From 3-Dimensional Printing to 5-Dimensional Printing: Enhancing Thoracic Surgical Planning and Resection of Complex Tumors

Purpose. Three-dimensional (3D) printing of anatomic models for complex surgical cases improves patient and resident education, operative team planning, and guides the operation. Our group describes two additional dimensions. Description. The process of 5-dimensional (5D) printing was developed for surgical planning. Pretreatment computed tomography and positron emission tomography scans were reformatted and fused. Selected anatomy from these studies, along with posttreatment computed tomography and magnetic resonance images, were coregistered and segmented. This fused anatomy was converted into stereolithography files for 3D printing. Evaluation. A patient presenting with a complex thoracic tumor was selected for 5D printing. 3D and 5D models were prepared to allow surgical teams to directly evaluate and compare the added benefits of information provided by printing in 5 dimensions. Conclusions. Printing 5D models in patients with complex thoracic pathology facilitates surgical planning, selecting margins for resection, anticipating potential difficulties, teaching for learners, and education for patients. (C) 2016 by The Society of Thoracic Surgeons