Individualized medicine using 3D printing technology in gynecology: a scoping review

Individualized medicine using 3D printing technology in gynecology: a scoping review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Individualized medicine using 3D printing technology in gynecology: a scoping review Carly M Cooke, Teresa E Flaxman, Lindsey Sikora, Olivier Miguel, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2530895/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 17 Mar, 2023 Read the published version in 3D Printing in Medicine → Version 1 posted 4 You are reading this latest preprint version Abstract Objective: Developments in 3-dimensional (3D) printing technology has made it possible to produce high quality, affordable 3D printed models for use in medicine. As a result, there is a growing assessment of this approach being published in the medical literature. The objective of this study was to outline the clinical applications of individualized 3D printing in gynecology through a scoping review. Data Sources: Four medical databases (Medline, Embase, Cochrane CENTRAL, Scopus) and grey literature were searched for publications meeting eligibility criteria up to 31 May 2021. Study Eligibility Criteria: Publications were included if they were published in English, had a gynecologic context, and involved production of patient specific 3D printed product(s). Study Appraisal and Synthesis Methods: Studies were manually screened and assessed for eligibility by two independent reviewers and data were extracted using pre-established criteria using Covidence software. Results : Overall, 32 studies (15 abstracts,17 full text articles) were included in the scoping review. Most studies were either case reports (12/32,38%) or case series (15/32,47%). Gynecologic sub-specialties in which the 3D printed models were intended for use included: gynecologic oncology (21/32,66%), benign gynecology (6/32,19%), pediatrics (2/32,6%), urogynecology (2/32,6%) and reproductive endocrinology and infertility (1/32,3%). Twenty studies (63%) printed 5 or less models, 6/32 (19%) printed greater than 5 (up to 50 models). Types of 3D models printed included: anatomical models (11/32,34%), medical devices, (2/32,6%) and template/guide/cylindrical applicators for brachytherapy (19/32,59%). Conclusions : Our scoping review has outlined novel clinical applications for individualized 3D printed models in gynecology. To date, they have mainly been used for production of patient specific 3D printed brachytherapy guides/applicators in patients with gynecologic cancer. However, individualized 3D printing shows great promise for utility in surgical planning, surgical education, and production of patient specific devices, across gynecologic subspecialties. Evidence supporting the clinical value of individualized 3D printing in gynecology is limited by studies with small sample size and non-standardized reporting, which should be the focus of future studies. gynecology patient specific scoping review 3D printing Figures Figure 1 Introduction Recent advancements in three-dimensional (3D) printing technology have facilitated the production of 3D printed models of exemplary quality. Continued reductions in operating costs and time to generate 3D printed models has increased feasibility and gained considerable interest from the medical field. 3D printed models can be scaled to size, and display fine details, closely resembling human anatomy. As a result, there is an increasing body of literature reporting on the clinical applications of 3D printing in medicine. In high-fidelity 3D printing protocols, segmentation software is used to convert high quality 2-dimensional (2D) Magnetic Resonance (MR), Computed Tomography (CT) or ultrasound (US) images to 3D digital models, which can then be printed. 1 Hence, 3D printed models have the ability to be patient specific, with clinical applications in personalized medicine. In gynecology, 3D printed models can depict patient-specific female pelvic anatomy and gynecologic pathology, which may benefit physicians, trainees, and patients in their understanding of complex disease and management options. With a growing body of literature in the area of 3D printing, there has been a need to summarize the data on 3D printing and develop clinical recommendations for its use. Systematic reviews have outlined the applications of 3D printing in surgery, identifying advantages including, better visualization of anatomy for pre-operative planning, improved operative outcomes, and decreased surgical time. 2 , 3 As well, there have been studies which have reviewed the uses of 3D devices within specific surgical specialties such as orthopedics, spinal surgery, neurosurgery, plastics, and urology. 4 – 8 However, challenges in summarizing the data has been reported 9 such that the overall efficacy and effectiveness of 3D printed models across medical specialties remains unknown due to the breadth of uses, lack of comparable hypotheses, and non standardized reporting of outcomes across the literature. 9 Objectives A broad range of clinically meaningful applications for 3D printing in gynecology have been identified in the literature. The primary objective of this study is to systematically report the clinical applications of individualized 3D printing in gynecology. Additional objectives will be to summarize the production process for printing patient specific 3D printed models and determine the feasibility of personalized 3D printing in gynecology. We have chosen to use a scoping review to summarize our data, considering the challenges with performing systematic reviews on the topic of 3D printing in medicine 9 and mainly related to the heterogeneity of relevant studies. Methods Eligibility Criteria, Information Sources, Search Strategy A systematic review of the published literature was conducted to evaluate the uses of 3D printing in gynecology. Inclusion criteria consisted of publications up to and including 31 May 2021, of all study designs, which were published in English, had a gynecologic context and involved production of patient specific 3D printed models. Publications involving 3D imaging alone, without patient-specific 3D model production; where 3D printing was used for bioprinting, scaffolding, tissue engineering; or where 3D printing was used in a purely obstetrical context (i.e for fetal imaging, investigating fetal pathology), were excluded. Four medical databases (Medline, Embase, CENTRAL, Scopus) and grey literature were searched using search terms which included “3D printing,” “gynecology” and relevant anatomic structures (vagina, cervix, uterus, fallopian tubes, ovaries, pelvic floor, ureters, urethra) or derivatives of these terms (Supplementary Material). Study Selection Studies were manually screened and assessed for eligibility by two independent reviewers, (CC, TF) initially by title and abstract review and subsequently by full text review. Data Extraction All data from studies selected for inclusion was extracted using a pre-established data extraction form. Disagreements between reviewers regarding study screening, eligibility, and data extraction were settled through discussion and consensus between the reviewers. Screening and data extraction was performed using the online platform Covidence. The study followed PRISMA protocol for scoping reviews. 10 Assessment of Risk of Bias NA Data Synthesis The primary outcome was clinical applications of individualized 3D printing in gynecology. Additional outcomes assessed were 1) the production process used for producing 3D printed models (software, 3D printer, printing materials), 2) measures of feasibility (3D printing costs, production time). A descriptive approach for data synthesis was used. Results Study selection Our search yielded 4102 studies, of which 990 duplicates were removed, leaving 3112 studies to be screened. Title and abstract screening was performed by the reviewers leaving 120 studies for assessment of full text for eligibility. Eighty-eight studies were excluded for the following reasons: models were not patient specific (52), articles were duplicates (17), not the correct patient population (8), models were not printed (7), not in English (2), non-human models (1), and/or could not be accessed (1). In total 32 studies were included for review. PRIMSA flowchart can be seen in Fig. 1 Study Characteristics Of the 32 studies reviewed, 13 (41%) were case series, 12 (38%) were case reports, 4 (13%) were cohort studies, 2 (6%) were controlled trials (1 randomized and 1 non randomized) and 1 (3%) was a retrospective study. Nineteen studies (59%) were full text articles and the remaining 13 (41%) were conference abstracts. Studies were carried out in 13 different countries, with the most common places being China (9), The United States (6) and Canda (4). Studies were performed from 2014 to most recent. Most studies (21, 66%) printed 5 or less models. Seven studies (22%) printed greater than 5, (up to 50 models) and 4 (13%) studies did not specify the number of models produced. Additional study characteristics can be seen in Table 1. Risk of bias NA Synthesis of Results Primary Outcome Clinical Applications and Impact of Personalized 3D Printed Models 3D printed models were intended for use by physicians (25/32, 78%), both physicians and patients (4/32, 13%), both physicians and trainees (1/32, 3%) or patients (2/32, 6%). Models were used in studies for each of the gynecologic subspecialties including, gynecologic oncology (23/32, 72%), benign gynecology (5/32, 16%), urogynecology (2/32, 6%), pediatric gynecology (1/32, 3%), and reproductive endocrinology and infertility (1/32, 3%). Patient pathologies studied included gynecologic cancer (23/32, 72%), uterine fibroids (3/32, 9%), Mullerian anomalies (2/32, 6%), endometriosis (1/32, 3%), placenta percreta (1/32, 3%), stress urinary incontinence (1/32, 3%), and infertility (1/32, 3%). In 20 (63%) studies, the patient specific 3D printed models being produced were brachytherapy templates/cylindrical applicators; in 10 (31%) studies they were anatomical models; and in 2 (6%) studies they were other medical devices. Specific 3D printed models produced in each study can be seen in Table 1. Secondary Outcomes 3d Printed Model Production And Feasibility Data sources used for production of the 3D printed models included: MRI (14/32, 44%), CT (7/32, 22%), both MRI and CT (5, 16%), physical exam (2/32, 6%), trial and error (2/32, 6%) or did not specify (2/32, 6%). Data software, 3D printers and 3D printing materials used varied across studies. The most commonly used 1) data software were Computer Aided Design (CAD) Software (4/32, 13%) and Solidworks (5/32, 16%); 2) 3D printers were Stratasys Fortus (3/32, 9%) and PolyJet J750 (3/32, 9%); and 3D printing material was polylactic acid (5/32, 16%). A large number of studies did not specify data software (12/32, 38%), 3D printer (13/32, 41%), or 3D printing materials (11/32, 34%) used. One study produced a 3D printed mold, from which multiple models could be produced. 3D printing costs were only provided by 2 (6%) studies and production time by 7 (22%) studies. Costs listed per model were $ 10.94 and $ 35 USD. Production time varied from 86 minutes to 5 days. Discussion With a growing body of literature in the area of 3D printing and continuous advancements in its technology, there has been a need to summarize the data on 3D printing and its clinical applications in medicine. We performed a scoping review to systematically report on the clinical applications of individualized 3D printing in gynecology. Although a review on the role of 3D printing in gynecology has previously been published, 11 this study was limited in its reporting of applications for reproductive surgery only. Furthermore, its search was limited to a single platform (Pubmed), yeidling only 11 studies, and lacked information on the feasibility and impact of 3D printing on patient outcomes in gynecology. Here, we present on themes regarding clinical applications of patient specific 3D printing in gynecology, as summarized below. Medical Devices Brachytherapy is an integral component of the management of both primary and recurrent gynecologic cancers. It facilitates the delivery of a high dose of localizaed radiation to a small volume tumor, while minimizing radiation dose to surrounding normal tissue. 12 To optimize treatment, selection of the most appropriate brachytherapy technique, intracavitary versus interstitial, and applicator, should be individualized based on the depth of invasion, distribution of disease, and patient specific anatomy. 13 A variety of applicator designs and sizes have been developed to limit patient discomfort while enhancing radiation dose distribution. 12 13 However, still it remains a challenge to find an optimally fitting brachytherapy applicator for each patient’s individual anatomy and pathology. 13 Our scoping review has highlighted that patient specific 3D printed brachytherapy devices have been the most commonly studied individualized 3D printed model in gynecology in the literature to date. 14-31 The 3D printed models produced and studied were mainly personalized vaginal brachytherapy cylinder applicators and or interstitial brachytherapy needle templates in a population of patients with gynecologic malignanies including primary vaginal cancer, locally advanced or recurrent cervical or endometrial cancer. 14-29 In addition, some studies created 3D printed devices that could be personalized and used in combination with standardized applicators or templates. 30 31 Some of the larger cohort studies provided clinically relevant results supporting the utility of individualized 3D printed devices for use in brachytherapy treatment of gynecological malignancies. Specifically, Logar et al. (2019) and Yuan et al. (2019) report increased radiation doses to the target volume and decreased dose to organs at risk, in patients with gynecologic malignancies previously treated with external beam radiation, when 3D printed individualized 1) vaginal applicators and 2) guidance templates, respectively, were used for brachytherapy treatment, in comparison to standardized devices. 19 28 Similarly, 3D printed individualized brachytherapy trans-vaginal template/applicator +/- transperineal template facilitated high dose parameters, a high response rate (84.4% 1 month after completion), with no severe complications, in of a group of patients with central recurrent gynecologic malignancy in the study by Jiang et al. (2020). 27 Further, Qu et al. (2021) showed that 3D-printed non-coplanar template (3D-PNCT)-assisted computed tomography (CT)-guided iodine-125 seed ablative brachytherapy could reduce the misalignment error and improve accuracy of needle puncture for non-central pelvic lesions. 