Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: Abdominal, hepatobiliary, and gastrointestinal conditions

BACKGROUND: Medical 3D printing has demonstrated value in anatomic models for abdominal, hepatobiliary, and gastrointestinal conditions. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness criteria for abdominal, hepatobiliary, and gastrointestinal 3D printing indications. METHODS: A literature search was conducted to identify all relevant articles using 3D printing technology associated with a number of abdominal pathologic processes. Each included study was graded according to published guidelines. RESULTS: Evidence-based appropriateness guidelines are provided for the following areas: intra-hepatic masses, hilar cholangiocarcinoma, biliary stenosis, biliary stones, gallbladder pathology, pancreatic cancer, pancreatitis, splenic disease, gastric pathology, small bowel pathology, colorectal cancer, perianal fistula, visceral trauma, hernia, abdominal sarcoma, abdominal wall masses, and intra-abdominal fluid collections. CONCLUSION: This document provides initial appropriate use criteria for medical 3D printing in abdominal, hepatobiliary, and gastrointestinal conditions

Analysis of superficial subcutaneous fat Camper\u27s and Scarpa\u27s fascia in a United States cohort

Together, the Camper\u27s and Scarpa\u27s fasciae form the superficial fat layer of the abdominal wall. Though they have clinical and surgical relevance, little is known about their role in body composition across diverse patient populations. This study aimed to determine the relationship between patient characteristics, including sex and body mass index, and the distribution of Camper\u27s and Scarpa\u27s fascial layers in the abdominal wall. A total of 458 patients\u27 abdominal CT examinations were segmented via CoreSlicer 1.0 to determine the surface area of each patient\u27s Camper\u27s, Scarpa\u27s, and visceral fascia layers. The reproducibility of segmentation was corroborated by an inter-rater analysis of segmented data for 20 randomly chosen patients divided between three study investigators. Pearson correlation and Student\u27s t-test analyses were performed to characterize the relationship between fascia distribution and demographic factors. The ratios of Camper\u27s fascia, both as a proportion of superficial fat (r = -0.44 an

Gene hunting of the Genetic Analysis Workshop 16 rheumatoid arthritis data using rough set theory

We propose to use the rough set theory to identify genes affecting rheumatoid arthritis risk from the data collected by the North American Rheumatoid Arthritis Consortium. For each gene, we employ generalized dynamic reducts in the rough set theory to select a subset of single-nucleotide polymorphisms (SNPs) to represent the genetic information from this gene. We then group the study subjects into different clusters based on their genotype similarity at the selected markers. Statistical association between disease status and cluster membership is then studied to identify genes associated with rheumatoid arthritis. Based on our proposed approach, we are able to identify a number of statistically significant genes associated with rheumatoid arthritis. Aside from genes on chromosome 6, our identified genes include known disease-associated genes such as PTPN22 and TRAF1. In addition, our list contains other biologically plausible genes, such as ADAM15 and AGPAT2. Our findings suggest that ADAM15 and AGPAT2 may contribute to a genetic predisposition through abnormal angiogenesis and adipose tissue

Two-stage joint selection method to identify candidate markers from genome-wide association studies

The interaction among multiple genes and environmental factors can affect an individual's susceptibility to disease. Some genes may not show strong marginal associations when they affect disease risk through interactions with other genes. As a result, these genes may not be identified by single-marker methods that are widely used in genome-wide association studies. To explore this possibility in real data, we carried out a two-stage model selection procedure of joint single-nucleotide polymorphism (SNP) analysis to detect genes associated with rheumatoid arthritis (RA) using Genetic Analysis Workshop 16 genome-wide association study data. In the first stage, the genetic markers were screened through an exhaustive two-dimensional search, through which promising SNP and SNP pairs were identified. Then, LASSO was used to choose putative SNPs from the candidates identified in the first stage. We then use the RA data collected by the Wellcome Trust Case Control Consortium to validate the putative genetic factors. Balancing computational load and statistical power, this method detects joint effects that may fail to emerge from single-marker analysis. Based on our proposed approach, we not only replicated the identification of important RA risk genes, but also found novel genes and their epistatic effects on RA. To our knowledge, this is the first two-dimensional scan based analysis for a real genome-wide association study

3D printing exposure and perception in radiology residency: Survey results of radiology chief residents

RATIONALE AND OBJECTIVES: The purpose of this study is to summarize a survey of radiology chief residents focused on 3D printing in radiology. MATERIALS AND METHODS: An online survey was distributed to chief residents in North American radiology residencies by subgroups of the Association of University Radiologists. The survey included a subset of questions focused on the clinical use of 3D printing and perceptions of the role of 3D printing and radiology. Respondents were asked to define the role of 3D printing at their institution and asked about the potential role of clinical 3D printing in radiology and radiology residencies. RESULTS: 152 individual responses from 90 programs were provided, with a 46% overall program response rate (n = 90/194 radiology residencies). Most programs had 3D printing at their institution (60%; n = 54/90 programs). Among the institutions that perform 3D printing, 33% (n = 18/54) have structured opportunities for resident contribution. Most residents (60%; n = 91/152 respondents) feel they would benefit from 3D printing exposure or educational material. 56% of residents (n = 84/151) believed clinical 3D printing should be centered in radiology departments. 22% of residents (n = 34/151) believed it would increase communication and improve relationships between radiology and surgery colleagues. A minority (5%; 7/151) believe 3D printing is too costly, time-consuming, or outside a radiologist\u27s scope of practice. CONCLUSIONS: A majority of surveyed chief residents in accredited radiology residencies believe they would benefit from exposure to 3D printing in residency. 3D printing education and integration would be a valuable addition to current radiology residency program curricula

Perineal hernia as a sequela of anal reconstruction surgeries in perianal Crohn\u27s disease

Perineal hernia is a rare complication of pelvic surgeries that can occur in patients with perianal Crohn\u27s disease (pCD) as a long-term outcome of surgeries for complex fistula treatment. We present a case of a symptomatic pCD male patient with multiple perianal surgeries who presents with anal pain, diarrhea, and discharge. Magnetic resonance imaging showed a perineal hernia in the ischioanal fossa violating the convergence of the left external sphincter complex. The hernia was treated with an open primary hernia repair via the perineal approach. It recurred after 3 months, and the patient underwent secondary hernia repair with gracilis muscle interposition and mesh placement. Unfortunately, this was complicated by superficial skin dehiscence and mesh extrusion, but the flap remained viable and the hernia repair was intact. Incidence, symptoms, risk factors, imaging findings, and management of perineal hernias are reviewed

Clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: Neurosurgical and otolaryngologic conditions

BACKGROUND: Medical three dimensional (3D) printing is performed for neurosurgical and otolaryngologic conditions, but without evidence-based guidance on clinical appropriateness. A writing group composed of the Radiological Society of North America (RSNA) Special Interest Group on 3D Printing (SIG) provides appropriateness recommendations for neurologic 3D printing conditions. METHODS: A structured literature search was conducted to identify all relevant articles using 3D printing technology associated with neurologic and otolaryngologic conditions. Each study was vetted by the authors and strength of evidence was assessed according to published guidelines. RESULTS: Evidence-based recommendations for when 3D printing is appropriate are provided for diseases of the calvaria and skull base, brain tumors and cerebrovascular disease. Recommendations are provided in accordance with strength of evidence of publications corresponding to each neurologic condition combined with expert opinion from members of the 3D printing SIG. CONCLUSIONS: This consensus guidance document, created by the members of the 3D printing SIG, provides a reference for clinical standards of 3D printing for neurologic conditions