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3D printing might save your life one day. It's transforming medicine and health care.

What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.

Northwell Health
  • Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
  • Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
  • Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.

Imagine that a health emergency strikes and you need an organ transplant – say, a heart. You get your name on a transplant list, but you find out there's a waiting period of six months. Tens of thousands of people find themselves in this dire situation every year. But 3D printing has the potential to change that forever.

The technology could usher in a future where transplantable organs can be printed not only cheaply, but also to the exact anatomical specifications of each individual patient.

What other innovations could 3D printing bring to medicine and health care? The sky is the limit, according to Dr. Todd Goldstein, a researcher with the corporate venturing arm of Northwell Health, New York State's largest health care provider and an industry leader in 3D-printing research and development.

"It comes down to what people can think up and dream up what they want to use 3D printing for," Goldstein says. "Ideally, you would hope that 50 years from now you'd have on-demand, 3D printing of organs."

While that's still on the horizon for researchers, 3D printing is already improving lives by revolutionizing medicine in three key areas.

​Printing realistic, customized organ models

3D printers can take images from MRI, PET, sonography or other technologies and convert them into life-size, three-dimensional models of patients' organs. These models serve as hands-on visualization tools that help surgeons plan the best approaches for complex procedures.

They also allow doctors to customize patient-specific models prior to surgery. For example, Northwell employs 3D printing in several clinical applications:

  • Tumor resection models clearly highlight the tumor and surrounding tissue
  • Orthopedic models are useful for pre-surgery measuring and medical device adjustments
  • Vascular models identify malformations in organs, tumors, sliced chambers, blood flow, valves, muscle tissue, and calcifications
  • Dentistry oral implants and appliances can be created in just one day, significantly reducing wait periods for Northwell dentists and their patients

Using realistic models not only delivers better health results but also shortens operating times. That gives patients less time under anesthesia, and hospitals potential savings of millions of dollars over just a few years.

Being able to visualize procedures before they occur also helps to comfort patients and their families. Take, for instance, the case of Barnaby Goberdhan, a man who discovered that his young son, Isaiah, had an aggressive tumor in his palate. Goberdhan met with Neha A. Patel, MD, a pediatric otolaryngologist at Cohen Children's Medical Center, a Northwell Health hospital, to discuss the procedure and learn about it with help from a 3D-printed model.

"Having a 3D printed depiction of my son was really helpful when talking with the doctor about his surgery," said Mr. Goberdhan. "The doctor was able to do more than talk me through what they were going to do – Dr. Patel showed me. There is almost nothing more frightening and stressful than having your child go through surgery. There were several options Dr. Patel walked us through for the best way to preserve Isaiah's teeth and prevent additional cuts within his mouth. I wanted all of my questions answered so I could be less fearful and more prepared to talk my son through what he was about to face. I wanted Isaiah to feel prepared. With the 3D model, we both felt more at ease."

For years, 3D printing surgical models was prohibitively expensive. Now, more affordable systems such as Formlabs' Form Cell give more hospitals across the country access to the technology in order to produce realistic, patient-specific models, usually within one day.

3D-printed prosthetics

Credit: Northwell Health

While 3D-printed organs are a long way in the future, today's technology is well suited for manufacturing prosthetics. 3D-printed prosthetics are often remarkably more affordable and personalized than their traditional counterparts. That's a big deal for many families, especially those with children who outgrow prosthetics and are forced to buy new ones.

One recent breakthrough in 3D-printed prosthetics came when Dan Lasko, a former Marine who lost the lower part of his left leg in Afghanistan, wanted the ability to swim with his prosthetic leg. Wearing prosthetics in water has been possible for years, but they typically slow swimmers down. No device had been able to go seamlessly from land to water or to help propel its wearer through the water.

To fix that, Northwell Health recently funded a project that developed The Fin – the world's first truly amphibious prosthetic. With The Fin, Lasko and his family can go straight into the pool from the locker room – or the diving board.

"I got back in the pool with my two young sons and for the first time was able to dive into the pool with them," Lasko said.

3D-printed prosthetics will help improve the daily lives of the nearly 2 million Americans who've lost a limb. That's promising because the increasing prevalence of Type 2 diabetes is expected to greatly increase the number of amputees in the U.S., according to a study published in the Archives of Physical Medicine and Rehabilitation.

​3D bioprinting

For years, 3D printers have manufactured various products: phone cases, toys, and even operational guns. To produce these objects, the machines heat a raw material, typically plastic, and build the object layer-by-layer according to a particular design.

3D bioprinting, a young field developed by researchers with Northwell Health, may someday perform the same process but instead with living cells in a raw material called bioink.

Daniel A. Grande, director at the Orthopedic Research Laboratory in the Feinstein Institute for Medical Research, an arm of Northwell Health, said he and his team first pursued 3D bioprinting by modifying 3D printers so they'd accept living cells.

"My initial concept of 3D printing was early studies that looked at modifying ink-jet printers, where we incorporate a bioink that includes cells within a delivery vehicle," Grande says. "That hydrogel can then be polymerized, or hardened, upon heat or UV-light stimulation, so that we can actually make a complex structure, three-dimensionally, that incorporates living cells. The hardened hydro-gel is then able to keep the cells alive and viable. It's also biocompatible, so it can be safely implanted in humans."

