{"id":18492,"date":"2020-03-16T19:09:22","date_gmt":"2020-03-16T19:09:22","guid":{"rendered":"https:\/\/www.ucf.edu\/pegasus\/?p=18492&post_type=story"},"modified":"2021-06-22T19:11:38","modified_gmt":"2021-06-22T19:11:38","slug":"models-for-success","status":"publish","type":"story","link":"https:\/\/www.ucf.edu\/pegasus\/models-for-success\/","title":{"rendered":"Models for Success"},"content":{"rendered":"

Spring 2020 | By Robert Stephens<\/em><\/p>\n

[lead]On a Sunday evening, Jack\u00a0Stubbs\u2019 phone rings. He\u00a0thinks about letting it go to\u00a0voicemail until he notices\u00a0who is calling: a doctor from Nemours\u00a0Children\u2019s Hospital. A small child with\u00a0badly impacted teeth needs surgery\u00a0right away, but it\u2019s complicated,\u00a0possibly life-threatening. The medical\u00a0team looks to Stubbs for help.[\/lead]<\/p>\n

Stubbs is not a doctor. As the\u00a0director of the Prototype Development\u00a0and 3D Print Lab (PD3D) at UCF, he\u2019s\u00a0basically a gadget guy. His demeanor\u00a0is as casual as the jeans he wears to\u00a0his office at Central Florida Research\u00a0Park. Here, Stubbs shows what first\u00a0appear to be toys. Behind him, the\u00a0constant drone of printers creates a\u00a0soothing backdrop of white noise.<\/p>\n

\u201cThis is the cool stuff,\u201d Stubbs says.\u00a0What you see barely begins to convey\u00a0what he means. Over here is a head\u00a0small enough to be on an American\u00a0Girl doll \u2014 except it\u2019s more humanlike.\u00a0Hey, isn\u2019t that a heart? It\u2019s remarkably\u00a0realistic. Oh, and there\u2019s a rib cage with\u00a0slime around a kidney.<\/p>\n

\u201cThat\u2019s a patient-specific replica of a\u00a0child\u2019s midsection,\u201d says Stubbs. \u201cThe\u00a0green stuff [represents] the tumor. We\u00a0don\u2019t know the child\u2019s name or where\u00a0the family lives, but I\u2019m guessing it\u2019s a\u00a0girl, about 5 years old.\u201d<\/p>\n

In other words, we\u2019re looking at the\u00a0closest depiction possible of a body\u00a0part of an actual child. We\u2019re also\u00a0looking at her cancer.<\/p>\n

\u201cA tumor isn\u2019t the nice, tidy lump\u00a0you see in pictures. In real life it\u2019s\u00a0messy, and it makes the job of a\u00a0physician challenging. That\u2019s why\u00a0these models are so valuable. We\u2019re\u00a0helping doctors save lives,\u201d Stubb says.<\/p>\n

[photo id=”19120″ title=”website2-ucf_29539874″ alt=”” position=”center” width=”100%”][\/photo]<\/p>\n

To be able to look at a model of a tumor from all angles, without the restrictions of an image on a computer screen, is completely changing how we are planning complex surgery,\u201d says Physician Craig Johnson, who is enterprise director of interventional radiology at Nemours Children\u2019s Health System and chair of the department of radiology at Nemours Children\u2019s Hospital in Orlando. (Photo by Nick Leyva \u201915)

<\/p><\/div>\n

[callout background=”#efece5″ content_align=”left” affix=”false” css_class=””] [blockquote source=”Jack Stubbs” cite=”” color=”#000000″ css_class=””]\u201cA tumor isn\u2019t the nice, tidy lump\u00a0you see in pictures. In real life it\u2019s\u00a0messy, and it makes the job of a\u00a0physician challenging. That\u2019s why\u00a0these models are so valuable. We\u2019re\u00a0helping doctors save lives.\u201d[\/blockquote][\/callout]<\/p>\n

Physician Craig Johnson chairs\u00a0the department of radiology\u00a0at Nemours Children\u2019s Health\u00a0System. He sees the young lives\u00a0that are at stake and talks with the families\u00a0trying to cope. He also appreciates the\u00a0importance of Stubbs\u2019 contributions.<\/p>\n

\u201cThe key to advancing medicine and saving\u00a0lives is to combine the minds of doctors,\u00a0clinicians and engineers,\u201d says Johnson.\u00a0\u201cThat\u2019s why Jack\u2019s patient-specific models are\u00a0game changers. You have to remind yourself\u00a0that each model is an exact replica, down to 0.1\u00a0millimeter of what is actually inside that child.\u201d<\/p>\n

The phone call Stubbs received on Sunday\u00a0helps illustrate the lifesaving process. A doctor\u00a0tells him about the patient\u2019s teeth being buried\u00a0deep among neurological tissues. Highly\u00a0developed MRIs and CT scans are helpful only\u00a0to a certain point.<\/p>\n

