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Firoza Kothari is the Co-Founder and CTO of Anatomiz3D LLP, an extensive ‘patient-specific’ solution provider to the healthcare industry, utilizing 3D Design, 3D Printing and, subsequently, Bioprinting technologies. She handles anatomical design, product development, strategy, collaborations and research at Anatomiz3D for 3 years now and is actively creating awareness in the fraternity by representing the technology at various platforms.
Anatomiz3D LLP is an organization incorporated to be a one-stop solution for customized medical products and applications, inventing and nurturing research along the way. 3D Printing is being utilized to create products that support various medical procedures, some of which are mentioned below as they are Anatomiz3D’s focus:
- Preoperative patient-specific surgical models used for pre-planning a surgery.
- Surgical Guides for cutting and drilling of bones.
- Pre Contouring of Implants on the 3D Printed model to reduce OT time
- Patient-Specific Implants for ensuring perfect fit and improved aesthetic outcome.
- Custom Prosthetics and Orthotics
Definition of 3D Printing related to Firoza’s expertise:
For the past 30 years, we have seen 3D Printing evolve as a technology, from slow, bulky, low accuracy machines to relatively fast, compact and good resolution printers. The invention of this technology in itself was a boost to the healthcare industry and we haven’t seen it slow down ever since.
For the industry I utilize it in, 3D printing is more than just a prototyping tool. It has proven to be a life savior on multiple occasions, and I mean this literally, not figuratively. Being able to convert Grey 2D Images to life-size 3D Models that aid in surgery automatically makes the whole surgical process a lot less complicated.
Can you share more details on how 3D Printing is currently used in your Industry?
In healthcare, 3D Printing is, primarily, serving as an addition to current 2D Imaging techniques. CT and MRI scans are basically 2D images stacked one above the other. These DICOM (Digital Imaging and Communications in Medicine) images are essentially Black and White images, formed by a range of grey scale values, each grey variant representing a certain type of tissue of the anatomy. To give one a brief understanding, the strongest bone appears white and air appears black in the images, the two extremes. All other tissues take up different colors on the grayscale to form a complete image of that particular section of the body. One CT or MRI of a patient will have roughly 300 such images (number of images is highly dependent on the type of equipment used and region of interest) and human eyes need to be trained to understand and analyze them in sequence.
DICOM to 3D Conversion software make use of this stacked property of the DICOM data to be worked on. Semi-automation of software currently available allows segmentation of basic anatomy to be performed very easily. Any further additions or subtractions can be done via editing tools that allow one to draw or erase on Data (imagine Microsoft Paint). Post design completion, what remains as drawn, gets converted to a 3D model, which can be exported in a 3D Printable format. It is important to note that understanding of anatomy is crucial while designing; else it might lead to the production of a faulty model, rendering it useless.
These models are used by surgeons to pre-plan a roadmap to operate on their patients. Following are the key advantages to various individuals involved in the healthcare ecosystem.
To the Medical Team:
- Addition to current 2D imaging techniques
- Decision making: whether to operate patient or not
- Faster and more precise Patient Specific treatment planning
- Such planning and practicing helps the medical team feel prepared and confident
- Implant pre-contouring
- Tools selection and Trajectory of screws can be fixed
- Improved communication within the team
- Student/Resident Education model
To the Hospital:
- OT time can be reduced
- More operations performed in a day
- The success rate can be defined over time
- More patient intake
To the Patient:
- Reduced blood loss
- Reduced time under anesthesia
- Reduced overall costs
- Improved recovery time
Apart from the anatomical models mentioned above, 3D Printing is now being widely used to fabricate customized implants that fit the patient perfectly, for cutting and drilling guides that help the surgeon place cuts at the pre-decided cuts and angles, custom prosthetics and orthotics that assist the patient to deal with post-surgical trauma and rehabilitation. Bioprinting is another major optimistic and futuristic application.
How do you see it in 5 or 10 years? What’s the roadmap you envision for 3D printing in your industry?
Our expectation is, that in the next 5 years, with improvements in quality and speed of technology, partnered with a drop in costs, most major hospitals and radiology centers will adopt 3D Printing as an in-house technology, making it mandatory as a product to be given along with the CD of the CT/MRI scan. Personalization of surgical practices using 3D printed implants and instruments won’t be a novelty, thereby observing trends of higher success rates.
Prosthetics and Orthotics industry will be able to fabricate on-the-go patient-specific products, providing their customers with custom fit and easily replaceable parts, reducing the need for any inventory.
Bioprinting, the new buzzword today, won’t be as naïve 10 years from now. Bioprinting is basically printing with animal cells, instead of plastics. Researchers have been successful enough to bring small 3D tissue constructs to pharmaceutical laboratories to test drugs on patient-specific tissues, one step closer to customized medicine. The rate at which the industry is growing through research is only proof of the fact that artificial replaceable organs, even though way beyond 10 years in the future, are still a possible future to imagine. We can hope for a world where we may not need organ donors someday.
What are the next steps and challenges to overcome to achieve your industry objectives for this technology?
The industry is still quite small due to its prohibitive costs. A load of payment falls on the already overburdened patient and not everyone is well aware of the possibilities of the technology. It is crucial that insurance companies start accepting this as a part of the diagnosis and treatment and eventually reimburse for the same.
On the technical front, the software available for 2D to 3D conversion are semi-automated, i.e., they can do some amount of basic segmentation, but are unable to analyze complex data. This leads to a need of knowledge-based designer, mostly a Biomedical Engineer, and a lot of time being spent on design activities, which is the most crucial part. This can be overcome by the evolution of more intelligent software that can help reduce the design time. They need to be more user-friendly for the medical community to accept the technology.
The speed of the printers, even though is much faster than before, still prohibits the use of this technology in emergency cases.
How mature is this market today?
The market is very raw. People have just started scraping the tip. The ecosystem is still naïve. The process is not well regulated. The liabilities are enormous but no one knows where it rests. Even though these problems exist, the awareness is spreading and necessary actions to regularize personalized healthcare are being taken.
How big can it become?
According to research reports by Markets and Markets, the 3D printing medical devices market is valued at USD 1.88 Billion by 2022, with an increasing CAGR of 17.5%
According to me, anyone and everyone who goes in for a CT or MRI form a potential market. Of course, this is not practical as of today, but the possibility is existent.
Who are the key players to follow?
The industry leaders who have established a stronghold in the market are companies like Materialise, Simpleware, 3D Systems, etc on the Software front. Medical giants such as GE, Philips, Siemens, etc, (basically those involved in the manufacturing of CT and MRI scans) are following suit. Medical device manufacturers such as Zimmer-Biomet, Stryker, etc, are at the forefront of customized instrumentation. Organovo is a major contributor to the Bioprinting field. We are aiming to be amongst these someday.
This is a guest post in our series Industry Insiders. If you’d like to participate in this series then contact us for more information.