Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

CT and 3-D printing aid surgical separation of conjoined twins

02.12.2015

A combination of detailed CT imaging and 3-D printing technology has been used for the first time in the surgical planning for separation of conjoined twins, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

Conjoined twins, or twins whose bodies are connected, account for approximately one of every 200,000 live births. Survival rates are low and separating them through surgery is extremely difficult because they often share organs and blood vessels.


This is a 3-D color segmentation of CT data with 3-D model.

Credit: Radiological Society of North America/Texas Children's Hospital

Specialists at Texas Children's Hospital in Houston brought a new approach to these challenges when they set out to surgically separate Knatalye Hope and Adeline Faith Mata, conjoined twins from Lubbock, Texas. Knatalye and Adeline were born on April 11, 2014, connected from the chest all the way down to the pelvis.

"This case was unique in the extent of fusion," said the study's lead author, Rajesh Krishnamurthy, M.D., chief of radiology research and cardiac imaging at Texas Children's Hospital. "It was one of the most complex separations ever for conjoined twins."

To prepare for the separation surgery, Dr. Krishnamurthy and colleagues performed volumetric CT imaging with a 320-detector scanner, administering intravenous contrast separately to both twins to enhance views of vital structures and help plan how to separate them to ensure survival of both children.

They used a technique known as target mode prospective EKG gating to freeze the motion of the hearts on the images and get a more detailed view of the cardiovascular anatomy, while keeping the radiation exposure low.

"The CT scans showed that the babies' hearts were in the same cavity but were not fused," Dr. Krishnamurthy said. "Also, we detected a plane of separation of the liver that the surgeons would be able to use."

The team translated the CT imaging results into a color-coded physical 3-D model with skeletal structures and supports made in hard plastic resin, and organs built from a rubber-like material. The livers were printed as separate pieces of the transparent resin, with major blood vessels depicted in white for better visibility.

The models were designed so that they could be assembled together or separated during the surgical planning process. The surgical team used the models during the exhaustive preparation process leading up to the surgery.

On February 17, a little more than 10 months after they were born, the Mata twins underwent surgical separation by a team of more than 26 clinicians, including 12 surgeons, six anesthesiologists and eight surgical nurses. The official separation took place approximately 18 hours into the 26-hour surgery.

The 3-D models proved to be an excellent source of information, as there were no major discrepancies between the models and the twins' actual anatomy.

"The surgeons found the landmarks for the liver, hearts and pelvic organs just as we had described," Dr. Krishnamurthy said. "The concordance was almost perfect."

Dr. Krishnamurthy expects the combination of volumetric CT, 3-D modeling, and 3-D printing to become a standard part of preparation for surgical separation of conjoined twins, although barriers remain to its adoption.

"The 3-D printing technology has advanced quite a bit, and the costs are declining. What's limiting it is a lack of reimbursement for these services," he said. "The procedure is not currently recognized by insurance companies, so right now hospitals are supporting the costs."

Besides assisting clinicians prepare for surgery, the 3-D model also served another important function: helping the twins' parents, Elysse and John Eric Mata, understand the process.

"When I showed the mother the model and explained the procedure, she held my hand and thanked me," Dr. Krishnamurthy recalled. "They said, 'For the first time, we understand what is going to happen with our babies.'"

Knatalye Hope returned home in May 2015 and her sister Adeline Faith came home a month later. They are both doing well and have a Facebook page, "Helping Faith & Hope Mata," with updates on their progress.

###

Co-authors on the study are Nicholas Dodd, B.S., Darrell Cass, M.D., Amrita Murali and Jayanthi Parthasarathy, B.D.S., M.S., Ph.D.

Note: Copies of RSNA 2015 news releases and electronic images will be available online at RSNA.org/press15 beginning Monday, Nov. 30.

RSNA is an association of more than 54,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on CT, visit RadiologyInfo.org.

Media Contact

Linda Brooks
lbrooks@rsna.org
630-590-7762

 @rsna

http://www.rsna.org 

Linda Brooks | EurekAlert!

Further reports about: 3-D 3-D printing technology CT CT imaging RSNA blood vessels

More articles from Medical Engineering:

nachricht New technique makes brain scans better
22.06.2017 | Massachusetts Institute of Technology

nachricht New technology enables effective simultaneous testing for multiple blood-borne pathogens
13.06.2017 | Elsevier

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Quantum thermometer or optical refrigerator?

23.06.2017 | Physics and Astronomy

A 100-year-old physics problem has been solved at EPFL

23.06.2017 | Physics and Astronomy

Equipping form with function

23.06.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>