It's a promising enterprise, and it can radically change how we experience medical care.

"3D bioprinting's potential is almost limitless and has the potential to replace many different parts of the human body," says Michael Dowling, president and CEO at Northwell Health, and author of Health Care Reboot. "Researchers envision a future with 3D printers in every emergency room, where doctors are able to print emergency implants of organs and bones on demand and revolutionize the way medicine is practiced."

Dr. Todd Goldstein explains more about 3D bioprinting below:

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A "very massive star" in the Kinman Dwarf galaxy caught the attention of astronomers in the early years of the 2000s: It seemed to be reaching a late-ish chapter in its life story and offered a rare chance to observe the death of a large star in a region low in metallicity. However, by the time scientists had the chance to turn the European Southern Observatory's (ESO) Very Large Telescope (VLT) in Paranal, Chile back around to it in 2019 — it's not a slow-turner, just an in-demand device — it was utterly gone without a trace. But how?

The two leading theories about what happened are that either it's still there, still erupting its way through its death throes, with less luminosity and perhaps obscured by dust, or it just up and collapsed into a black hole without going through a supernova stage. "If true, this would be the first direct detection of such a monster star ending its life in this manner," says Andrew Allan of Trinity College Dublin, Ireland, leader of the observation team whose study is published in Monthly Notices of the Royal Astronomical Society.

So, em...

Between astronomers' last look in 2011 and 2019 is a large enough interval of time for something to happen. Not that 2001 (when it was first observed) or 2019 have much meaning, since we're always watching the past out there and the Kinman Dwarf Galaxy is 75 million light years away. We often think of cosmic events as slow-moving phenomena because so often their follow-on effects are massive and unfold to us over time. But things happen just as fast big as small. The number of things that happened in the first 10 millionth of a trillionth of a trillionth of a trillionth of a second after the Big Bang, for example, is insane.

In any event, the Kinsman Dwarf Galaxy, or PHL 293B, is far way, too far for astronomers to directly observe its stars. Their presence can be inferred from spectroscopic signatures — specifically, PHL 293B between 2001 and 2011 consistently featured strong signatures of hydrogen that indicated the presence of a massive "luminous blue variable" (LBV) star about 2.5 times more brilliant than our Sun. Astronomers suspect that some very large stars may spend their final years as LBVs.

Though LBVs are known to experience radical shifts in spectra and brightness, they reliably leave specific traces that help confirm their ongoing presence. In 2019 the hydrogen signatures, and such traces, were gone. Allan says, "It would be highly unusual for such a massive star to disappear without producing a bright supernova explosion."

The Kinsman Dwarf Galaxy, or PHL 293B, is one of the most metal-poor galaxies known. Explosive, massive, Wolf-Rayet stars are seldom seen in such environments — NASA refers to such stars as those that "live fast, die hard." Red supergiants are also rare to low Z environments. The now-missing star was looked to as a rare opportunity to observe a massive star's late stages in such an environment.

Celestial sleuthing

In August 2019, the team pointed the four eight-meter telescopes of ESO's ESPRESSO array simultaneously toward the LBV's former location: nothing. They also gave the VLT's X-shooter instrument a shot a few months later: also nothing.

Still pursuing the missing star, the scientists acquired access to older data for comparison to what they already felt they knew. "The ESO Science Archive Facility enabled us to find and use data of the same object obtained in 2002 and 2009," says Andrea Mehner, an ESO staff member who worked on the study. "The comparison of the 2002 high-resolution UVES spectra with our observations obtained in 2019 with ESO's newest high-resolution spectrograph ESPRESSO was especially revealing, from both an astronomical and an instrumentation point of view."

Examination of this data suggested that the LBV may have indeed been winding up to a grand final sometime after 2011.

Team member Jose Groh, also of Trinity College, says "We may have detected one of the most massive stars of the local Universe going gently into the night. Our discovery would not have been made without using the powerful ESO 8-meter telescopes, their unique instrumentation, and the prompt access to those capabilities following the recent agreement of Ireland to join ESO."

Combining the 2019 data with contemporaneous Hubble Space Telescope (HST) imagery leaves the authors of the reports with the sense that "the LBV was in an eruptive state at least between 2001 and 2011, which then ended, and may have been followed by a collapse into a massive BH without the production of an SN. This scenario is consistent with the available HST and ground-based photometry."

Or...

A star collapsing into a black hole without a supernova would be a rare event, and that argues against the idea. The paper also notes that we may simply have missed the star's supernova during the eight-year observation gap.

LBVs are known to be highly unstable, so the star dropping to a state of less luminosity or producing a dust cover would be much more in the realm of expected behavior.

Says the paper: "A combination of a slightly reduced luminosity and a thick dusty shell could result in the star being obscured. While the lack of variability between the 2009 and 2019 near-infrared continuum from our X-shooter spectra eliminates the possibility of formation of hot dust (⪆1500 K), mid-infrared observations are necessary to rule out a slowly expanding cooler dust shell."

The authors of the report are pretty confident the star experienced a dramatic eruption after 2011. Beyond that, though:

"Based on our observations and models, we suggest that PHL 293B hosted an LBV with an eruption that ended sometime after 2011. This could have been followed by
(1) a surviving star or
(2) a collapse of the LBV to a BH [black hole] without the production of a bright SN, but possibly with a weak transient."

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