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The tumour shown in a neuroblastoma, one of the most common cancers in children, accounting for 10% of cancers diagnosed in children

3D printing by the CIM Foundation helps to simulate operations on children with cancer

Surgeons at the Sant Joan de Déu Hospital in Barcelona have planned a complex operation to remove a tumour by printing it using the 3D printing technologies developed by the CIM Foundation, a UPC technology centre.

02/07/2014
The CIM Foundation —a technology centre belonging to the Universitat Politècnica de Catalunya · BarcelonaTech (UPC)— has proved that applying 3D printing in the medical field is feasible by printing a difficult-to-remove tumour in 3D. The printed model has helped a team of surgeons at the Sant Joan de Déu Hospital in Barcelona to carefully plan a highly complex operation.

The tumour shown is a neuroblastoma, one of the most common cancers in children, accounting for 10% of cancers diagnosed in children. They are extremely aggressive tumours that form in the nerve tissue and are mainly diagnosed in children under five. Treatment involves the surgical removal of the tumour in combination with chemotherapy and/or radiotherapy.

Surgical removal, however, poses a number of difficulties because of the location of the neuroblastoma, which surrounds blood vessels and arteries. Surgeons have to be extremely precise to extract tumour cells without damaging arteries and endangering the patient's life. Rehearsing the operation in advance is crucial, as it allows surgeons to work on the most effective way of removing the tumour and to practise it repeatedly before the operation. It also reduces the time of the operation, prevents complications and allows surgeons to study how they can remove as much of the tumour as possible.

In order to plan complex tumour-removal procedures, even on tumours which would appear to be inoperable, a team of surgeons at the Sant Joan de Déu Hospital decided to start making 3D replicas of the tumours. In collaboration with the CIM Foundation, they made a 3D copy of a neuroblastoma in a five-year-old boy. To make it, technicians at the CIM Foundation crossed data from computed tomography and magnetic resonance images taken from the child.

Although 3D printing has long been used in the field of maxillofacial surgery to model bone, soft tissue is an entirely new application. The difficulties of this application were twofold: first, radiologists and manufacturers had to study the scans of the affected area together and decide on the actual contours of the tissue, and second, the printed model had to be made with two different materials that were as similar as possible to the soft tissues that surgeons had to operate on.

The copy of the tumour was made using technology that allows printing on two types of materials. A resin was used to model the blood vessels and organs in the affected area, and another resin, translucent and of a soft consistency similar to that of the tumour, was used to allow surgeons to practise removing it without damaging the vessels and organs. To visualise the result sought in the operation, a prototype was also built of the organs without the tumour.

The CIM Foundation is the leading 3D printing technology centre in Catalonia and it is behind RepRapBCN, a low-cost 3D printer project. It not only promotes the research and application of these new digital manufacturing technologies in industry and the domestic sphere in Catalonia, but on the basis of the experience described therein it is now planning to develop new technology with the Sant Joan de Déu Hospital that allows materials of different textures and colours to be used to make models more realistic.

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