29 These studies each used uniquely designed patient specific 3D printed brachytherapy applicators/templates for specific gynecologic oncology patient populations, and altogether suggest significant benefit to their use. Studies which can reproduce these results, and provide long term data on outcomes, while also investigating feasibility may facilitate wider spread use of these devices in a clinical setting in the future. While the literature regarding the use of patient specific 3D printed personalized devices has been well explored in the context of brachytherapy applicators, there may be further utility of 3D printed personlized medical devices for other purposes. Barsky et al. (2018) showed that a patient specific silicone pessary produced from a 3D printed mold was effective in management of stress urinary incontinence and showed no short term complications. 32 Authors from another study, which was however excluded from this review due to it’s obstetrical context, similarly used 3D printing to produce a patient specific cervical cerclage pessary. 33 Unique utility was additionally shown by Pavan et al. where an individualized 3D printed vaginal mold was used by a patient with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome following McIndoe modified vaginoplasty, as a permanent dilator post-operatively promoting return to sexual function. 34 This scoping review has outlined excellent examples of patient specific medical devices in gynecology, including brachytherapy applicator/templates, pessaries, and a vaginal dilator. Other studies have presented approaches and assessed the feasability of using 3D printing to introduce multiple shapes and sizes of various gynecologic devices such that variations in patient anatomy can be better accomodated for. Examples include connector tubing for dilatation and evacuation, 35 intrauterine balloons for management of post partum hemorrhage, 36 vaginal speculums, 37 and drug eluting intravaginal rings. 38-43 . When applicable, create patient specific devices using 3D printing can have an even greater potential for best fit, which can improve their effectiveness and patient experience. Hence efforts should be made to continue to create, produce, and study personalized devices in gynecology further. Some challenges to the widespread production and use of patient specific devices are related to cost and time burden of production, and the requirement of approval from health regulatory bodies. But, larger studies showing effectiveness and safety may help to overcome some of these limitations. Surgical Planning Studies have also suggested a role for individualized 3D printed models for surgical planning. As initial proof of this concept, Ajao et al. and Mackey et al. produced high fidelity individualized 3D printed models which were shown to accurately represent gynecologic pathology (i.e endometriotic nodules or fibroids) in relation to the surrounding tissues, and closely correlated with patient anatomy at the time of surgery. 44 45 Additional studies have outlined the the utility of patient-specific 3D printed models for surgical planning and intraoperative assistance further 11 46-50 In preparation for benign gynecologic procedures, Flaxman et al. (2020) found that that the use of patient-specific 3D-printed models altered the surgeons’ perception of surgical difficulty, perceived risk for surgical complications, and planned hemostatic techniques, and increased their confidence in their pre-operative plan 46 and Chen et al. (2017) showed that the models decreased operative time and blood loss. 48 Baek et al. (2016) and Sayed Aluwee et al. (2017) reported that gynecologic oncologists had an increased comprehension of patient anatomy and pathology (eg. tumor size, shape, borders), 49 , 50 and increased confidence in route of excision, 49 with use of individualized 3D printed models, in preparation for oncologic surgeries. Finally, Barbosa et al. (2019) reported that patient specific 3D printed models provided novel information and assisted in planning of infertility procedures, including hyperoscopic myomectomy, septoplasty and embryo transfer, and assessment of ovarian reserve in preparation for IVF. 11 Overall, these studies highlight that in preparation for complex gynecologic procedures, across gynecologic subspecialties, personalized 3D printed models may provide additional infomation to the surgeon regarding patient specific anatomy and pathology, greatly assisting in the development of their surgical plan. While theoretically, with better preparation for the surgical procedure, it seems that there is the potential for the models to help to reduce complications and improve outcomes, none of the studies in this review were able to provide evidence to support this. Hence, studies are needed to further investigate surgical outcomes related to the use of patient specific 3D printed models for surgical planning to provide clearer evidence to the benefit of their use. Two studies have also shown benefit of 3D printed patient specific models for brachytherapy planning. 51 , 52 In these studies, 3D printed patient specific models were effective and non invasive for pre-planning brachytherapy in patients with cervical cancer. 51 , 52 Physicians using the models, reported high fidelity and usefulness, and their overall evaluation of the cer­vical cancer model was 8.0 ± 0.8 points. 52 Education Personalized 3D printed models have also been investigated as an educational tool. In one study, patient specific 3D models of Mullerian anomalies were found to increase gynecologists’ understanding of Mullerian anomalies and their confidence in surgical correction. 53 There is also evidence that they may help to promote patient education. 49 , 50 , 52 Patients report greater understanding of their disease and radiotherapy treatment or surgical intervention with the assistance of the 3D printed models. 49 , 50 , 52 The literature regarding the utility of patient specific 3D printed models for educational purposes in this scoping review appears limited. However, during our review of the literature, we did note that there is more significant data regarding the use of non-patient specific 3D printed models in education in gynecology. 54-56 Unfortunately, these were excluded from our scoping review due to the non-patient specific nature of the 3D printed models. This has idenitified a need for a furture study to summarize the literature regarding 3D printing overall, inclusive of both patient specfic and non-patient specific models, for the purposes of trainee education in gynecology. Methodological considerations Our study has identified a need for larger, higher quality studies and more consistent reporting on the topic of individualized 3D printing in gynecology. The majority of the studies in this scoping review were case reports or small case series which were proof of concept pilot studies. These studies have provided strong evidence that we now have the technology to produce patient specific 3D printed models in gynecology, and that there are many great uses possible. However, unfortunately the workflow process for production of the personalized 3D printed models including software, 3D printer, and materials used, as well as measures of feasibility, such as cost, and time for production were widely under-reported. As a result, reproducibility of these studies is limited. Further, the true feasibility of personalized 3D printed models remains unknown, as measures of feasibility were mainly unreported. Further, when they were reported, for example, cost per model of $10.94 and $35 USD, is misleading, as this does not account for the costs of the printer itself, and payment of the team who are needed to assist in preparing images for 3D printing. Further production time again was mainly unreported or else highly variable and non specific. Finally, while the studies in this scoping review suggest clinical benefit to the use of patient specific 3D printed models, the data to support this was scant. Again, there was a focus on the ability to produce patient specific 3D printed models, but minimal data providing evidence to their impact on patient outcomes. In order for personalized 3D printing to be used in a widespread fashion in gynecology and supported by our heathcare system, we need studies which provide cost-to-benefit analysis and which provide evidence of their ability to improve patient outcomes. Hence, we are putting out a call for larger, experimental studies with clear and consistent reporting of feasibility measures on the topic of personalized 3D printing in gynecology, which will provide us with the data we need to promote their ongoing utility in this specialty. Conclusion Overall, this study has highlighted that there are a number of studies on the topic of personalized 3D printing in gynecology currently available. Through our scoping review we have summarized the literature to date on the topic of personalized 3D printing in gynecology and outlined many novel and potentially practice changing uses across gynecologic subspecialties. Some of these uses have included personalized applicators/templates for brachtherapy in the management of gynecologic malignancies, and other customized medical devices, as well as patient specific models for surgical planning and patient and trainee education. Declarations Ethical Approval: Not Applicable. Competing interests : S.S. has participated in a speakers bureau and received research grants and consulting fees from Bayer Pharma, Myovant and AbbVie. The author confirms these sponsorships had no involvement in this study. C.C., T.F., L.S., and O.M. l have no disclosures to report. Authors' contributions: C.C. and T.F. did data extraction. C.C. wrote main manuscript text. L.S. conducted search strategy and provided methodological support. O.M. provided content expertise. S.S. provided study conceptualization and content expertise. All authors reviewed final manuscript. Funding: This work has been supported by the Physicians’ Services Incorporated Foundation Canada (Grant Number: R20-23) Availability of data and materials: Not available References Flaxman TE, Cooke CM, Miguel OX, et al. A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery. 3D Printing in Medicine 2021, 7: 17 doi: 10.1186/s41205-021-00107-7 Tack P, Victor J, Gemmel P, et al. 3D-printing techniques in a medical setting: a systematic literature review. Biomed Eng Online 2016;15(1):115. doi: 10.1186/s12938-016-0236-4. Martelli N, Serrano C, van den Brink H, et al. Advantages and disadvantages of 3-dimensional printing in surgery: A systematic review. Surgery 2016;159(6):1485-500. doi: 10.016/j.surg.2015.12.017. Jiang M, Chen G, Coles-Black J, et al. Three-dimensional printing in orthopaedic preoperative planning improves intraoperative metrics: a systematic review. ANZ J Surg 2020;90(3):243-50. doi: 10.1111/ans.15549. Wilcox B, Mobbs RJ, Wu AM, et al. Systematic review of 3D printing in spinal surgery: the current state of play. J Spine Surg 2017;3(3):433-43. doi: 10.21037/jss.2017.09.01. Randazzo M, Pisapia JM, Singh N, et al. 3D printing in neurosurgery: A systematic review. Surg Neurol Int 2016;7(Suppl 33):S801-S09. doi: 10.4103/2152-7806.194059. Bauermeister AJ, Zuriarrain A, Newman MI. Three-Dimensional Printing in Plastic and Reconstructive Surgery: A Systematic Review. Ann Plast Surg 2016;77(5):569-76. doi: 10.1097/SAP.0000000000000671. Cacciamani GE, Okhunov Z, Meneses AD, et al. Impact of Three-dimensional Printing in Urology: State of the Art and Future Perspectives. A Systematic Review by ESUT-YAUWP Group. Eur Urol 2019;76(2):209-21. doi: 10.1016/j.eururo.2019.04.044. Diment LE, Thompson MS, Bergmann JHM. Clinical efficacy and effectiveness of 3D printing: a systematic review. BMJ Open 2017;7(12):e016891. doi: 10.1136/bmjopen-2017-91. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med 2018;169(7):467-73. doi: 10.7326/M18-0850. Barbosa MZ, Zylbersztejn DS, de Mattos LA, et al. Three-dimensionally-printed models in reproductive surgery: systematic review and clinical applications. Minerva Ginecol 2019;71(3):235-44. doi: https://dx.doi.org/10.23736/S0026-4784.19.04319-3 Jonathan S. Berek NFH, illustrations and design by Tim Hengst GBDB. Berek & Hacker's gynecologic oncology: Fifth edition. Philadelphia : Wolters Kluwer/Lippincott Williams & Wilkins Health, [2010]. Glaser SM, Mohindra P, Mahantshetty U, et al. Complications of intracavitary brachytherapy for gynecologic cancers and their management: A comprehensive review. Brachytherapy 2021; 20(5):984-994. Sethi R, Cunha JAN, Mellis K, et al. 3d printed custom applicator for high-dose-rate intracavitary vaginal cuff brachytherapy. Brachytherapy 2014;13:S93. Sethi R, Cunha A, Mellis K, et al. Clinical applications of custom-made vaginal cylinders constructed using three-dimensional printing technology. J Contemp Brachytherapy 2016;8(3):208-14. doi: https://dx.doi.org/10.5114/jcb.2016.60679 Semeniuk O, Cherpak A, Robar J. Design and evaluation of 3D printable patient-specific applicators for gynecologic HDR brachytherapy. Med Phys 2021;20:20. doi: https://dx.doi.org/10.1002/mp.14888 Mohammadi R, Siavashpour Z, Aghdam SRH, et al. Manufacturing and evaluation of multi-channel cylinder applicator with 3D printing technology. J Contemp Brachytherapy 2021;13(1):80-90. doi: https://dx.doi.org/10.5114/jcb.2021.103590 Kudla M, Batchelar D, Crook J, et al. Custom Applicator Design and Manufacture Automation for Interstitial Gynecological Brachytherapy. Brachytherapy 2019;18 (3):S14. doi: http://dx.doi.org/10.1016/j.brachy.2019.04.035 Logar HBZ, Hudej R, Segedin B. Development and assessment of 3D-printed individual applicators in gynecological MRI-guided brachytherapy. J Contemp Brachytherapy 2019;11(2):128-36. doi: https://dx.doi.org/10.5114/jcb.2019.84741 Logar H, Hudej R, Kobav M. 3d-printed multi-channel vaginal applicator for brachytherapy in gynecological cancer. International J Gynecological Cancer 2020;30(4):A102-A03. doi: http://dx.doi.org/10.1136/ijgc-2020-ESGO.178 Zhao J, Liang Y, Liu Z, et al. Dosimetry Verification of 3D-Printing Template Assisted 125 I Seedinterstitial Brachytherapy for Retroperitoneal Lymph Node Metastasis in Gynecologicaloncology. Brachytherapy 2019;18 (3):S103. doi: http://dx.doi.org/10.1016/j.brachy.2019.04.225 Zhao Z, Tang X, Mao Z, et al. The design of an individualized cylindrical vaginal applicator with oblique guide holes using 3D modeling and printing technologies. J Contemp Brachytherapy 2019;11(5):479-87. doi:https://dx.doi.org/10.5114/jcb.2019.88441 Qu A, Wang JJ, Jiang YL, et al. Comparison of Planning between 3D-Printing Non-Coplanar Template and 3D-printing Coplanar Template Assisted Radioactive Seed Implantation as Re-irradiation for Pelvic Wall Recurrent Gynecologic Malignant Tumors. Int J Radiation Oncol Biol Physics 2019;105(1):E711. doi: http://dx.doi.org/10.1016/j.ijrobp.2019.06.875 Laan RC, Nout RA, Dankelman J, et al. MRI-driven design of customised 3D printed gynaecological brachytherapy applicators with curved needle channels. 