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Currently, surgical pathology training takes place in a high-stakes environment and is highly variable due to the availability of specimens, variable anatomy and surgical procedure, and distorting pathological findings. This challenge has been identified for the Diagnostic and Molecular Pathology, Diagnostic and Clinical Pathology residencies, and Pathology Assistant Masters programs.
We have designed and created a system that utilizes a 3D representation of surgical specimens that can be used to address the above challenges.
3D-generated assets can be used for:
Use in training simulation and for maintenance of competency
Generate 3D printed models for demonstration of routine and specimens with complex anatomy
Training experience standardization
Distributive (remote) learning
Virtual reality ready
A special mold system was also designed to reproduce 3D models in other materials, such as silicone and cuttable organic materials
Practice of technical skills, especially for rare and unusual specimens
Incorporated into the institution's Standard Operating Procedures (SOP) to improve grossing/dissection accuracy
Enhanced SOPs to reduce errors in interpretation
Generation of high-quality illustrations for lectures, examinations, presentations, publications, training material, and SOP
Examples of these are outlined below.
Designed principles of 3D assets were based on the following:
Practical – focus on high-yield areas directly related to improving practice
Cost-effective – low-cost materials, with emphasis on longevity and reusability
Accessible – easily sharable technology, distributive learning, and low-cost of production with consumer-grade equipment
Workflow outline:
Workflow outline:
3D scanning and photogrammetry are used in the creation of digital assets, which include:
3D models
3D surface scan models (normal and pathology)
Printing of 3D solid models
Printable mold system for the creation of silicone models and cuttable materials
Resin 3D print
Resin 3D print
Solid, Durable with high detail resolution
Silicone cast
Silicone cast
Flexible, Reusable, Very long storage
Cuttable cast
Cuttable cast
Flexible, Organic reusable material cutting simulation, Limited storage and durability
Cuttable casts
Cuttable casts
Cuttable casts can be used for simulation, including anatomical orientation, inking, and dissection. The quality of the models allows simulation of removal of specific margins (examples below, including CBD and duodenal margins) and organ sectioning according to SOP. Custom-sized tumours can be embedded to enhance the simulation experience, if needed.
Whipple specimen
Whipple specimen
Precut specimen, high level of cast details
Example of CBD duct margin removal
Example of duodenal margin removal
Example of sectioning
Resultant slices can be used to simulation other parts specimen handling, such as mapping
Custom tumors can be introduced to enhace simulation
Example of 3D Whipple Model
Example of 3D Whipple Model
The model can be used for online modules and in conjunction with a simulation of the physical Whipple specimen cast
Once the main model is available, various pathologies (such as cancer) can be introduced with minimal resources. An example demonstrates a diagrammatic cut section showing the presence of infiltrative carcinoma.
Example of 3D Whipple Model
Example of 3D Whipple Model
The model can be used for the creation of high-quality diagrams for use in SOPs, lectures, publications, and training material
Example of shaded rendering of Whipple specimen
Example of 3D Glossectomy Model
Example of 3D Glossectomy Model
3D-printed molds are used to cast specimens for various materials, including various grade and hardness silicones and cuttable materials
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