Daily Bulletin 2015

Converting DICOM Images to 3‑D Printed Models Critical to Progress

Monday, Nov. 30, 2015

The impact of 3-D printing is so significant that it may become the standard way that doctors "talk to their patients." However, certain challenges must be overcome before the modality realizes its full potential in radiology and healthcare overall, said a presenter of a Sunday session.

"3-D printing is a completely disruptive technology in general and in medicine," said Frank Rybicki, M.D., Ph.D., professor and chair of the Department of Radiology at the University of Ottawa Faculty of Medicine. "It will change the way that doctors do procedures. It will change the way we teach young physicians."

Frank Rybicki, M.D., Ph.D.

Frank Rybicki, M.D., Ph.D.

3-D printing refers to the fabrication of graspable objects from digital models. 3-D printing itself depends on the advanced imaging modalities and protocols to generate source DICOM images amenable for printing. And while advanced visualization displays play a role in communicating information to referring clinicians, "there is an unmet need that radiologists need to fulfill to render DICOM images as 3-D printed models capable of providing both tactile feedback and tangible depth information of both anatomic and pathologic states," Dr. Rybicki said.

"Radiologists are trained to make a diagnosis using 'routine' 2-D images such as CT and MRI," Dr. Rybicki said. "Thus far, we don't have evidence that 3-D printing changes diagnoses. We hope that the ability to diagnose from 3-D printing will be realized in the future.

"Until now, what radiologists have not been able to do is allow the referring physician—for example the surgeon—to plan the procedure ahead of time with a 3-D model that can be held in their hand," said Dr. Rybicki. "Sometimes, the 'referring' physician is a radiologist doing an image-guided procedure. There is a large amount of evidence showing that this is now an essential part of patient care."

Radiologists will need to learn the software to convert images to DICOM, said Dr. Rybicki.

"It is essential that radiologists invest the time to learn the methods so that the printing of medical models from CT and MR images becomes integrated with radiology departments," he said. (See related RSNA sessions below).

Dr. Rybicki first began moderating didactic courses in 3-D printing at RSNA 2013. For the first time last year, participants were taught the software used to convert the image from a CT scan to a hand-held printed model. At this year's session, they did the same.


3-D printed cardiac model of a baby with congenital heart disease. Participants in the 3-D Printing (Hands-on) courses designed the same model from a standard CT Scan.

Reimbursement, Cost Remain Hurdles

There are a number of obstacles to more mainstream adoption of 3-D printing, including cost, training, materials, equipment, guidelines and the need for a consensus in terminology.

"If we're going to get reimbursement, we need a single reporting standard for 3-D printing," Dr. Rybicki said.

And reimbursement, he said, will be a major hurdle.

"All payors know that we need 3-D printing, and that it will eventually be reimbursed as the demand continues to swell," he said. "It will happen, but there are a lot of pressures to contain costs."

"Many vendors at RSNA 2015 are introducing new 3-D printing software, hardware and new collaborations," he said "This will drive down the costs over time."

DICOM, 3-D Printing Focus of RSNA 2015 Sessions

3-D Printing in Radiology (IN121-ED-TUA6)
Tuesday, Dec. 1, 12:15-12:45 p.m., Informatics (IN) Community, Learning Center

Presenters review 3-D printing technologies important to radiology practice; describe the steps to create a Standard Tessellation Language (STL) file from DICOM images; and illustrate the uses of 3-D printing in radiology.

3-D Printing (Hands-on) (RCA33)
Tuesday, Dec.1, 12:30-2:00 p.m., Room S401AB

The session will begin with a DICOM file and proceed through the steps to create a printable Standard Tessellation Language (STL) file. Attendees will learn to convert a set of DICOM files into a 3-D printed model through a series of simple steps.

3-D Printing (Hands-on) (RCA51)
Thursday, Dec. 1, 8:30-10:00 a.m., Room S401AB

This session repeats the Tuesday session.

Question of the Day:

We just purchased a new CT scanner from a different vendor and it's like trying to learn a new language to understand their parameters. How do I learn the new nomenclature?

Tip of the day:

Even if it is your personal lead apron, if it is stored on-site at the clinic, it must be checked annually as part of a quality assurance program.

The RSNA 2015 Daily Bulletin is owned and published by the Radiological Society of North America, Inc., 820 Jorie Blvd., Oak Brook, IL 60523.