07062017-Hayes-Alex-Mr Jun17

New technology is creating an array of opportunities for enhanced patient outcomes, according to RPH Bioengineer, Alex Hayes.

07062017-2a.-Cast-vs.-MouldThere’s no doubt about it, the ability to capture objects in 3D has been a boon for ‘reverse engineering’. This is particularly so in personalised medicine, in which patient imaging is used to create customised devices.

3D Scanning, as its name suggests, uses optical techniques to reconstruct the surface of an object in three dimensions.

In the past, scanners required trained operators and spatial tracking, and were highly sensitive to reflections and other interferences linked with ambient surroundings. Recent advances in computing power and electronics have made 3D scanning much more affordable and user-friendly. There are even hobbyists using it!

New technology such as stereophotography and mobile-phone accessibility creates possibilities for practical applications in real-world situations.

In medicine, the ability to replicate the ‘shape’ of a patient without the need for radiation or expensive medical imaging offers new and improved ways to streamline patient care. Its use is becoming the new standard of care at both RPH and FSH, particularly in orthotics and prosthetics clinics. And the advantages are significant.

07062017-2b.-MouldPatients can now be scanned in minutes and without the complications of traditional casting techniques. The ability to model a patient’s anatomy without direct contact mean less discomfort and a reduced risk of injury to fragile patients. In cases such as scoliosis the modifications can be optimised via computer simulation to improve results.

This technology, used in conjunction with sophisticated manufacturing techniques such as 3D printing and robotic carving vastly improves patient outcomes. Digital storage means models can be reproduced on demand, replacing the need to store bulky, heavy plaster casts. And it’s also significantly easier to handle for imaging staff and clinicians.

More and more clinical services are using this technology. The Rehabilitation Technology Unit, which operates out of RPH, and the State Rehabilitation Service has successfully introduced 3D scanning into clinical practice. They produce custom spinal jackets, ankle-foot orthoses and contoured cushions, which includes an entire prone-mattress with significantly improved turnaround times.

Patients can be digitally ‘cast’ in the clinic, on the wards or in their own home. The scan is then modified virtually and the final product is then carved on a seven-axis robotic milling machine at RPH. At FSH, the Maxillofacial Prosthetics department has utilised 3D scanning to develop a variety of cosmetic prostheses for exenteration and otectomy patients. In the past, a cast of the contralateral side had to be painstakingly mirrored by eye using expert judgment. Now, scans of the contralateral side can be captured, mirrored and modelled within minutes and are ready for 3D printing.

3D Scanning allows a hands-off approach to manufacturing allowing staff more time to see patients. While it does have limitations – only external surface images can be captured – 3D scanning offers a wide range of possibilities in the digital age of medicine.

Images courtesy Medical Illustrations, FSH

By Alex Hayes

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