3D Print Med 2019;5(1):8. doi: https://dx.doi.org/10.1186/s41205-019-0047-x Sekii S, Tsujino K, Kosaka K, et al. Inversely designed, 3D-printed personalized template-guided interstitial brachytherapy for vaginal tumors. J Contemp Brachytherapy 2018;10(5):470-77. doi: https://dx.doi.org/10.5114/jcb.2018.78832 Wadi-Ramahi S, Jastaniyah N, Constantinescu C, et al. 3D printed patient-specific mould for HDR gyn treatment. Medical Physics 2018;45 (6):e594-e95. doi: http://dx.doi.org/10.1002/mp.12938 Jiang P, Qu A, Wei S, et al. The Preliminary Results of 3-Dimensional Printed Individual Template Assisted 192Ir High-Dose Rate Interstitial Brachytherapy for Central Recurrent Gynecologic Cancer. Technology in Cancer Research & Treatment 2020;19:1533033820971607. doi: 10.1177/1533033820971607 Yuan X, Zhang Y, Miao J, et al. Dosimetric analysis of 3D-printed minimally invasive-guided template in the combined intracavitary/interstitial brachytherapy treatment of locally advanced cervical cancer. Int J Gynecologic Cancer 2019;29(4): A284. Qu A, Jiang P, Wei S, et al. Accuracy and dosimetric parameters comparison of 3D-printed non-coplanar template-assisted computed tomography-guided iodine-125 seed ablative brachytherapy in pelvic lateral recurrence of gynecological carcinomas. J Contemp Brachytherapy 2021;13(1):39-45. doi: http://dx.doi.org/10.5114/JCB.2021.103585 Lindegaard JC, Madsen ML, Traberg A, et al. Individualised 3D printed vaginal template for MRI guided brachytherapy in locally advanced cervical cancer. Radiotherapy and Oncology 2016;118(1):173-75. doi: https://doi.org/10.1016/j.radonc.2015.12.012 Petric P, Fokdal LU, Traberg Hansen A, et al. 3D-printed tandem-needle-template for image guided adaptive brachytherapy in cervical cancer. Radiotherapy and Oncology 2019;133(1):S87. doi: http://dx.doi.org/10.1016/S0167-8140%2819%2930595-X Barsky M, Kelley R, Bhora FY, et al. Customized Pessary Fabrication Using Three-Dimensional Printing Technology. Obstet Gynecol 2018;131(3):493-97. doi: https://dx.doi.org/10.1097/AOG.0000000000002461 Tudela F, Kelley R, Ascher-Walsh C, et al. Low cost 3D printing for the creation of cervical cerclage pessary used to prevent preterm birth: A preliminary study. Obstetrics and Gynecology 2016;127(1):154S. doi: http://dx.doi.org/10.1097/01.AOG.0000483614.84976.50 Pavan LI, Bourguignon GA, Ubertazzi EP. Vaginoplasty: modified McIndoe using xenograft and a tailored 3D-printer mold. Int Urogynecol J Pelvic Floor Dysfunct 2021;04:04. doi: https://dx.doi.org/10.1007/s00192-021-04689-y Stitely ML, Paterson H. Using Three-Dimensional Printing to Fabricate a Tubing Connector for Dilation and Evacuation. Obstet Gynecol 2016;127(2):317-9. doi: https://dx.doi.org/10.1097/AOG.0000000000001237 Kondoh E, Chigusa Y, Ueda A, et al. Novel intrauterine balloon tamponade systems for postpartum hemorrhage. Acta Obstet Gynecol Scand 2019;98(12):1612-17. doi: https://dx.doi.org/10.1111/aogs.13692 Wolford JE, Crawford E, Tewari SE, et al. Pilot study of 3d printed vaginal speculums (3dps) for screen-and-treat cervical neoplasia program in Mwanza, Tanzania. International Journal of Gynecological Cancer 2018;28 (2):86. doi: http://dx.doi.org/10.1097/01.IGC.0000546279.09648.02 Welsh N, Wilson M, Malcolm K, et al. 3D printing of microbicide vaginal rings: A proof-of-concept study. AIDS Research and Human Retroviruses 2016;32 (1):114. doi: http://dx.doi.org/10.1089/aid.2016.5000.abstracts Tappa K, Jammalamadaka U, Ballard DH, et al. Medication eluting devices for the field of OBGYN (MEDOBGYN): 3D printed biodegradable hormone eluting constructs, a proof of concept study. PLoS ONE 2017;12(8):e0182929. doi: https://dx.doi.org/10.1371/journal.pone.0182929 Walker L, Chen Y, Traore YL, et al. Mathematical prediction of hydrophilic chemotherapeutic elution kinetics from a reservoir polyurethane intravaginal ring fabricated by fused deposition modeling 3D printing. Journal of Pharmacy and Pharmaceutical Sciences 2017;20 (2):122s. Benhabbour SR, Janusziewicz R, Mecham S, et al. Innovative 3D printed intravaginal rings: Reengineering multipurpose intravaginal rings for prevention of HIV and unintended pregnancy. AIDS Research and Human Retroviruses 2018;34 (1):72. doi: http://dx.doi.org/10.1089/aid.2018.5000.abstracts Fu J, Yu X, Jin Y. 3D printing of vaginal rings with personalized shapes for controlled release of progesterone. Int J Pharm 2018;539(1-2):75-82. doi: https://dx.doi.org/10.1016/j.ijpharm.2018.01.036 Tiboni M, Campana R, Frangipani E, et al. 3D printed clotrimazole intravaginal ring for the treatment of recurrent vaginal candidiasis. Int J Pharm 2021;596:120290. doi: http://dx.doi.org/10.1016/j.ijpharm.2021.120290 Ajao MO, Clark NV, Kelil T, et al. Case Report: Three-Dimensional Printed Model for Deep Infiltrating Endometriosis. J Minim Invasive Gynecol 2017;24(7):1239-42. doi: 10.016/j.jmig.2017.06.006. Epub 17 Jun 19. Mackey A, Ng JI, Core J, et al. Three-Dimensional-Printed Uterine Model for Surgical Planning of a Cesarean Delivery Complicated by Multiple Myomas. Obstet Gynecol 2019;133(4):720-24. doi: https://dx.doi.org/10.1097/AOG.0000000000003107 Flaxman T, Cooke CM, Sheikh A, et al. Pre-Surgical Planning Using Patient-Specific 3D Printed Anatomical Models for Women with Uterine Fibroids. Journal of Minimally Invasive Gynecology 2020;27(7):S71-S72. doi: 10.1016/j.jmig.2020.08.596 Reddy H, Maghsoudlou P, Pepin K, et al. Use of 3D Model in Laparoscopic Myomectomy. Journal of Minimally Invasive Gynecology 2019;26(7):S19. doi: 10.1016/j.jmig.2019.09.507 Chen J, He H, Song T, et al. Utilizing 3D printing model of placenta percreta to guide obstetric operation. Obstetrics and Gynecology 2017;129 (1):42S. Baek M-H, Kim D-Y, Kim N, et al. Incorporating a 3-dimensional printer into the management of early-stage cervical cancer. Journal of Surgical Oncology 2016;114(2):150-52. doi: https://doi.org/10.1002/jso.24292 Sayed Aluwee SAZB, Zhou X, Kato H, et al. Evaluation of pre-surgical models for uterine surgery by use of three-dimensional printing and mold casting. Radiological Physics and Technology 2017;10(3):279-85. doi: 10.1007/s12194-017-0397-2 Chang A. 3D printing technology is a feasible and efficient tool for pre-planning for image guided brachytherapy of cervix cancers. Brachytherapy 2018;17 (4 Supplement 1):S111. Wang F, Luo H, Cheng H, et al. Is 3D printinggided threedimensional brachytherapy suitable for cervical cancer: From one single research institute? European Journal of Gynaecological Oncology 2020;41(4):591-97. doi: http://dx.doi.org/10.31083/J.EJGO.2020.04.4932 Hadden R, Grover S, Chuen J, et al. Utility of 3D printed models of Mullerian anomalies as a teaching tool. 3D Printing in Medicine Conference: 3dMed Australia Conference 2018;4(Supplement 1) doi: http://dx.doi.org/10.1186/s41205-018-0036-5 Crain CL, Winfrey OK, Jackson WL, et al. Teaching Pediatric Straddle Injury Repair with Use of a 3D Printed Model. J Pediatr Adolesc Gynecol 2021;34(6):862-64. doi: 10.1016/j.jpag.2021.05.005. Towner MN, Lozada-Capriles Y, LaLonde A, et al. Creation and Piloting of a Model for Simulating a Minimally Invasive Myomectomy. Cureus 2019;11(3):e4223. doi: https://dx.doi.org/10.7759/cureus.4223 Bartellas M, Ryan S, Doucet G, et al. Three-Dimensional Printing of a Hemorrhagic Cervical Cancer Model for Postgraduate Gynecological Training. Cureus 2017;9(1):e950. doi: https://dx.doi.org/10.7759/cureus.950 Tables Table 1. Study characteristics First author, date Publication Type Study Design Sub-specialty Patient Population 3D Printed Product Intended Use Intended User Key Study Findings* Ajao, 2017 Full text Case report BEN Endometriosis Anatomical model Anatomical comprehension MD The 3D model accurately demonstrated the relationship of the endometriotic nodule to the patient’s anatomy Baek, 2016 Full text Case report ONC Cervical cancer Anatomical model Anatomical comprehension; surgical planning; patient education MD; PT 3D models facilitate patient education and assist surgeons to plan operative intervention Barbosa, 2019 Full text Case series REI Infertility Anatomical model Surgical planning; improving assisted reproductive techniques MD 3D models are feasible and can improve assisted reproductive techniques, assist in surgical planning Barsky, 2018 Full text Case report URO Stress urinary incontinence Other medical device Customized pessary for stress urinary incontinence PT A customized 3D printed pessary for treatment of stress urinary incontinence was successfully produced and inserted Chang, 2018 Conference abstract Case series ONC Locally advanced cervical cancer Brachytherapy device Brachytherapy treatment MD 3D printing technology enabled precise apposition of applicators and dosimetry for image guided cervical cancer brachytherapy Chen, 2017 Conference abstract Case series BEN Placenta percreta Anatomical model Anatomical comprehension; surgical planning MD; PT The 3D printed model facilitated accurate assessment of placenta percreta and surgical planning, to improve maternal and fetal outcomes Flaxman, 2020 Conference abstract Case series BEN Uterine fibroids Anatomical model Anatomical comprehension; surgical planning PT 3D printed models increased surgeon’s understanding of complex anatomy and impacted their surgical plan Hadden, 2018 Conference abstract Case series PED Congenital Mullerian anomalies Anatomical model Anatomical comprehension; provider education PT; TR 3D models increased gynaecologists' understanding of congenital Mullerian anomalies and surgical confidence Jiang, 2020 Full text Cohort study ONC Central pelvic recurrent gynecologic cancer Brachytherapy device Brachytherapy planning and treatment MD 3D printed individual template based high dose rate interstitial brachytherapy is feasible and efficient, permitting delivery of localized interstitial brachytherapy Kudla, 2019 Conference abstract Case report ONC Locally recurrent endometrial cancer Brachytherapy device Brachytherapy treatment MD The custom applicator improved the quality and ease of delivery of interstitial vaginal brachytherapy Laan, 2019 Full text Case series ONC Gynaecologic cancer Brachytherapy device Brachytherapy treatment MD A personalised vaginal topography-based 3D printed for brachytherapy needle applicators, derived from patient MRI data was successfully designed and produced Lindegaard, 2016 Full text Case report ONC Locally advanced cervical cancer Brachytherapy device Brachytherapy treatment MD 3D printing enabled a high degree of individualisation and exemplified superior dose distribution in brachytherapy treatment of stage IVA cervical cancer Logar, 2019 Full text Cohort study ONC Locally advanced primary/recurrent gynecologic cancer Brachytherapy device Brachytherapy treatment MD With use of 3D printed applicators, all dose volume parameters for clinical target volume improved without compromising dose constraints for organs at risk Logar, 2020 Conference abstract Case series ONC Vaginal/recurrent endometrial cancer Brachytherapy device Brachytherapy treatment MD An individually-designed multi-channel vaginal applicator was well tolerated, increased target coverage in advanced tumours, minimized trauma to surrounding tissue Mackey, 2019 Full text Case report BEN Uterine fibroids Anatomical model Anatomical comprehension; surgical planning MD The 3D-printed model facilitated cesarian section planning and use was associated with good maternal/fetal outcomes. Mohammadi, 2021 Full text Case report ONC Locally advanced cervical cancer Brachytherapy device Brachytherapy treatment MD High-temp resin with SLA 3D patient-specific multi-channel cylindrical applicators show mechanical accuracy and effective dosimetry Pavan, 2021 Full text Case report URO Mullerian agenesis; MRKH syndrome Other medical device Post-surgical customized vaginal mold PT Functional, histological and anatomical results were reached with the 3D printed tailored mold Petric, 2019 Conference abstract Cohort study ONC Locally advanced cervical cancer Brachytherapy device Brachytherapy treatment MD The use of 3D printed tandem needle template for image guided brachytherapy in locally advanced cervical cancer allowed successful management of disease Qu, 2017 Conference Case report ONC Recurrent cervical cancer Brachytherapy device Brachytherapy treatment MD The 3D printed individual applicator facilitated precise planning and decreased complications Qu, 2019 Conference abstract Non-randomised control trial ONC Pelvic wall recurrent gynecologic cancer Brachytherapy device Brachytherapy treatment MD When used for preoperative planning, both 3D-printed non coplanar template (3D-PNCT) and 3D-printed coplanar template achieve prescription dose, 3D-PNCT was more safe Qu, 2021 Full text Retrospective study ONC Non-central pelvic recurrent gynecologic cancer Brachytherapy device Brachytherapy treatment MD 3D-printed non coplanar template assisted CT-guided 125I-seed ablative brachytherapy is a safe and feasible treatment Reddy, 2019 Conference abstract Case series BEN Uterine fibroids Anatomical model Anatomical comprehension; surgical planning MD Patient-specific 3D models facilitated preoperative and intraoperative planning for laparoscopic myomectomy Sayed Aluwee, 2017 Full text Case series ONC Endometrial cancer Anatomical model Anatomical comprehension; surgical planning; patient education MD; PT Personalized uterine 3D physical models using 3D printing and mold casting methods based on 3D MR images are useful for planning by surgeons, and patient communication Sekii, 2018 Full text Case series ONC Recurrent cervical cancer Brachytherapy device Brachytherapy treatment MD 3D printing templates designed inversely have potential to assist in interstitial brachytherapy for vaginal tumors Semeniuk, 2021 Full text Case series ONC Gynecologic cancer Brachytherapy device Brachytherapy treatment MD Patient-specific cylinders provide comparable dose to the target, with advanced healthy tissue sparing Sethi, 2014 Conference abstract Case report ONC Endometrial cancer Brachytherapy device Brachytherapy treatment MD Successful production of a patient specific vaginal cylinder applicator for high-dose-rate intracavitary brachytherapy Sethi, 2016 Full text Case series ONC Primary/recurrent endometrial cancer Brachytherapy device Brachytherapy treatment MD Successful production of biocompatible, sterilizable, custom applicators for gynecologic brachytherapy Wadi-Ramahi, 2018 Conference abstract Case report ONC Gynaecologic cancer Brachytherapy device Brachytherapy treatment MD Patient-specific 3D printed molds facilitated personalized brachytherapy, specific to patient and tumor anatomy Wang, 2020 Full text Cohort study ONC Cervical cancer Anatomical model Anatomical comprehension; patient education MD; PT 3D printed models can display patient anatomy and pathology to guide individualized brachytherapy for cervical cancer and communicate with patients Yuan, 2019 Full text Randomized control trial ONC Recurrent cervical cancer Brachytherapy device Brachytherapy treatment MD The 3D printed minimally invasive guidance template-assisted treatment provided dosimetry advantage Zhao, 2019 Conference abstract Case series ONC Retroperitoneal lymph node metastasis in gynecologic cancer Brachytherapy device Brachytherapy treatment MD 3D printing template in seed implantation provides accurate positioning for treating retroperitoneal lymph node metastasis in gynecological oncology Zhao, 2019 Full text Case report ONC Cervical cancer Brachytherapy device Brachytherapy treatment MD A higher dose coverage of the target and better sparing of the organs at risk can be achieved by using a3D-printed, individualized cylinder Acronyms used: Sub-specialty: BEN – benign gynecology; ONC – gynecologic oncology; REI – reproductive endocrinology and infertility; URO – Urogynecology; PED – Pediatric Gynecology Intended user: MD – physicians; PT – patients, TR – trainees *Key findings were paraphrased directly from the study manuscripts Table 2. 