Key result
Photogrammetry of 3D-printed aortic valves yields sub-millimetric differences versus 2D CT, demonstrating high preprocedural accuracy.
Why the study?
The accuracy of 3D-printed aortic valve models created from cardiac computed tomography angiography images using planimetric and photogrammetric measurement methods was not established.
Does photogrammetric measurement of 3D-printed aortic valve models accurately reflect planimetric measurements from 2D computed tomography in patients with severe aortic stenosis?
Cross-Sectional (n=20)
No
Does photogrammetric measurement of 3D-printed aortic valve models accurately reflect planimetric measurements from 2D computed tomography in patients with severe aortic stenosis?
Digital photogrammetry of 3D-printed aortic valve models provides measurements that are highly comparable to standard 2D computed tomography planimetry.
Accuracy in 3D-printed models should not yet change practice; leaves open prospective outcome validation in severe aortic stenosis.
Background 3D printing has changed the paradigm of personalized medicine. Similarly to fingerprints, there are no two identical hearts; consequently, in cardiology, diagnosis and treatment, either medical, interventional or surgical, must be individualized according to the specific problem of a particular patient. The aim of this proof-of-concept study was to analyze two measurement methods, the planimetric and the photogrammetric method, in the process of creating a 3D-printed model from cardiac computed tomography angiography images and to evaluate the accuracy of an aortic valve anatomical model. Material and methods Cardiac computed tomography images, obtained from 20 patients with severe aortic stenosis, underwent stereolithographic reconstruction using 3D Slicer to create digital 3D models of the aortic valves. Serial measurements of six key elements of the aortic valvular apparatus were measured on the 3D model and compared to the measurements taken on the 2D computed tomography images. Results The differences between the two measurement methods were sub-millimetric in case of the left ventricular outflow tract and the sinotubular junction, and 1.386 mm for the left sinus of Valsalva (p = 0.0412), 0.3476 mm for the right sinus of Valsalva (p = 0.1874), and 0.6905 mm for the non-coronary Valsalva sinuses (p = 0.1353). Sinus heights were also similar, with a difference of 0.0119 mm (p = 0.6521). Conclusion In this study, the results of digital photogrammetry were superimposable to those of computed tomography scan measurements. The accuracy of each 3D-printed model depends on geometric complexity, the level of training of the personnel, and on the resources of each 3D printing laboratory.
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Cernica et al. (2023) conducted a cross-sectional in Severe aortic stenosis (n=20). Photogrammetric measurements of 3D-printed models vs. Planimetric measurements on 2D cardiac CT was evaluated on Difference in left sinus of Valsalva diameter between planimetric and photogrammetric measurements (MD 1.386 mm, p=0.0412). Photogrammetric measurements of 3D-printed aortic valve models showed sub-millimetric differences compared to 2D computed tomography for most landmarks, demonstrating high accuracy for preprocedural planning.
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