背景:肝脏病理患者受益于图像引导干预。建议对肝脏体模进行介入程序的培训,直到达到基本熟练程度为止。在过去的40年里,已经进行了一些尝试来开发材料来模拟人类肝脏的成像特征,以创建肝脏模型。仍然缺乏可访问性,可重复和具有成本效益的软肝体模的图像引导程序训练。方法:从CT扫描DICOM文件开始,我们使用InVesalius(CentrodeTecnologiadainformaçoRenatoArcherCTI,InVesalius3开源软件,坎皮纳斯,巴西)用于分割,AutodeskFusion360withNetfabb(Autodesk软件公司,Fusion3602.0.19426与AutodeskNetfabbPremium2023.064位版,旧金山,CA,美国)用于3D建模和StratasysFortus380mc3D打印机(Stratasys3D打印公司,Fortus380MC3D打印机,明尼阿波利斯,MN,美国)。使用3D打印的模具,我们用14种不同的食谱创造了14种基于明胶的肝脏模型,用水,铸糖和脱水明胶,含不同量的静脉脂质溶液和工业酒精的32%脂肪牛乳奶油。我们测试了所有这些幻影以及离体猪肝脏和人类正常人,通过测量弹性来测量脂肪肝和肝硬化,剪切波速度,超声衰减,CT扫描密度,MRI信号强度和骨折力。我们评估了测试的结果,以及超声波的光学外观,CT和MRI,为了找到用于图像引导程序训练的基于明胶的体模的最佳配方。结果:经过对所有幻影食谱的评估,我们选择了14克明胶/100毫升水的透明幻影和不透明幻影的最佳配方,含25%奶油的食谱。结论:这些基于肝脏明胶的幻影配方是一种廉价的,图像引导和诊断程序培训的可重复和可获得的替代方案,将满足有价值培训的大多数要求。
Background: Patients with liver pathology benefit from image-guided interventions. Training for interventional procedures is recommended to be performed on liver phantoms until a basic proficiency is reached. In the last 40 years, several attempts have been made to develop materials to mimic the imaging characteristics of the human liver in order to create liver phantoms. There is still a lack of accessible, reproducible and cost-effective soft liver phantoms for image-guided procedure training. Methods: Starting from a CT-scan DICOM file, we created a 3D-printed liver mold using InVesalius (Centro de Tecnologia da informação Renato Archer CTI, InVesalius 3 open-source software, Campinas, Brazil) for segmentation, Autodesk Fusion 360 with Netfabb (Autodesk software company, Fusion 360 2.0.19426 with Autodesk Netfabb Premium 2023.0 64-Bit Edition, San Francisco, CA, USA) for 3D modeling and Stratasys Fortus 380 mc 3D printer (Stratasys 3D printing company, Fortus 380 mc 3D printer, Minneapolis, MN, USA). Using the 3D-printed mold, we created 14 gelatin-based liver phantoms with 14 different recipes, using water, cast sugar and dehydrated gelatin, 32% fat bovine milk cream with intravenous lipid solution and technical alcohol in different amounts. We tested all these phantoms as well as ex vivo pig liver and human normal, fatty and cirrhotic liver by measuring the elasticity, shear wave speed, ultrasound attenuation, CT-scan density, MRI signal intensity and fracture force. We assessed the results of the testing performed, as well as the optical appearance on ultrasound, CT and MRI, in order to find the best recipe for gelatin-based phantoms for image-guided procedure training. Results: After the assessment of all phantom recipes, we selected as the best recipe for transparent phantoms one with 14 g of gelatin/100 mL water and for opaque phantom, the recipes with 25% cream. Conclusions: These liver gelatin-based phantom recipes are an inexpensive, reproducible and accessible alternative for training in image-guided and diagnostic procedures and will meet most requirements for valuable training.