3D-printed model production specifics First author, date Data Source Software 3D Printer 3D Printing Material Cost per Model (USD) Production Time No. of Models Ajao, 2017 MRI Mediprint PolyJet J750, Stratasys NS NS NS 1 Baek, 2016 CT NS Objet 260 CONNEX 3D printer, Stratasys NS NS NS 1 Barbosa, 2019 MRI 3D PolyJet Studio; GrabcaD Print Polyjet J750, Stratasys Veroclear rGD810; Vero Magenta rGD 851; Tango Plus FlX930 NS 86mins – 30hrs 4 Barsky, 2018 Trial/error SolidWorks Fused deposition modeling printer (model NS) Polylactic acid $10.94 2 hrs 3 Chang, 2018 CT/MRI NS Fortus 450mc, Stratasys Polymer materials NS NS 5 Chen, 2017 MRI NS NS NS NS NS 2 Flaxman, 2020 MRI NS NS Resin NS NS 5 Hadden, 2018 MRI NS NS NS NS NS NS Jiang, 2020 CT/MRI Materialise Mimics, Geomagic LITE450HD-B, Shanghai Liantai Technology Co Ltd. Medical curing resin NS NS 32 Kudla, 2019 MRI Eclipse; SolidWorks; Brachyvision NS NS NS NS 1 Laan, 2019 MRI Oncentra, 3D Slicer; SolidWorks; MeVi-sLab; MatLab Digital light processing (DLP)-based printer (Perfactory 4 mini XL, Envisiontec) Liquid photopolymer resin NS NS 2 Lindegaard, 2016 CT/MRI BrachyVision; Matlab; SolidWorks Projet 3510 SD, 3D Systems Visijet M3 Crystal, 3D Systems NS 3days (Print: 9hrs) 2 Logar, 2019 MRI BrachyVision Formiga P100 3D printer Biocompatible polyamide PA 2200 NS NS 9 Logar, 2020 MRI NS Selective laser sintering technology (model NS) Biocompatible polyamide PA NS NS 2 Mackey, 2019 MRI 3D Slicer Ultimaker 3 Extended 3D printer Polylactic acid filament $35.00 49.5hrs (printing) 1 Mohammadi, 2021 CT Fusion 360; Meshmixer UnionTech RS Pro 600 High-temp resinFLHTAM02 model, Formlabs Inc. NS 4-5 hrs NS Pavan, 2021 Trial/error NS NS Polylactic acid NS NS NS Petric, 2019 MRI NS NS Biocompatible autoclavable material NS NS 13 Qu, 2017 CT NS NS NS NS NS 1 Qu, 2019 NS NS NS NS NS NS NS Qu, 2021 CT Magics, Materialise RS6000, Shanghai Liantaiv 3D Technology Company Inc. NS NS NS 38 Reddy, 2019 MRI Mediprint PolyJet J750, Stratasys Polymer NS NS 3 Sayed Aluwee, 2017 MRI NS Fused deposition modeling printer (model NS) Polylactic acid with biodegradable thermoplastic NS 3 - 5 days 5 Sekii, 2018 CT/MRI CAD Software, Fusion 360 v.2.03174, Autodesk Inc. Outsourced, DMM.com Polycarbonate/acrylonitrile-butadiene-styrene (PC-ABS) polymer alloy NS Design: 2-3hrs Print: 6-7days 2 Semeniuk, 2021 CT Eclipse; Oncentra; Matlab NS Biocompatible polymethyl methacrylate; tungsten-polylactic acid composite NS Design: 3hrs Print: 3hrs 2 Sethi, 2014 Physical exam CAD software, Autodesk Inc. Fortus 400mc, Stratasys PC-ISO biocompatible thermoplastic NS NS 1 Sethi, 2016 Physical exam CAD software, Autodesk Inc. Fortus 400mc, Stratasys PC-ISO thermoplastic NS NS 3 Wadi-Ramahi, 2018 CT CAD software NS NS NS NS 2 Wang, 2020 MRI 3DDOCTOR NS Thermoplastics NS NS 50 Yuan, 2019 CT/MRI Prowess Panther, Unicorn 3D template system EP-A650 NS NS NS 11 Zhao, 2019 NS NS NS NS NS NS 18 Zhao, 2019 CT 3ds Max, Autodesk Inc.; MakerBot Replicator+, MakerBot Polylactic acid NS NS 1 Acronyms used: USD – United States Dollars NS – Not Specified CAD – Computer Aided Design Additional Declarations No competing interests reported. Supplementary Files Appendix1.docx Appendix 1. Search Strategy Cite Share Download PDF Status: Published Journal Publication published 17 Mar, 2023 Read the published version in 3D Printing in Medicine → Version 1 posted Editorial decision: Accepted 17 Feb, 2023 Editor assigned by journal 01 Feb, 2023 Submission checks completed at journal 01 Feb, 2023 First submitted to journal 30 Jan, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2530895","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":172353222,"identity":"c80a3377-306b-4c53-bf74-d92e057eabfa","order_by":0,"name":"Carly M Cooke","email":"","orcid":"","institution":"University of Ottawa","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Carly","middleName":"M","lastName":"Cooke","suffix":""},{"id":172353223,"identity":"e3f011bc-aa65-436a-bdb2-6880c07e80f4","order_by":1,"name":"Teresa E Flaxman","email":"","orcid":"","institution":"Ottawa Hospital Research Institute","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Teresa","middleName":"E","lastName":"Flaxman","suffix":""},{"id":172353224,"identity":"dbaff1bb-5931-4ed8-8ef1-38c918e47cad","order_by":2,"name":"Lindsey Sikora","email":"","orcid":"","institution":"University of Ottawa","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Lindsey","middleName":"","lastName":"Sikora","suffix":""},{"id":172353225,"identity":"92435b8d-49c5-4675-b60a-75ae5634f96f","order_by":3,"name":"Olivier Miguel","email":"","orcid":"","institution":"Ottawa Hospital Research Institute","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Olivier","middleName":"","lastName":"Miguel","suffix":""},{"id":172353226,"identity":"122151ce-9cd7-454c-ac3b-e7938ddbacee","order_by":4,"name":"Sukhbir S Singh","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsElEQVRIiWNgGAWjYJCCA0Akx8DAQ6IWYx6StIB0JfYQrUV+RvrDwwW/7qTvZ+89wPCjhggtBjdyDA7P7HuW28NzLoGx5xgxWiRyGA7z9hzO7ZHIMWBmYCPOYQ9AWtJ5wFr+EaGF4UaCwWGeH4cTwFoY24hx2Jk3Bod5Gw4b9pw5Y3Cwt48Yh7WnP/7M8+ewPHt7j+GDH9+IcRgIwNxzgFgNQPCHBLWjYBSMglEw8gAAaSo6Ppp8d5wAAAAASUVORK5CYII=","orcid":"","institution":"University of Ottawa","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Sukhbir","middleName":"S","lastName":"Singh","suffix":""}],"badges":[],"createdAt":"2023-01-30 18:14:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2530895/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2530895/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s41205-023-00169-9","type":"published","date":"2023-03-17T20:02:39+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":32393976,"identity":"692a7bc1-8404-4cea-a984-356382861b53","added_by":"auto","created_at":"2023-02-02 16:57:18","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":47541,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA flowchart\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-2530895/v1/a1a10304dea19166adbaadfe.png"},{"id":44723049,"identity":"acd436fe-1e2e-42d3-a716-f7941d3a1e52","added_by":"auto","created_at":"2023-10-16 20:12:29","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":510254,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2530895/v1/eb8e7633-011f-48eb-8b59-217c09d7de3f.pdf"},{"id":32395113,"identity":"c5074c96-6e0d-45f9-a15e-cbf4c1d5f68a","added_by":"auto","created_at":"2023-02-02 17:05:18","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":32147,"visible":true,"origin":"","legend":"\u003cp\u003eAppendix 1. Search Strategy\u003c/p\u003e","description":"","filename":"Appendix1.docx","url":"https://assets-eu.researchsquare.com/files/rs-2530895/v1/cf2f74cf5d2b4e71ab18fccf.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Individualized medicine using 3D printing technology in gynecology: a scoping review","fulltext":[{"header":"Introduction","content":"\u003cp\u003eRecent advancements in three-dimensional (3D) printing technology have facilitated the production of 3D printed models of exemplary quality. Continued reductions in operating costs and time to generate 3D printed models has increased feasibility and gained considerable interest from the medical field. 3D printed models can be scaled to size, and display fine details, closely resembling human anatomy. As a result, there is an increasing body of literature reporting on the clinical applications of 3D printing in medicine.\u003c/p\u003e \u003cp\u003eIn high-fidelity 3D printing protocols, segmentation software is used to convert high quality 2-dimensional (2D) Magnetic Resonance (MR), Computed Tomography (CT) or ultrasound (US) images to 3D digital models, which can then be printed.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e Hence, 3D printed models have the ability to be patient specific, with clinical applications in personalized medicine. In gynecology, 3D printed models can depict patient-specific female pelvic anatomy and gynecologic pathology, which may benefit physicians, trainees, and patients in their understanding of complex disease and management options.\u003c/p\u003e \u003cp\u003eWith a growing body of literature in the area of 3D printing, there has been a need to summarize the data on 3D printing and develop clinical recommendations for its use. Systematic reviews have outlined the applications of 3D printing in surgery, identifying advantages including, better visualization of anatomy for pre-operative planning, improved operative outcomes, and decreased surgical time.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e As well, there have been studies which have reviewed the uses of 3D devices within specific surgical specialties such as orthopedics, spinal surgery, neurosurgery, plastics, and urology.\u003csup\u003e\u003cspan additionalcitationids=\"CR5 CR6 CR7\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e However, challenges in summarizing the data has been reported \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e such that the overall efficacy and effectiveness of 3D printed models across medical specialties remains unknown due to the breadth of uses, lack of comparable hypotheses, and non standardized reporting of outcomes across the literature. \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e"},{"header":"Objectives","content":"\u003cp\u003eA broad range of clinically meaningful applications for 3D printing in gynecology have been identified in the literature. The primary objective of this study is to systematically report the clinical applications of individualized 3D printing in gynecology. Additional objectives will be to summarize the production process for printing patient specific 3D printed models and determine the feasibility of personalized 3D printing in gynecology. We have chosen to use a scoping review to summarize our data, considering the challenges with performing systematic reviews on the topic of 3D printing in medicine \u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e and mainly related to the heterogeneity of relevant studies.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eEligibility Criteria, Information Sources, Search Strategy\u003c/h2\u003e \u003cp\u003eA systematic review of the published literature was conducted to evaluate the uses of 3D printing in gynecology. Inclusion criteria consisted of publications up to and including 31 May 2021, of all study designs, which were published in English, had a gynecologic context and involved production of patient specific 3D printed models. Publications involving 3D imaging alone, without patient-specific 3D model production; where 3D printing was used for bioprinting, scaffolding, tissue engineering; or where 3D printing was used in a purely obstetrical context (i.e for fetal imaging, investigating fetal pathology), were excluded.\u003c/p\u003e \u003cp\u003eFour medical databases (Medline, Embase, CENTRAL, Scopus) and grey literature were searched using search terms which included \u0026ldquo;3D printing,\u0026rdquo; \u0026ldquo;gynecology\u0026rdquo; and relevant anatomic structures (vagina, cervix, uterus, fallopian tubes, ovaries, pelvic floor, ureters, urethra) or derivatives of these terms (Supplementary Material).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy Selection\u003c/h2\u003e \u003cp\u003eStudies were manually screened and assessed for eligibility by two independent reviewers, (CC, TF) initially by title and abstract review and subsequently by full text review.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Extraction\u003c/h2\u003e \u003cp\u003eAll data from studies selected for inclusion was extracted using a pre-established data extraction form. Disagreements between reviewers regarding study screening, eligibility, and data extraction were settled through discussion and consensus between the reviewers. Screening and data extraction was performed using the online platform Covidence. The study followed PRISMA protocol for scoping reviews. \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eAssessment of Risk of Bias\u003c/h2\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003eNA\u003c/h2\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eData Synthesis\u003c/h2\u003e \u003cp\u003eThe primary outcome was clinical applications of individualized 3D printing in gynecology. Additional outcomes assessed were 1) the production process used for producing 3D printed models (software, 3D printer, printing materials), 2) measures of feasibility (3D printing costs, production time). A descriptive approach for data synthesis was used.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eStudy selection\u003c/h2\u003e \u003cp\u003eOur search yielded 4102 studies, of which 990 duplicates were removed, leaving 3112 studies to be screened. Title and abstract screening was performed by the reviewers leaving 120 studies for assessment of full text for eligibility. Eighty-eight studies were excluded for the following reasons: models were not patient specific (52), articles were duplicates (17), not the correct patient population (8), models were not printed (7), not in English (2), non-human models (1), and/or could not be accessed (1). In total 32 studies were included for review. PRIMSA flowchart can be seen in Fig.\u0026nbsp;1\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eStudy Characteristics\u003c/h2\u003e \u003cp\u003eOf the 32 studies reviewed, 13 (41%) were case series, 12 (38%) were case reports, 4 (13%) were cohort studies, 2 (6%) were controlled trials (1 randomized and 1 non randomized) and 1 (3%) was a retrospective study. Nineteen studies (59%) were full text articles and the remaining 13 (41%) were conference abstracts. Studies were carried out in 13 different countries, with the most common places being China (9), The United States (6) and Canda (4). Studies were performed from 2014 to most recent. Most studies (21, 66%) printed 5 or less models. Seven studies (22%) printed greater than 5, (up to 50 models) and 4 (13%) studies did not specify the number of models produced. Additional study characteristics can be seen in Table\u0026nbsp;1.