\u201cCan you help us?\u201d the doctor asks.<\/p>\n

This is what enticed Stubbs and Fluvio Lobo,\u00a0principal research and development engineer\u00a0at PD3D, to leave their lab at the University\u00a0of Minnesota and take positions at UCF.\u00a0Here, they have the opportunity to combine\u00a0technology, healthcare<\/a> and education to do\u00a0something incredible \u2014 one precious life\u00a0at a time.<\/p>\n

[photo id=”19122″ title=”Website2-UCF-NEMOURS-PD3D-Lab-Guys-CMYK” alt=”” position=”center” width=”100%”][\/photo]<\/p>\n

At UCF\u2019s PD3D lab in Central Florida\u00a0Research Park, Director Jack Stubbs, Principal\u00a0Research and Development Engineer Fluvio\u00a0Lobo, Director of Generative Design Jim\u00a0Inziello and artist Robert Sims \u201919<\/strong> collaborate with Nemours to produce the final 3D-printed surgical planning models<\/a>. (Photo by Nick Leyva \u201915)

<\/p><\/div>\n

A few hours after the phone call, Stubbs\u2019\u00a0team receives images of the child\u2019s skull.\u00a0Then the magic happens. PD3D director of\u00a0generative design Jim Inziello and researcher\u00a0Robert Sims \u201919<\/strong> add color-textured surfaces\u00a0and features that will allow the doctors to\u00a0better visualize the focal points of the surgery.\u00a0The information is fed into a Stratasys Polyjet\u00a0J750 printer \u2014 one of the most advanced 3D\u00a0printers of its kind, and one of the first to use\u00a0FDA-approved software to develop anatomical\u00a0models. Soon, a replica of the child\u2019s jaw will\u00a0be in Stubbs\u2019 hands. He will deliver it to the\u00a0physician, who in turn will use it with a team\u00a0of neurologists, reconstructive surgeons and\u00a0nurses. They will see the jaw and the buried\u00a0teeth and the brain, not in pictures, but in the\u00a0closest thing to real life. Then they will practice\u00a0the surgery before the surgery.<\/p>\n

\u201cIt takes out the guesswork, big-time,\u201d says\u00a0Johnson. \u201cThe surgeons can see everything\u00a0the way they\u2019ll see it when they open the\u00a0actual body rather than on a two-dimensional\u00a0flat-panel TV. Sometimes they\u2019ll change their\u00a0approach, maybe change an angle to remove a\u00a0tumor and also save a kidney rather than taking\u00a0it all out.\u201d<\/p>\n

It\u2019s something Johnson could barely imagine\u00a0when he and a colleague first saw a 3D printer\u00a0at Best Buy in 2014 and thought, \u201cWhat\u00a0if?\u201d The future seemed to arrive fast when\u00a0Nemours partnered with the PD3D lab three\u00a0years later. Their first case together provided\u00a0the ultimate test.<\/p>\n

\u201cWe had a teenager whose family had been\u00a0told there was no way to treat a tumor that had\u00a0grown to the size of a small basketball,\u201d says\u00a0Johnson. \u201cThe tumor was around too many\u00a0of his organs, and it had blood vessels around\u00a0it. Chemo wasn\u2019t working. He had no more\u00a0options.<\/p>\n

The Nemours doctors weren\u2019t sure how\u00a0helpful a model from the PD3D lab would be.<\/p>\n

But they practiced on the model prior to the\u00a0surgery and strategized how to specifically and\u00a0safely remove the tumor. The boy walked out\u00a0of the hospital three days later.<\/p>\n

\u201cIt\u2019s been two years, and he\u2019s had no\u00a0recurrence of the cancer,\u201d Johnson says.<\/p>\n

[photo id=”19121″ title=”Website2-ucf_58034787″ alt=”” position=”center” width=”100%”][\/photo]<\/p>\n

Pushpak Patel, a radiology technologist, leads 3D printing services at Nemours and works with the hospital\u2019s CT and MRI groups to make the right imaging for the models. (Photo by Nick Leyva \u201915)

<\/p><\/div>\n

While Stubbs and Lobo don\u2019t have direct\u00a0contact with patients, they do hear the good\u00a0news from the doctors. \u201cHearing that \u2026 it\u00a0means a lot,\u201d says Lobo.<\/p>\n

Word has started to spread. The UCF\u00a0team has provided patient-specific models\u00a0for hospital teams as far away as Seattle and\u00a0San Francisco. Lake Nona Medical City will\u00a0present more opportunities as it grows. Stubbs\u00a0does admit frustration about moving this\u00a0technology out further and faster, even though\u00a0the 3D-printed models are being used in 113\u00a0hospitals in North America and more than 250\u00a0worldwide.<\/p>\n

\u201cThat isn\u2019t enough. There are thousands of\u00a0hospitals around the world,\u201d he says, holding\u00a0a replica of a rib cage. \u201cThis only costs $1,200\u00a0to print. We have an opportunity to change\u00a0healthcare \u2014 to make it more affordable\u00a0and to save lives.\u201d<\/p>\n

