Personalized 3D printed model of kidney and tumor anatomy: a useful tool for patient education

Abstract

Purpose: To assess the impact of 3D printed models of renal tumor on patient's understanding of their conditions. Patient understanding of their medical condition and treatment satisfaction has gained increasing attention in medicine. Novel technologies such as additive manufacturing [also termed three-dimensional (3D) printing] may play a role in patient education.

Methods: A prospective pilot study was conducted, and seven patients with a primary diagnosis of kidney tumor who were being considered for partial nephrectomy were included after informed consent. All patients underwent four-phase multi-detector computerized tomography (MDCT) scanning from which renal volume data were extracted to create life-size patient-specific 3D printed models. Patient knowledge and understanding were evaluated before and after 3D model presentation. Patients' satisfaction with their specific 3D printed model was also assessed through a visual scale.

Results: After viewing their personal 3D kidney model, patients demonstrated an improvement in understanding of basic kidney physiology by 16.7 % (p = 0.018), kidney anatomy by 50 % (p = 0.026), tumor characteristics by 39.3 % (p = 0.068) and the planned surgical procedure by 44.6 % (p = 0.026).

Conclusion: Presented herein is the initial clinical experience with 3D printing to facilitate patient's pre-surgical understanding of their kidney tumor and surgery.

Keywords: 3D printing; Education; Kidney tumors; Partial nephrectomy; Renal cancer.

Conflict of interest statement

Conflict of interest The authors declare that they have no competing interests.

Figures

Fig. 1

3D printed model for case 1. Comparative views of the CT scan at the nephrographic phase (a axial, b coronal and c sagittal planes) and corresponding views of the physical model (d superior and median view, e median and anterior view, f lateral view). An inferior polar cyst is also displayed on this model (translucent yellow). The cubes show the 3D printed model orientation in space (I = inferior face, A = anterior face, L = lateral side, S = superior face, P = posterior face, M = median side). Case 1 underwent a left radical nephrectomy for a 65 × 56 × 42 mm clear cell renal cell carcinoma, pT1bN0Mx, Fuhrman grade 3

Fig. 2

3D printed model for case 4. Comparative views of the CT scan at the nephrographic phase (a axial, b coronal and c sagittal planes) and corresponding views of the physical model (d superior and median view, e median and anterior view, f median and posterior view). The cubes show the 3D printed model orientation in space (I = inferior face, A = anterior face, L = lateral side, S = superior face, P = posterior face, M = median side). Case 7 underwent a left partial nephrectomy for a 36 × 22 × 16 mm clear cell renal cell carcinoma, pT1aNxMx, Fuhrman grade 3

Fig. 3

3D printed model for case 7. Comparative views of the CT scan at the nephrographic phase (a axial, b coronal and c sagittal planes) and corresponding views of the physical model (d superior view, e median view, f median view). The cubes show the 3D printed model orientation in space (I = inferior face, A = anterior face, L = lateral side, S = superior face, P = posterior face, M = median side). Case 7 underwent a left partial nephrectomy for a 21 × 15 × 15 mm angiomyolipoma

Fig. 4

Percentage of correct responses per patient, before and after 3D printed model presentation. Individual analysis of patient’s understanding improvement (percentage of correct responses) on four areas: a basic kidney physiology; b kidney anatomy; c disease and tumor characteristics; d surgical procedure and risk of complications. 3D p. model = 3D printed model. Pt = patient

Fig. 5

Mean percentage of correct responses per cognitive component, before and after 3D printed model presentation. Group analysis showing the mean improvement rate of patient’s understanding on four cognitive components. After 3D printed model presentation, the mean improvement rate of understanding was 16.7, 50, 39.3 and 44.6 % for basic kidney physiology, kidney anatomy, disease and tumor characteristics and surgical procedure and risk of complications, respectively