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eRisk of bias\u003c/h2\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003eNA\u003c/h2\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eSynthesis of Results\u003c/h2\u003e \u003cdiv id=\"Sec16\" class=\"Section3\"\u003e \u003ch2\u003ePrimary Outcome\u003c/h2\u003e \u003cdiv id=\"Sec17\" class=\"Section4\"\u003e \u003ch2\u003eClinical Applications and Impact of Personalized 3D Printed Models\u003c/h2\u003e \u003cp\u003e3D printed models were intended for use by physicians (25/32, 78%), both physicians and patients (4/32, 13%), both physicians and trainees (1/32, 3%) or patients (2/32, 6%). Models were used in studies for each of the gynecologic subspecialties including, gynecologic oncology (23/32, 72%), benign gynecology (5/32, 16%), urogynecology (2/32, 6%), pediatric gynecology (1/32, 3%), and reproductive endocrinology and infertility (1/32, 3%). Patient pathologies studied included gynecologic cancer (23/32, 72%), uterine fibroids (3/32, 9%), Mullerian anomalies (2/32, 6%), endometriosis (1/32, 3%), placenta percreta (1/32, 3%), stress urinary incontinence (1/32, 3%), and infertility (1/32, 3%). In 20 (63%) studies, the patient specific 3D printed models being produced were brachytherapy templates/cylindrical applicators; in 10 (31%) studies they were anatomical models; and in 2 (6%) studies they were other medical devices. Specific 3D printed models produced in each study can be seen in Table\u0026nbsp;1.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eSecondary Outcomes\u003c/h2\u003e \u003c/div\u003e\n\u003ch3\u003e3d Printed Model Production And Feasibility\u003c/h3\u003e\n\u003cp\u003eData sources used for production of the 3D printed models included: MRI (14/32, 44%), CT (7/32, 22%), both MRI and CT (5, 16%), physical exam (2/32, 6%), trial and error (2/32, 6%) or did not specify (2/32, 6%). Data software, 3D printers and 3D printing materials used varied across studies. The most commonly used 1) data software were Computer Aided Design (CAD) Software (4/32, 13%) and Solidworks (5/32, 16%); 2) 3D printers were Stratasys Fortus (3/32, 9%) and PolyJet J750 (3/32, 9%); and 3D printing material was polylactic acid (5/32, 16%). A large number of studies did not specify data software (12/32, 38%), 3D printer (13/32, 41%), or 3D printing materials (11/32, 34%) used. One study produced a 3D printed mold, from which multiple models could be produced.\u003c/p\u003e \u003cp\u003e3D printing costs were only provided by 2 (6%) studies and production time by 7 (22%) studies. Costs listed per model were \u003cspan\u003e$\u003c/span\u003e10.94 and \u003cspan\u003e$\u003c/span\u003e35 USD. Production time varied from 86 minutes to 5 days.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWith a growing body of literature in the area of 3D printing and continuous advancements in its technology, there has been a need to summarize the data on 3D printing and its clinical applications in medicine. We performed a scoping review to systematically report on the clinical applications of individualized 3D printing in gynecology. Although a review on the role of 3D printing in gynecology has previously been published, \u003csup\u003e11\u003c/sup\u003e this study was limited in its reporting of applications for reproductive surgery only. Furthermore, its search was limited to a single platform (Pubmed), yeidling only 11 studies, and lacked information on the feasibility and impact of 3D printing on patient outcomes in gynecology. Here, we present on themes regarding clinical applications of patient specific 3D printing in gynecology, as summarized below.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eMedical Devices\u003c/h2\u003e\n\u003cp\u003eBrachytherapy is an integral component of the management of both primary and recurrent gynecologic cancers. It facilitates the delivery of a high dose of localizaed radiation to a small volume tumor, while minimizing radiation dose to surrounding normal tissue.\u003csup\u003e12\u003c/sup\u003e To optimize treatment, selection of the most appropriate brachytherapy technique, \u0026nbsp;intracavitary versus interstitial, and applicator, should be individualized based on the depth of invasion, distribution of disease, and patient specific anatomy.\u0026nbsp;\u003csup\u003e13\u003c/sup\u003e A variety of applicator designs and sizes have been developed to limit patient discomfort while enhancing radiation dose distribution.\u003csup\u003e12 13\u003c/sup\u003e However, still it remains a challenge to find an optimally fitting brachytherapy applicator for each patient\u0026rsquo;s individual anatomy and pathology.\u0026nbsp;\u003csup\u003e13\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur scoping review has highlighted that patient specific 3D printed brachytherapy devices have been the most commonly studied individualized 3D printed model in gynecology in the literature to date.\u0026nbsp;\u003csup\u003e14-31\u003c/sup\u003e The 3D printed models produced and studied were mainly personalized vaginal brachytherapy cylinder applicators and or interstitial brachytherapy needle templates in a population of patients with gynecologic malignanies including primary vaginal cancer, locally advanced or recurrent cervical or endometrial cancer.\u0026nbsp;\u003csup\u003e14-29\u003c/sup\u003e In addition, some studies created 3D printed devices that could be personalized and used in combination with standardized applicators or templates.\u0026nbsp;\u003csup\u003e30 31\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eSome of the larger cohort studies provided clinically relevant results supporting the utility of individualized 3D printed devices for use in brachytherapy treatment of gynecological malignancies. Specifically, Logar et al. (2019) and Yuan et al. (2019) report increased radiation doses to the target volume and decreased dose to organs at risk, in patients with gynecologic malignancies previously treated with external beam radiation, when 3D printed individualized 1) vaginal applicators and 2) guidance templates, respectively, were used for brachytherapy treatment, in comparison to standardized devices. \u003csup\u003e19 28\u003c/sup\u003e Similarly, 3D printed individualized brachytherapy trans-vaginal template/applicator +/- transperineal template facilitated high dose parameters, a high response rate (84.4% 1 month after completion), with no severe complications, in of a group of patients with central recurrent gynecologic malignancy in the study by Jiang et al. (2020). \u003csup\u003e27\u003c/sup\u003e Further, Qu et al. (2021) showed that 3D-printed non-coplanar template (3D-PNCT)-assisted computed tomography (CT)-guided iodine-125 seed ablative brachytherapy could reduce the misalignment error and improve accuracy of needle puncture for non-central pelvic lesions. \u003csup\u003e29\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThese studies each used uniquely designed patient specific 3D printed brachytherapy applicators/templates for specific gynecologic oncology patient populations, and altogether suggest significant benefit to their use. Studies which can reproduce these results, and provide long term data on outcomes, while also investigating feasibility may facilitate wider spread use of these devices in a clinical setting in the future. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWhile the literature regarding the use of patient specific 3D printed personalized devices has been well explored in the context of brachytherapy applicators, there may be further utility of 3D printed personlized medical devices for other purposes. Barsky et al. (2018) showed that a patient specific silicone pessary produced from a 3D printed mold was effective in management of stress urinary incontinence and showed no short term complications.\u003csup\u003e32\u003c/sup\u003e Authors from another study, which was however excluded from this review due to it\u0026rsquo;s obstetrical context, similarly used 3D printing to produce a patient specific cervical cerclage pessary.\u003csup\u003e33\u003c/sup\u003e Unique utility was additionally shown by Pavan et al. where an individualized 3D printed vaginal mold was used by a patient with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome following McIndoe modified vaginoplasty, as a permanent dilator post-operatively promoting return to sexual function. \u003csup\u003e34\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThis scoping review has outlined excellent examples of patient specific medical devices in gynecology, including brachytherapy applicator/templates, pessaries, and a vaginal dilator. Other studies have presented approaches and assessed the feasability of using 3D printing to introduce multiple shapes and sizes of various gynecologic devices such that variations in patient anatomy can be better accomodated for. Examples include connector tubing for dilatation and evacuation,\u003csup\u003e35\u003c/sup\u003e intrauterine balloons for management of post partum hemorrhage,\u003csup\u003e36\u003c/sup\u003e vaginal speculums,\u003csup\u003e37\u003c/sup\u003e and drug eluting intravaginal rings. \u003csup\u003e38-43\u003c/sup\u003e. When applicable, create patient specific devices using 3D printing can have an even greater potential for best fit, which can improve their effectiveness and patient experience. Hence efforts should be made to continue to create, produce, and study personalized devices in gynecology further. Some challenges to the widespread production and use of patient specific devices are related to cost and time burden of production, and the requirement of approval from health regulatory bodies. But, larger studies showing effectiveness and safety may help to overcome some of these limitations.\u003c/p\u003e\n\u003ch2\u003eSurgical Planning\u003c/h2\u003e\n\u003cp\u003eStudies have also suggested a role for individualized 3D printed models for surgical planning. As initial proof of this concept, Ajao et al. and Mackey et al. produced high fidelity individualized 3D printed models which were shown to accurately represent gynecologic pathology (i.e endometriotic nodules or fibroids) in relation to the surrounding tissues, and closely correlated with patient anatomy at the time of surgery. \u003csup\u003e44 45\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eAdditional studies have outlined the the utility of patient-specific 3D printed models for surgical planning and intraoperative assistance further \u003csup\u003e11 46-50\u003c/sup\u003e\u0026nbsp; In preparation for benign gynecologic procedures, Flaxman et al. (2020) found that that the use of patient-specific 3D-printed models altered the surgeons\u0026rsquo; perception of surgical difficulty, perceived risk for surgical complications, and planned hemostatic techniques, and increased their confidence in their pre-operative plan\u003csup\u003e46\u003c/sup\u003e and Chen et al. (2017) \u0026nbsp;showed that the models decreased operative time and blood loss.\u003csup\u003e48\u003c/sup\u003e Baek et al. (2016) and Sayed Aluwee et al. (2017) reported that gynecologic oncologists had an increased comprehension of patient anatomy and pathology (eg. tumor size, shape, borders), \u003csup\u003e49\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e50\u003c/sup\u003e\u0026nbsp; \u0026nbsp;and increased confidence in route of excision, \u003csup\u003e49\u003c/sup\u003e with use of individualized 3D printed models, in preparation for oncologic surgeries. Finally, Barbosa et al. (2019) reported that patient specific 3D printed models provided novel information and assisted in planning of infertility procedures, including hyperoscopic myomectomy, septoplasty and embryo transfer, and assessment of ovarian reserve in preparation for IVF.\u003csup\u003e11\u003c/sup\u003e \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOverall, these studies highlight that in preparation for complex gynecologic procedures, across gynecologic subspecialties, personalized 3D printed models may provide additional infomation to the surgeon regarding patient specific anatomy and pathology, greatly assisting in the development of their surgical plan. \u0026nbsp;While theoretically, with better preparation for the surgical procedure, it seems that there is the potential for the models to help to reduce complications and improve outcomes, none of the studies in this review were able to provide evidence to support this. Hence, studies are needed to further investigate surgical outcomes related to the use of patient specific 3D printed models for surgical planning to provide clearer evidence to the benefit of their use.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTwo studies have also shown benefit of 3D printed patient specific models for brachytherapy planning. \u003csup\u003e51\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e52\u003c/sup\u003e In these studies, 3D printed patient specific models were effective and non invasive for pre-planning brachytherapy in patients with cervical cancer. \u003csup\u003e51\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e52\u003c/sup\u003e Physicians using the models, reported high fidelity and usefulness, and their overall evaluation of the cer\u0026shy;vical cancer model was 8.0 \u0026plusmn; 0.8 points. \u003csup\u003e52\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eEducation\u003c/h2\u003e\n\u003cp\u003ePersonalized 3D printed models have also been investigated as an educational tool. In one study, patient specific 3D models of Mullerian anomalies were found to increase gynecologists\u0026rsquo; understanding of Mullerian anomalies and their confidence in surgical correction. \u003csup\u003e53\u003c/sup\u003e There is also evidence that they may help to promote patient education. \u0026nbsp;\u003csup\u003e49\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e50\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e52\u003c/sup\u003e Patients report \u0026nbsp;greater understanding of their disease and radiotherapy treatment or surgical intervention with the assistance of the 3D printed models.\u003csup\u003e\u0026nbsp;\u003c/sup\u003e\u003csup\u003e49\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e50\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e52\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThe literature regarding the utility of patient specific 3D printed models for educational purposes in this scoping review appears limited. However, during our review of the literature, we did note that there is more significant data regarding the use of non-patient specific 3D printed models in education in gynecology.\u003csup\u003e54-56\u003c/sup\u003e Unfortunately, these were excluded from our scoping review due to the non-patient specific nature of the 3D printed models. This has idenitified a need for a furture study to summarize the literature regarding 3D printing overall, inclusive of both patient specfic and non-patient specific models, for the purposes of trainee education in gynecology.