Cootie.
Here at TCT we’ve reported on many of the amazing medical feats 3D printing has enabled from detailed medical models to metal cranial implants. But it’s not just humans that are benefitting from the numerous advantages the technology presents, as the veterinary world is discovering.
When Dr. Deveau, Radiation Oncologist and Clinical Associate Professor at Texas A&M’s Veterinary School, was researching treatments for Cutaneous Lymphoma, a type of cancer that affects the skin, he was introduced to Cootie, a small Bischon Frise who had travelled from New Jersey to Texas with her owner in search of an alterative treatment for this rare condition.
Typically, when humans are treated for Cutaneous Lymphoma, they are awake and required to remain stationary to ensure that radiation only passes through a particular area of the body and not too deep into the skin to avoid hitting non-affected organs. As you can imagine, for a dog, remaining in the same position throughout treatment is not that simple and so the procedure had been deemed impossible for animals affected with the disease. After performing some tests on a cadaver dog, which each took between two to three hours, Deveau concluded it would be incredibly difficult to perform this particular form of radiation treatment on a living patient. So Deveau came up with the idea to use a custom mould that would position the animal in the optimum position and ensure repeatability throughout their course of treatment.
3D printed treatment shell.
Having already performed CT scans on Cootie during consultation, the university had usable 3D data to hand, which could easily be turned into a digital file for manufacturing. But the traditional method of making moulds is expensive, specifically for one-offs, so an alternative was needed. With little experience in the technology beforehand, Deveau invested in a Gigabot 3D printer, a large-format, open source machine manufactured by Re:3D, to print a custom mould, or ‘treatment shell’, for Cootie.
“With the moulds, it was a very creative solution to the problem, no one had gone down that route of “what if we encased these patients in something so that we had them not only immobilised but so that every time they came in we knew they were in exactly the same spot”,” Morgan Hamel, Global Sales Manager, at Re:3D explained. “If you tried to do that before 3D printing your options were limited, you’d be limited to literally making a mould of the patient, which is very costly.”
These moulds are effectively a shell of the outer body that are placed around the animal to stop it from moving around and acts as a barrier to any infections during surgery. Cootie’s mould was printed in four pieces and took several days to complete at around 90% infill. The reason for this high infill level was to restrict the amount of radiation passing through the body but also to take more radiation out of the body and put it into the shell so that the radiation interacting with the shell could then turn around and back scatter into the patient. By around the fifth treatment Cootie was in strong partial remission and by the end of the course of therapy, she was in complete remission.
Cootie during a treatment session.
So far Cootie is the only animal to have been treated using Deveau’s method but the hope is that it can be adopted at other veterinary centres around the world. Theoretically, that shouldn’t be too difficult. Unlike other 3D printed medical devices, the moulds don’t require any certification but Morgan explains there is another potential barrier that the industry faces and that's education.
“I think a lot of people are hesitant to get into 3D printing if they haven’t been using it already and it’s true, there is a pretty hefty learning curve associated with 3D printing. What we're finding is that there are a lot of vet schools already using 3D printing just not quite to its fullest advantage. If they want something printed they have to send it to an engineer or get it printed in another part of the university and it’s just not convenient. They would love the ability to have a dedicated veterinary 3D printer at their disposal so that they could really easily work on these use cases that they have in mind because there are so many applications for 3D printing in veterinary
Cootie after treatment.
medicine, it’s just about implementing it.”
That’s precisely what is happening now at Texas A&M as a result of Dr. Deveau’s research. He’s now passing on his knowledge to other areas of the university where fellow professors and doctors are keen to learn if something is possible with this technology. According to Dr. Deveau, there is a big push from the veterinary sector to adopt more model-based training as the curriculum is re-designed to deliver more clinically focussed scenarios for hands-on experience. By giving clinicians the ability to visualise and pre-plan for the optimal method of surgery, the technology is opening up the doors to treatment for countless other animals.
Morgan added: “I think the biggest lesson he learned was that you can never anticipate all of the uses that will come out of having a 3D printer because there's pretty much an infinite amount of things you can use one for. It’s just about getting it in front of somebody and letting their imagination take over to figure out how they can make it practical for them.”
