midwest, as there are only a few of the centers that have this capability of doing 3D printing.
Melanie: Amazing, thank you both for joining us today. What a fascinating topic. Thank you again for all the work that you are doing. A physician can refer a patient by calling Children’s direct physician access line at 1-800-678-HELP, that’s 1-800-678-4357. You’re listening to Radio Rounds with St. Louis Children’s Hospital. For more information on resources available at St. Louis Children’s Hospital, you can go to stlouischildrens.org, that’s stlouischildrens.org. This is Melanie Cole, thank you so much for listening.