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eMethodological considerations\u003c/h2\u003e\n\u003cp\u003eOur study has identified a need for larger, higher quality studies and more consistent reporting on the topic of individualized 3D printing in gynecology. The majority of the studies in this scoping review were case reports or small case series which were proof of concept pilot studies. These studies have provided strong evidence that we now have the technology to produce patient specific 3D printed models in gynecology, and that there are many great uses possible. However, unfortunately the workflow process for production of the personalized 3D printed models including software, 3D printer, and materials used, as well as measures of feasibility, such as cost, and time for production were widely under-reported. As a result, reproducibility of these studies is limited. Further, the true feasibility of personalized 3D printed models remains unknown, as measures of feasibility were mainly unreported. Further, when they were reported, for example, cost per model of \u0026nbsp;$10.94 and $35 USD, is misleading, as this does not account for the costs of the printer itself, and payment of the team who are needed to assist in preparing \u0026nbsp;images for 3D printing. Further production time again was mainly unreported or else highly variable and non specific. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFinally, while the studies in this scoping review suggest clinical benefit to the use of patient specific 3D printed models, the data to support this was scant. Again, there was a focus on the ability to produce patient specific 3D printed models, but minimal data providing evidence to their impact on patient outcomes. In order for personalized 3D printing to be used in a widespread fashion in gynecology and supported by our heathcare system, we need studies which provide cost-to-benefit analysis and which provide evidence of their ability to improve patient outcomes. Hence, we are putting out a call for larger, experimental studies with clear and consistent reporting of feasibility measures on the topic of personalized 3D printing in gynecology, which will provide us with the data we need to promote their ongoing utility in this specialty. \u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOverall, this study has highlighted that there are a number of studies on the topic of personalized 3D printing in gynecology currently available. Through our scoping review we have summarized the literature to date on the topic of personalized 3D printing in gynecology and outlined many novel and potentially practice changing uses across gynecologic subspecialties. Some of these uses have included personalized applicators/templates for brachtherapy in the management of gynecologic malignancies, and other customized medical devices, as well as patient specific models for surgical planning and patient and trainee education.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval:\u0026nbsp;\u003c/strong\u003eNot Applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e S.S. has participated in a speakers bureau and received research grants and consulting fees from Bayer Pharma, Myovant and AbbVie. The author confirms these sponsorships had no involvement in this study. C.C., T.F., L.S., and O.M. l have no disclosures to report. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eC.C. and T.F. did data extraction. C.C. wrote main manuscript text. L.S. conducted search strategy and provided methodological support. O.M. provided content expertise. S.S. provided study conceptualization and content expertise. All authors reviewed final manuscript. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u0026nbsp; This work has been supported by the Physicians\u0026rsquo; Services Incorporated Foundation Canada (Grant Number: R20-23)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Availability of data and materials:\u003c/strong\u003e Not available\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eFlaxman TE, Cooke CM, Miguel OX, et al. A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery. \u003cem\u003e3D Printing in Medicine\u003c/em\u003e 2021, 7: 17 doi: 10.1186/s41205-021-00107-7\u003c/li\u003e\n\u003cli\u003eTack P, Victor J, Gemmel P, et al. 3D-printing techniques in a medical setting: a systematic literature review. \u003cem\u003eBiomed Eng Online\u003c/em\u003e 2016;15(1):115. doi: 10.1186/s12938-016-0236-4.\u003c/li\u003e\n\u003cli\u003eMartelli N, Serrano C, van den Brink H, et al. Advantages and disadvantages of 3-dimensional printing in surgery: A systematic review. \u003cem\u003eSurgery\u003c/em\u003e 2016;159(6):1485-500. doi: 10.016/j.surg.2015.12.017. \u003c/li\u003e\n\u003cli\u003eJiang M, Chen G, Coles-Black J, et al. Three-dimensional printing in orthopaedic preoperative planning improves intraoperative metrics: a systematic review. \u003cem\u003eANZ J Surg\u003c/em\u003e 2020;90(3):243-50. doi: 10.1111/ans.15549. \u003c/li\u003e\n\u003cli\u003eWilcox B, Mobbs RJ, Wu AM, et al. Systematic review of 3D printing in spinal surgery: the current state of play. \u003cem\u003eJ Spine Surg\u003c/em\u003e 2017;3(3):433-43. doi: 10.21037/jss.2017.09.01.\u003c/li\u003e\n\u003cli\u003eRandazzo M, Pisapia JM, Singh N, et al. 3D printing in neurosurgery: A systematic review. \u003cem\u003eSurg Neurol Int\u003c/em\u003e 2016;7(Suppl 33):S801-S09. doi: 10.4103/2152-7806.194059. \u003c/li\u003e\n\u003cli\u003eBauermeister AJ, Zuriarrain A, Newman MI. Three-Dimensional Printing in Plastic and Reconstructive Surgery: A Systematic Review. \u003cem\u003eAnn Plast Surg\u003c/em\u003e 2016;77(5):569-76. doi: 10.1097/SAP.0000000000000671.\u003c/li\u003e\n\u003cli\u003eCacciamani GE, Okhunov Z, Meneses AD, et al. Impact of Three-dimensional Printing in Urology: State of the Art and Future Perspectives. A Systematic Review by ESUT-YAUWP Group. \u003cem\u003eEur Urol\u003c/em\u003e 2019;76(2):209-21. doi: 10.1016/j.eururo.2019.04.044. \u003c/li\u003e\n\u003cli\u003eDiment LE, Thompson MS, Bergmann JHM. Clinical efficacy and effectiveness of 3D printing: a systematic review. \u003cem\u003eBMJ Open\u003c/em\u003e 2017;7(12):e016891. doi: 10.1136/bmjopen-2017-91.\u003c/li\u003e\n\u003cli\u003ePRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. \u003cem\u003eAnn Intern Med\u003c/em\u003e 2018;169(7):467-73. doi: 10.7326/M18-0850. \u003c/li\u003e\n\u003cli\u003eBarbosa MZ, Zylbersztejn DS, de Mattos LA, et al. Three-dimensionally-printed models in reproductive surgery: systematic review and clinical applications. \u003cem\u003eMinerva Ginecol\u003c/em\u003e 2019;71(3):235-44. doi: https://dx.doi.org/10.23736/S0026-4784.19.04319-3\u003c/li\u003e\n\u003cli\u003eJonathan S. Berek NFH, illustrations and design by Tim Hengst GBDB. Berek \u0026amp; Hacker\u0026apos;s gynecologic oncology: Fifth edition. Philadelphia : Wolters Kluwer/Lippincott Williams \u0026amp; Wilkins Health, [2010].\u003c/li\u003e\n\u003cli\u003eGlaser SM, Mohindra P, Mahantshetty U, et al. Complications of intracavitary brachytherapy for gynecologic cancers and their management: A comprehensive review. \u003cem\u003eBrachytherapy \u003c/em\u003e2021; 20(5):984-994.\u003c/li\u003e\n\u003cli\u003eSethi R, Cunha JAN, Mellis K, et al. 3d printed custom applicator for high-dose-rate intracavitary vaginal cuff brachytherapy. \u003cem\u003eBrachytherapy\u003c/em\u003e 2014;13:S93.\u003c/li\u003e\n\u003cli\u003eSethi R, Cunha A, Mellis K, et al. Clinical applications of custom-made vaginal cylinders constructed using three-dimensional printing technology. \u003cem\u003eJ Contemp Brachytherapy\u003c/em\u003e 2016;8(3):208-14. doi: https://dx.doi.org/10.5114/jcb.2016.60679\u003c/li\u003e\n\u003cli\u003eSemeniuk O, Cherpak A, Robar J. Design and evaluation of 3D printable patient-specific applicators for gynecologic HDR brachytherapy. \u003cem\u003eMed Phys\u003c/em\u003e 2021;20:20. doi: https://dx.doi.org/10.1002/mp.14888\u003c/li\u003e\n\u003cli\u003eMohammadi R, Siavashpour Z, Aghdam SRH, et al. Manufacturing and evaluation of multi-channel cylinder applicator with 3D printing technology. \u003cem\u003eJ Contemp Brachytherapy\u003c/em\u003e 2021;13(1):80-90. doi: https://dx.doi.org/10.5114/jcb.2021.103590\u003c/li\u003e\n\u003cli\u003eKudla M, Batchelar D, Crook J, et al. Custom Applicator Design and Manufacture Automation for Interstitial Gynecological Brachytherapy. \u003cem\u003eBrachytherapy\u003c/em\u003e 2019;18 (3):S14. doi: http://dx.doi.org/10.1016/j.brachy.2019.04.035\u003c/li\u003e\n\u003cli\u003eLogar HBZ, Hudej R, Segedin B. Development and assessment of 3D-printed individual applicators in gynecological MRI-guided brachytherapy. \u003cem\u003eJ Contemp Brachytherapy\u003c/em\u003e 2019;11(2):128-36. doi: https://dx.doi.org/10.5114/jcb.2019.84741\u003c/li\u003e\n\u003cli\u003eLogar H, Hudej R, Kobav M. 3d-printed multi-channel vaginal applicator for brachytherapy in gynecological cancer. \u003cem\u003eInternational J Gynecological Cancer\u003c/em\u003e 2020;30(4):A102-A03. doi: http://dx.doi.org/10.1136/ijgc-2020-ESGO.178\u003c/li\u003e\n\u003cli\u003eZhao J, Liang Y, Liu Z, et al. Dosimetry Verification of 3D-Printing Template Assisted \u003csup\u003e125\u003c/sup\u003eI Seedinterstitial Brachytherapy for Retroperitoneal Lymph Node Metastasis in Gynecologicaloncology. \u003cem\u003eBrachytherapy\u003c/em\u003e 2019;18 (3):S103. doi: http://dx.doi.org/10.1016/j.brachy.2019.04.225\u003c/li\u003e\n\u003cli\u003eZhao Z, Tang X, Mao Z, et al. The design of an individualized cylindrical vaginal applicator with oblique guide holes using 3D modeling and printing technologies. \u003cem\u003eJ Contemp Brachytherapy\u003c/em\u003e 2019;11(5):479-87. doi:https://dx.doi.org/10.5114/jcb.2019.88441\u003c/li\u003e\n\u003cli\u003eQu A, Wang JJ, Jiang YL, et al. Comparison of Planning between 3D-Printing Non-Coplanar Template and 3D-printing Coplanar Template Assisted Radioactive Seed Implantation as Re-irradiation for Pelvic Wall Recurrent Gynecologic Malignant Tumors. \u003cem\u003eInt J Radiation Oncol Biol Physics \u003c/em\u003e2019;105(1):E711. doi: http://dx.doi.org/10.1016/j.ijrobp.2019.06.875 \u003c/li\u003e\n\u003cli\u003eLaan RC, Nout RA, Dankelman J, et al. MRI-driven design of customised 3D printed gynaecological brachytherapy applicators with curved needle channels. \u003cem\u003e3D Print Med\u003c/em\u003e 2019;5(1):8. doi: https://dx.doi.org/10.1186/s41205-019-0047-x\u003c/li\u003e\n\u003cli\u003eSekii S, Tsujino K, Kosaka K, et al. Inversely designed, 3D-printed personalized template-guided interstitial brachytherapy for vaginal tumors. \u003cem\u003eJ Contemp Brachytherapy\u003c/em\u003e 2018;10(5):470-77. doi: https://dx.doi.org/10.5114/jcb.2018.78832\u003c/li\u003e\n\u003cli\u003eWadi-Ramahi S, Jastaniyah N, Constantinescu C, et al. 3D printed patient-specific mould for HDR gyn treatment. \u003cem\u003eMedical Physics\u003c/em\u003e 2018;45 (6):e594-e95. doi: http://dx.doi.org/10.1002/mp.12938\u003c/li\u003e\n\u003cli\u003eJiang P, Qu A, Wei S, et al. The Preliminary Results of 3-Dimensional Printed Individual Template Assisted 192Ir High-Dose Rate Interstitial Brachytherapy for Central Recurrent Gynecologic Cancer. \u003cem\u003eTechnology in Cancer Research \u0026amp; Treatment\u003c/em\u003e 2020;19:1533033820971607. doi: 10.1177/1533033820971607\u003c/li\u003e\n\u003cli\u003eYuan X, Zhang Y, Miao J, et al. Dosimetric analysis of 3D-printed minimally invasive-guided template in the combined intracavitary/interstitial brachytherapy treatment of locally advanced cervical cancer. \u003cem\u003eInt J Gynecologic Cancer\u003c/em\u003e 2019;29(4): A284.\u003c/li\u003e\n\u003cli\u003eQu A, Jiang P, Wei S, et al. Accuracy and dosimetric parameters comparison of 3D-printed non-coplanar template-assisted computed tomography-guided iodine-125 seed ablative brachytherapy in pelvic lateral recurrence of gynecological carcinomas. \u003cem\u003eJ Contemp Brachytherapy\u003c/em\u003e 2021;13(1):39-45. doi: http://dx.doi.org/10.5114/JCB.2021.103585\u003c/li\u003e\n\u003cli\u003eLindegaard JC, Madsen ML, Traberg A, et al. Individualised 3D printed vaginal template for MRI guided brachytherapy in locally advanced cervical cancer. \u003cem\u003eRadiotherapy and Oncology\u003c/em\u003e 2016;118(1):173-75. doi: https://doi.org/10.1016/j.radonc.2015.12.012\u003c/li\u003e\n\u003cli\u003ePetric P, Fokdal LU, Traberg Hansen A, et al. 3D-printed tandem-needle-template for image guided adaptive brachytherapy in cervical cancer. \u003cem\u003eRadiotherapy and Oncology\u003c/em\u003e 2019;133(1):S87. doi: http://dx.doi.org/10.1016/S0167-8140%2819%2930595-X\u003c/li\u003e\n\u003cli\u003eBarsky M, Kelley R, Bhora FY, et al. Customized Pessary Fabrication Using Three-Dimensional Printing Technology. \u003cem\u003eObstet Gynecol\u003c/em\u003e 2018;131(3):493-97. doi: https://dx.doi.org/10.1097/AOG.0000000000002461\u003c/li\u003e\n\u003cli\u003eTudela F, Kelley R, Ascher-Walsh C, et al. Low cost 3D printing for the creation of cervical cerclage pessary used to prevent preterm birth: A preliminary study. \u003cem\u003eObstetrics and Gynecology\u003c/em\u003e 2016;127(1):154S. doi: http://dx.doi.org/10.1097/01.AOG.0000483614.84976.50\u003c/li\u003e\n\u003cli\u003ePavan LI, Bourguignon GA, Ubertazzi EP. Vaginoplasty: modified McIndoe using xenograft and a tailored 3D-printer mold. \u003cem\u003eInt Urogynecol J Pelvic Floor Dysfunct\u003c/em\u003e 2021;04:04. doi: https://dx.doi.org/10.1007/s00192-021-04689-y\u003c/li\u003e\n\u003cli\u003eStitely ML, Paterson H. Using Three-Dimensional Printing to Fabricate a Tubing Connector for Dilation and Evacuation. \u003cem\u003eObstet Gynecol\u003c/em\u003e 2016;127(2):317-9. doi: https://dx.doi.org/10.1097/AOG.0000000000001237\u003c/li\u003e\n\u003cli\u003eKondoh E, Chigusa Y, Ueda A, et al. Novel intrauterine balloon tamponade systems for postpartum hemorrhage. \u003cem\u003eActa Obstet Gynecol Scand\u003c/em\u003e 2019;98(12):1612-17. doi: https://dx.doi.org/10.1111/aogs.13692\u003c/li\u003e\n\u003cli\u003eWolford JE, Crawford E, Tewari SE, et al. Pilot study of 3d printed vaginal speculums (3dps) for screen-and-treat cervical neoplasia program in Mwanza, Tanzania. \u003cem\u003eInternational Journal of Gynecological Cancer\u003c/em\u003e 2018;28 (2):86. doi: http://dx.doi.org/10.1097/01.IGC.0000546279.09648.02\u003c/li\u003e\n\u003cli\u003eWelsh N, Wilson M, Malcolm K, et al. 3D printing of microbicide vaginal rings: A proof-of-concept study. \u003cem\u003eAIDS Research and Human Retroviruses\u003c/em\u003e 2016;32 (1):114. doi: http://dx.doi.org/10.1089/aid.2016.5000.abstracts\u003c/li\u003e\n\u003cli\u003eTappa K, Jammalamadaka U, Ballard DH, et al. Medication eluting devices for the field of OBGYN (MEDOBGYN): 3D printed biodegradable hormone eluting constructs, a proof of concept study. \u003cem\u003ePLoS ONE\u003c/em\u003e 2017;12(8):e0182929. doi: https://dx.doi.org/10.1371/journal.pone.0182929\u003c/li\u003e\n\u003cli\u003eWalker L, Chen Y, Traore YL, et al. Mathematical prediction of hydrophilic chemotherapeutic elution kinetics from a reservoir polyurethane intravaginal ring fabricated by fused deposition modeling 3D printing. \u003cem\u003eJournal of Pharmacy and Pharmaceutical Sciences\u003c/em\u003e 2017;20 (2):122s.