Growth of Trifolium subterraneum L. Selected for Sparse and Abundant Nodulation as Affected by Root Temperature and Rhizobium Strain

RESP-625

Creating Realistic 3D Models as Teaching Aids for Large Colorectal Polyp Assessment

Aims Endoscopists training in more advanced polypectomy techniques need to acquire skills in optical diagnosis. They must be able to estimate the risk of malignancy within a large, non-pedunculated colorectal polyp (LNPCP) because this is critical for decision-making regarding treatment, and to avoid adverse outcomes [Tate 2023]. Assessment is based on size, morphology, surface characteristics (pit/vascular pattern, demarcated areas) and other features such as tethering and ulceration. Since LNPCPs account for only 2-5% of polyps, they are infrequently encountered during training. Assessment skills are usually taught using photographs or videos. These generally highlight areas of interest, which makes it difficult for trainees to learn the skills necessary to interrogate a polyp to find discriminating features independently. We aimed to develop a comprehensive library of digital 3D LNPCPs which could be used as an interactive online teaching resource, and to 3D print a selection of these to create physical training models. Methods Virtual polyp models were created from reference images using digital 3D modelling software, ZBrush. A range of pit patterns were produced using reaction diffusion simulation software and overlayed on the polyps to create realistic 3D surface textures. The process was guided throughout by an experienced endoscopist. Digital 3D polyps were uploaded to an on-line learning environment where they could be manipulated and explored by users, with 'hot-spots' allowing annotations and additional learning material to be accessed via mouse click. Selected polyps were 3D printed in both durable and flexible resins, and finished by hand-painting. Evaluation was sought from expert colonoscopists who rated the models for realism and potential usefulness as educational tools. Results Both the digital 3D polyps and the physical 3D versions were rated as showing a high degree of realism. Morphology and discriminating features such as demarcated areas and variations in pit pattern were deemed sufficiently realistic to be useful for training. Suggestions for improvement included simulating the effects of chromoendoscopy and narrow band imaging (NBI) for the digital versions, and to present them in a more engaging environment, such as a simulated segment of colon. Conclusions We have demonstrated that close collaboration between experienced clinicians, and artists with expertise in 3D modelling and fabrication, can produce artificial polyps of sufficient fidelity to be useful as educational aids for teaching LNPCP assessment skills. Further work is ongoing to develop the models to provide simulations of image enhancement, and to present them in a navigable 3D on-screen simulated colon