Inter-institutional protocol for the use of three-dimensional printing in the childhood epilepsy surgical planning: from 3D modeling to neuronavigation

This study is the first step in the effort for the use of three-dimensional (3D) printing in pediatric surgical planning by establishing effective collaboration between Ribeirao Preto Clinics Hospital (HCRP) and Renato Archer Center for Information Technology (CTI). The first printed biomodel can be used to support discussion and decision making, and neuronavigation before the surgery for training of cutting plans and incisions. The main focus of 3D printing for specific case handling is to reduce side damages by improving individual surgical planning and personnel training before surgery. One object representing brain and face segment of a patient was produced by 3D printing technology based on magnetic resonance imaging (MRI) data. Specific landmarks were measured by three distinct methods: manual caliper, InVesalius software measurement tool and neuronavigation coordinate detection. The mean coefficient of variation was 7.17% between all methods and landmarks measured. Our first results validate the combined use of biomodels with InVesalius software tools for assessment of individual brain anatomy providing manual handling and visualization of three-dimensional models. The creation of communication protocols between the teams involved and navigation protocols for quality control opens possibility of long term training program, congregating agents from research areas in Medical Physics, Medical Sciences and Neuroscience. Index Terms additive manufacture, neuronavigation, surgical planning, open source software, InVesalius.