[callout background=”#efece5″ content_align=”left” affix=”false” css_class=””] [blockquote source=”Jack Stubbs” cite=”” color=”#000000″ css_class=””]\u201cThis only costs $1,200\u00a0to print. We have an opportunity to change\u00a0healthcare \u2014 to make it more affordable\u00a0and to save lives.\u201d[\/blockquote][\/callout]<\/p>\n

Hospitals, despite copious financial reserves,\u00a0cannot realistically do what\u2019s being done at\u00a0UCF. It isn\u2019t just a $400,000 3D printer. It\u2019s\u00a0literally a village, where expertise in computer\u00a0science<\/a>, mechanical engineering<\/a>, biomedical\u00a0sciences<\/a>, psychology<\/a> and architecture<\/a> can make\u00a0these tiny heads and hearts come to life.<\/p>\n

\u201cArt students<\/a> are as important as anyone,\u201d\u00a0says Lobo. \u201cThey paint each model to look the\u00a0way a doctor will see it in surgery. They don\u2019t\u00a0make it pretty \u2014 they make it realistic.\u201d<\/p>\n

Stubbs hands over a model of two conjoined\u00a0heads, so small they both can be held in one\u00a0palm. With this model, two lives could be saved.<\/p>\n

\u201cIt\u2019s hard to describe how motivating it is\u00a0when we hear what we hear on the other side\u00a0of this procedure,\u201d says Johnson, referring to\u00a0a child in post-op. \u201cIt\u2019s more than a black and\u00a0white image or a piece of plastic. It\u2019s a living\u00a0child.\u201d<\/p>\n

In the laid-back office at Research Park, a\u00a0printer continues to hum. The model of the\u00a0child\u2019s impacted teeth should be ready later\u00a0this afternoon. Stubbs will deliver it himself to\u00a0the surgical team, who will be given the chance\u00a0to see the nuances and angles they hadn\u2019t seen\u00a0previously. They will operate tomorrow.<\/p>\n

\u201cThis is as real as it gets,\u201d says Stubbs. \u201cHow\u00a0cool is that?\u201d<\/p>\n

[callout background=”#ffffff” content_align=”left” affix=”false” css_class=””]<\/p>\n

MODELS FOR SUCCESS<\/h2>\n
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A clear plastic was used to create\u00a0a model of 3-month-old conjoined twins\u00a0to allow doctors to clearly see where their\u00a0blood vessels are located. Craniopagus\u00a0twins, those who share a skull but not a\u00a0brain, is a rare phenomenon and separation\u00a0surgery requires surgeons to navigate\u00a0delicate networks of arteries and veins that\u00a0can often be tangled.<\/p>\n<\/div>\n<\/div>\n

[divider][\/divider]<\/p>\n

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[photo id=”19114″ css_class=”img-responsive” inline_css=”margin: 0 auto;” title=”ModelForSuccess-Example-Spine” alt=”” position=”center” width=”300px”][\/photo]<\/div>\n
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This model of an 8-year-old patient’s\u00a0severe scoliosis\u00a0allowed doctors to show and\u00a0explain to the patient and his parents exactly\u00a0how the child\u2019s spine was curving. It also\u00a0allowed surgeons to determine a surgical plan\u00a0that would be almost impossible to visualize\u00a0and plan using CT images alone.<\/p>\n<\/div>\n<\/div>\n

[divider][\/divider]<\/p>\n

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[photo id=”19113″ css_class=”img-responsive” inline_css=”margin: 0 auto;” title=”ModelForSuccess-Example-Lungs” alt=”” position=”center” width=”300px”][\/photo]<\/div>\n
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The yellow object depicts a tumor\u00a0within the abdomen of a 3-year-old patient.\u00a0Surgeons used the model to determine how\u00a0to remove the mass, which was growing\u00a0between his kidneys (shown in dark red)\u00a0and his pancreas (teal), while being sure\u00a0to not rupture any of his veins (blue) or his\u00a0arteries (orangish-red).<\/p>\n<\/div>\n<\/div>\n

[divider][\/divider]<\/p>\n

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[photo id=”19136″ css_class=”img-responsive” inline_css=”margin: 0 auto;” title=”ModelForSuccess-Example-Heart” alt=”” position=”center” width=”300px”][\/photo]<\/div>\n
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To help a 15-year-old patient better understand how a heart\u00a0functions\u00a0and how his particular condition affects it, doctors at Nemours\u00a0Children\u2019s Hospital used this model, which combines colors and labels to\u00a0illustrate the patient\u2019s anatomy. For example, the dark blue region in the\u00a0front is a pulmonary artery, magenta is the right ventricle and yellow is the\u00a0left ventricle.<\/p>\n<\/div>\n<\/div>\n

[divider][\/divider]<\/p>\n

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