\u003c/li\u003e\n\u003cli\u003eBenhabbour SR, Janusziewicz R, Mecham S, et al. Innovative 3D printed intravaginal rings: Reengineering multipurpose intravaginal rings for prevention of HIV and unintended pregnancy. \u003cem\u003eAIDS Research and Human Retroviruses\u003c/em\u003e 2018;34 (1):72. doi: http://dx.doi.org/10.1089/aid.2018.5000.abstracts\u003c/li\u003e\n\u003cli\u003eFu J, Yu X, Jin Y. 3D printing of vaginal rings with personalized shapes for controlled release of progesterone. \u003cem\u003eInt J Pharm\u003c/em\u003e 2018;539(1-2):75-82. doi: https://dx.doi.org/10.1016/j.ijpharm.2018.01.036\u003c/li\u003e\n\u003cli\u003eTiboni M, Campana R, Frangipani E, et al. 3D printed clotrimazole intravaginal ring for the treatment of recurrent vaginal candidiasis. \u003cem\u003eInt J Pharm\u003c/em\u003e 2021;596:120290. doi: http://dx.doi.org/10.1016/j.ijpharm.2021.120290\u003c/li\u003e\n\u003cli\u003eAjao MO, Clark NV, Kelil T, et al. Case Report: Three-Dimensional Printed Model for Deep Infiltrating Endometriosis. \u003cem\u003eJ Minim Invasive Gynecol\u003c/em\u003e 2017;24(7):1239-42. doi: 10.016/j.jmig.2017.06.006. Epub 17 Jun 19.\u003c/li\u003e\n\u003cli\u003eMackey A, Ng JI, Core J, et al. Three-Dimensional-Printed Uterine Model for Surgical Planning of a Cesarean Delivery Complicated by Multiple Myomas. \u003cem\u003eObstet Gynecol\u003c/em\u003e 2019;133(4):720-24. doi: https://dx.doi.org/10.1097/AOG.0000000000003107\u003c/li\u003e\n\u003cli\u003eFlaxman T, Cooke CM, Sheikh A, et al. Pre-Surgical Planning Using Patient-Specific 3D Printed Anatomical Models for Women with Uterine Fibroids. \u003cem\u003eJournal of Minimally Invasive Gynecology\u003c/em\u003e 2020;27(7):S71-S72. doi: 10.1016/j.jmig.2020.08.596\u003c/li\u003e\n\u003cli\u003eReddy H, Maghsoudlou P, Pepin K, et al. Use of 3D Model in Laparoscopic Myomectomy. \u003cem\u003eJournal of Minimally Invasive Gynecology\u003c/em\u003e 2019;26(7):S19. doi: 10.1016/j.jmig.2019.09.507\u003c/li\u003e\n\u003cli\u003eChen J, He H, Song T, et al. Utilizing 3D printing model of placenta percreta to guide obstetric operation. \u003cem\u003eObstetrics and Gynecology\u003c/em\u003e 2017;129 (1):42S.\u003c/li\u003e\n\u003cli\u003eBaek M-H, Kim D-Y, Kim N, et al. Incorporating a 3-dimensional printer into the management of early-stage cervical cancer. \u003cem\u003eJournal of Surgical Oncology\u003c/em\u003e 2016;114(2):150-52. doi: https://doi.org/10.1002/jso.24292\u003c/li\u003e\n\u003cli\u003eSayed Aluwee SAZB, Zhou X, Kato H, et al. Evaluation of pre-surgical models for uterine surgery by use of three-dimensional printing and mold casting. \u003cem\u003eRadiological Physics and Technology\u003c/em\u003e 2017;10(3):279-85. doi: 10.1007/s12194-017-0397-2\u003c/li\u003e\n\u003cli\u003eChang A. 3D printing technology is a feasible and efficient tool for pre-planning for image guided brachytherapy of cervix cancers. \u003cem\u003eBrachytherapy\u003c/em\u003e 2018;17 (4 Supplement 1):S111.\u003c/li\u003e\n\u003cli\u003eWang F, Luo H, Cheng H, et al. Is 3D printinggided threedimensional brachytherapy suitable for cervical cancer: From one single research institute? \u003cem\u003eEuropean Journal of Gynaecological Oncology\u003c/em\u003e 2020;41(4):591-97. doi: http://dx.doi.org/10.31083/J.EJGO.2020.04.4932\u003c/li\u003e\n\u003cli\u003eHadden R, Grover S, Chuen J, et al. Utility of 3D printed models of Mullerian anomalies as a teaching tool. \u003cem\u003e3D Printing in Medicine Conference: 3dMed Australia Conference\u003c/em\u003e 2018;4(Supplement 1) doi: http://dx.doi.org/10.1186/s41205-018-0036-5\u003c/li\u003e\n\u003cli\u003eCrain CL, Winfrey OK, Jackson WL, et al. Teaching Pediatric Straddle Injury Repair with Use of a 3D Printed Model. \u003cem\u003eJ Pediatr Adolesc Gynecol\u003c/em\u003e 2021;34(6):862-64. doi: 10.1016/j.jpag.2021.05.005. \u003c/li\u003e\n\u003cli\u003eTowner MN, Lozada-Capriles Y, LaLonde A, et al. Creation and Piloting of a Model for Simulating a Minimally Invasive Myomectomy. \u003cem\u003eCureus\u003c/em\u003e 2019;11(3):e4223. doi: https://dx.doi.org/10.7759/cureus.4223\u003c/li\u003e\n\u003cli\u003eBartellas M, Ryan S, Doucet G, et al. Three-Dimensional Printing of a Hemorrhagic Cervical Cancer Model for Postgraduate Gynecological Training. \u003cem\u003eCureus\u003c/em\u003e 2017;9(1):e950. doi: https://dx.doi.org/10.7759/cureus.950\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Study characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"973\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFirst author, date\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePublication Type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSub-specialty\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient Population\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3D Printed Product\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntended Use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntended User\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e\u003cstrong\u003eKey Study Findings*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eAjao, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eBEN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eEndometriosis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eAnatomical comprehension\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eThe 3D model accurately demonstrated the relationship of the endometriotic nodule to the patient\u0026rsquo;s anatomy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eBaek, 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eCervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eAnatomical comprehension; surgical planning; patient education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD; PT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D models facilitate patient education and assist surgeons to plan operative intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eBarbosa, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eREI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eInfertility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eSurgical planning; improving assisted reproductive techniques\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D models are feasible and can improve assisted reproductive techniques, assist in surgical planning\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eBarsky, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eURO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eStress urinary incontinence\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eOther medical device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eCustomized pessary for stress urinary incontinence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003ePT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eA customized 3D printed pessary for treatment of stress urinary incontinence was successfully produced and inserted\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eChang, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eLocally advanced cervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D printing technology enabled precise apposition of applicators and dosimetry for image guided cervical cancer brachytherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eChen, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eBEN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003ePlacenta percreta\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eAnatomical comprehension; surgical planning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD; PT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eThe 3D printed model facilitated accurate assessment of placenta percreta and surgical planning, to improve maternal and fetal outcomes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eFlaxman, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eBEN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eUterine fibroids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eAnatomical comprehension; surgical planning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003ePT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D printed models increased surgeon\u0026rsquo;s understanding of complex anatomy and impacted their surgical plan\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eHadden, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003ePED\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eCongenital Mullerian anomalies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eAnatomical comprehension; provider education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003ePT; TR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D models increased gynaecologists\u0026apos; understanding of congenital Mullerian anomalies and surgical confidence\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eJiang, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCohort study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eCentral pelvic recurrent gynecologic cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy planning and treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D printed individual template based high dose rate interstitial brachytherapy is feasible and efficient, permitting delivery of localized interstitial brachytherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eKudla, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eLocally recurrent endometrial cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eThe custom applicator improved the quality and ease of delivery of interstitial vaginal brachytherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eLaan, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eGynaecologic cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eA personalised vaginal topography-based 3D printed for brachytherapy needle applicators, derived from patient MRI data was successfully designed and produced\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eLindegaard, 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eLocally advanced cervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D printing enabled a high degree of individualisation and exemplified superior dose distribution in brachytherapy treatment of stage IVA cervical cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eLogar, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCohort study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eLocally advanced primary/recurrent gynecologic cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eWith use of 3D printed applicators, all dose volume parameters for clinical target volume improved without compromising dose constraints for organs at risk\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eLogar, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eVaginal/recurrent endometrial cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eAn individually-designed multi-channel vaginal applicator was well tolerated, increased target coverage in advanced tumours, minimized trauma to surrounding tissue\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eMackey, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eBEN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eUterine fibroids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eAnatomical comprehension; surgical planning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eThe 3D-printed model facilitated cesarian section planning and use was associated with good maternal/fetal outcomes.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eMohammadi, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eLocally advanced cervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eHigh-temp resin with SLA 3D patient-specific multi-channel cylindrical applicators show mechanical accuracy and effective dosimetry\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003ePavan, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eURO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eMullerian agenesis; MRKH syndrome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eOther medical device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003ePost-surgical customized vaginal mold\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003ePT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eFunctional, histological and anatomical results were reached with the 3D printed tailored mold\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003ePetric, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCohort study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eLocally advanced cervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eThe use of 3D printed tandem needle template for image guided brachytherapy in locally advanced cervical cancer allowed successful management of disease\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eQu, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eRecurrent cervical cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eThe 3D printed individual applicator facilitated precise planning and decreased complications\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eQu, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eNon-randomised control trial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003ePelvic wall recurrent gynecologic cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eWhen used for preoperative planning, both 3D-printed non coplanar template (3D-PNCT) and 3D-printed coplanar template achieve prescription dose, 3D-PNCT was more safe\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eQu, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eRetrospective study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eNon-central pelvic recurrent gynecologic cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D-printed non coplanar template assisted CT-guided\u0026nbsp;125I-seed ablative brachytherapy is a safe and feasible treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eReddy, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eBEN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eUterine fibroids\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eAnatomical comprehension; surgical planning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003ePatient-specific 3D models facilitated preoperative and intraoperative planning for laparoscopic myomectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eSayed Aluwee, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eEndometrial cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eAnatomical comprehension; surgical planning; patient education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD; PT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003ePersonalized uterine 3D physical models using 3D printing and mold casting