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Development of an Ultrasound Phantom for Spinal Injections With 3-Dimensional Printing

West, Simeon J. FRCA*; Mari, Jean-Martial PhD*; Khan, Azalea BSc*; Wan, Jordan H. Y. BSc*; Zhu, Wenjie BSc*; Koutsakos, Ioannis G. BSc*; Rowe, Matthew PhD*; Kamming, Damon FRCA; Desjardins, Adrien E. PhD*

Regional Anesthesia and Pain Medicine: September/October 2014 - Volume 39 - Issue 5 - p 429–433
doi: 10.1097/AAP.0000000000000136
BRIEF TECHNICAL REPORT

Background and Objectives This report describes a method for producing anatomically detailed, low-cost ultrasound phantoms of the spine with 3-dimensional printing. An implementation that involves representing a portion of the lumbar spine and the ligamentum flavum with 2 different printing materials and the surrounding soft tissues with agar gel is presented.

Methods A computed tomography image volume of a patient with normal spinal anatomy was segmented to isolate the spine. Segments representing the ligamentum flavum and a supporting pedestal were digitally added, and the result was printed with a 3-dimensional printer. The printed spine was embedded in agar gel as a soft tissue component. Ultrasound images of the phantom were acquired and compared with those acquired from a human patient.

Results The sonographic appearances of the phantom compared favorably with those observed from the human patient. The soft tissue component was suitable for needle insertions and could be remade replacing the agar.

Conclusions Ultrasound phantoms that are derived directly from patient anatomy have strong potential as learning tools for ultrasound-guided spinal insertions, and they could be used as preprocedural planning tools in cases involving pathologies, implants, or abnormal anatomies. Three-dimensional printing is a promising method for producing low-cost phantoms with designs that can be readily shared across clinical institutions.

Supplemental digital content is available in the text.

From the *University College London and †University College Hospital, London, United Kingdom.

Accepted for publication June 19, 2014.

Address correspondence to: Simeon J. West, FRCA, Main Theatres, Maple Bridge Link Corridor, Podium 3, University College Hospital, 235 Euston Rd, London, United Kingdom NW1 2BU (e-mail: simeon.west@nhs.net).

Attribution: Department of Medical Physics and Bioengineering, University College London.

This study received funding from 2 student summer grants and incorporates the work of 4 BSc students, who made substantial contributions as part of their BSc projects at University College London. A.K. was granted £1520 toward subsistence by the Wellcome Trust and J.H.Y.W. was granted £2000 toward subsistence from the Institute of Making at the University College London. In addition, funding from the Department of Medical Physics and Bioengineering at University College London was used for 3-dimensional printing costs.

This study was presented orally at the European Society for Regional Anaesthesia 2013 Meeting in Glasgow. The presentation was entitled “Development of a Phantom for Ultrasound Guided Spinal and Epidural Anaesthesia With Three-Dimensional Polymer Printing.”

The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.rapm.org).

Copyright © 2014 by American Society of Regional Anesthesia and Pain Medicine.