methods based on 3D MR images are useful for planning by surgeons, and patient communication\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eSekii, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eRecurrent cervical cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D printing templates designed inversely have potential to assist in interstitial brachytherapy for vaginal tumors\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eSemeniuk, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eGynecologic cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003ePatient-specific cylinders provide comparable dose to the target, with advanced healthy tissue sparing\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eSethi, 2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eEndometrial cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eSuccessful production of a patient specific vaginal cylinder applicator for high-dose-rate intracavitary brachytherapy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eSethi, 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003ePrimary/recurrent endometrial cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eSuccessful production of biocompatible, sterilizable, custom applicators for gynecologic brachytherapy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eWadi-Ramahi, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eGynaecologic cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003ePatient-specific 3D printed molds facilitated personalized brachytherapy, specific to patient and tumor anatomy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eWang, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCohort study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eCervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eAnatomical model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eAnatomical comprehension; patient education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD; PT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D printed models can display patient anatomy and pathology to guide individualized brachytherapy for cervical cancer and communicate with patients\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eYuan, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eRandomized control trial\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eRecurrent cervical cancer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eThe 3D printed minimally invasive guidance template-assisted treatment provided dosimetry advantage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eZhao, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eConference abstract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase series\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eRetroperitoneal lymph node metastasis in gynecologic cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003e3D printing template in seed implantation provides accurate positioning for treating retroperitoneal lymph node metastasis in gynecological oncology\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"7.708119218910586%\"\u003e\n \u003cp\u003eZhao, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"7.810894141829394%\"\u003e\n \u003cp\u003eFull text\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eCase report\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"6.7831449126413155%\"\u003e\n \u003cp\u003eONC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"9.763617677286742%\"\u003e\n \u003cp\u003eCervical cancer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"10.688591983556012%\"\u003e\n \u003cp\u003eBrachytherapy device\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"15.51901336073998%\"\u003e\n \u003cp\u003eBrachytherapy treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.858170606372045%\"\u003e\n \u003cp\u003eMD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"29.08530318602261%\"\u003e\n \u003cp\u003eA higher dose coverage of the target and better sparing of the organs at risk can be achieved by using a3D-printed, individualized cylinder\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003cspan style=\"text-align: inherit;\"\u003eAcronyms used:\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSub-specialty:\u003c/strong\u003e BEN \u0026ndash; benign gynecology; ONC \u0026ndash; gynecologic oncology; REI \u0026ndash; reproductive endocrinology and infertility; URO \u0026ndash; Urogynecology; PED \u0026ndash; Pediatric Gynecology\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIntended user:\u003c/strong\u003e MD \u0026ndash; physicians; PT \u0026ndash; patients, TR \u0026ndash; trainees\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e*Key findings were paraphrased directly from the study manuscripts\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. 3D-printed model production specifics\u0026nbsp;\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable align=\"\" border=\"1\" cellpadding=\"0\" cellspacing=\"0\" width=\"964\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.78838174273859%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFirst author, date\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817427385892117%\"\u003e\n \u003cp\u003e\u003cstrong\u003eData Source\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.634854771784234%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSoftware\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.57676348547718%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3D Printer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.53941908713693%\"\u003e\n \u003cp\u003e\u003cstrong\u003e3D Printing Material\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.912863070539419%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCost per\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eModel (USD)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817427385892117%\"\u003e\n \u003cp\u003e\u003cstrong\u003eProduction Time\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.912863070539419%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo. of Models\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eAjao, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eMediprint\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003ePolyJet J750, Stratasys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eBaek, 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eObjet 260 CONNEX 3D printer, Stratasys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eBarbosa, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003e3D PolyJet Studio; GrabcaD Print\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003ePolyjet J750, Stratasys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eVeroclear rGD810; Vero Magenta rGD 851; Tango Plus FlX930\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003e86mins \u0026ndash; 30hrs\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eBarsky, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eTrial/error\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eSolidWorks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eFused deposition modeling printer (model NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePolylactic acid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e$10.94\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003e2 hrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eChang, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT/MRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eFortus 450mc, Stratasys\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePolymer materials\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eChen, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eFlaxman, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eResin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eHadden, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eJiang, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT/MRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eMaterialise Mimics, Geomagic\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eLITE450HD-B, Shanghai Liantai Technology Co Ltd.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eMedical curing resin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eKudla, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eEclipse; SolidWorks; Brachyvision\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eLaan, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eOncentra, 3D Slicer; SolidWorks; MeVi-sLab; MatLab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eDigital light processing (DLP)-based printer (Perfactory 4 mini XL, Envisiontec)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eLiquid photopolymer resin\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eLindegaard, 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT/MRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eBrachyVision; Matlab; SolidWorks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eProjet 3510 SD, 3D Systems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eVisijet M3 Crystal, 3D Systems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003e3days (Print: 9hrs)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eLogar, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eBrachyVision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eFormiga P100 3D printer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eBiocompatible polyamide PA 2200\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eLogar, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eSelective laser sintering technology (model NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eBiocompatible polyamide PA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eMackey, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003e3D Slicer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eUltimaker 3 Extended 3D printer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePolylactic acid filament\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e$35.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003e49.5hrs (printing)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eMohammadi, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eFusion 360; Meshmixer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eUnionTech RS Pro 600\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eHigh-temp resinFLHTAM02 model, Formlabs Inc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003e4-5 hrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003ePavan, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eTrial/error\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePolylactic acid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003ePetric, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eBiocompatible autoclavable material\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eQu, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eQu, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eQu, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eMagics, Materialise\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eRS6000, Shanghai Liantaiv 3D Technology Company Inc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eReddy, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eMediprint\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003ePolyJet J750, Stratasys\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePolymer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eSayed Aluwee, 2017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eFused deposition modeling printer (model NS)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePolylactic acid with biodegradable thermoplastic\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003e3 - 5 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eSekii, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT/MRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eCAD Software, Fusion 360 v.2.03174, Autodesk Inc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eOutsourced, DMM.com\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePolycarbonate/acrylonitrile-butadiene-styrene (PC-ABS) polymer alloy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eDesign: 2-3hrs\u003c/p\u003e\n \u003cp\u003ePrint: 6-7days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eSemeniuk, 2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eEclipse; Oncentra; Matlab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eBiocompatible polymethyl methacrylate; tungsten-polylactic acid composite\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eDesign: 3hrs\u003c/p\u003e\n \u003cp\u003ePrint: 3hrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eSethi, 2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003ePhysical exam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eCAD software, Autodesk Inc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eFortus 400mc, Stratasys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePC-ISO biocompatible thermoplastic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eSethi, 2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003ePhysical exam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eCAD software, Autodesk Inc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eFortus 400mc, Stratasys\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePC-ISO thermoplastic\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eWadi-Ramahi, 2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eCAD software\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eWang, 2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eMRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003e3DDOCTOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eThermoplastics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eYuan, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT/MRI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eProwess Panther, Unicorn 3D template system\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eEP-A650\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eZhao, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"10.78838174273859%\"\u003e\n \u003cp\u003eZhao, 2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"17.634854771784234%\"\u003e\n \u003cp\u003e3ds Max, \u0026nbsp;Autodesk Inc.; MakerBot\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"21.57676348547718%\"\u003e\n \u003cp\u003eReplicator+, MakerBot\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20.53941908713693%\"\u003e\n \u003cp\u003ePolylactic acid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"8.817427385892117%\"\u003e\n \u003cp\u003eNS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"5.912863070539419%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAcronyms used:\u003c/p\u003e\n\u003cp\u003eUSD \u0026ndash; United States Dollars\u003c/p\u003e\n\u003cp\u003eNS \u0026ndash; Not Specified\u003c/p\u003e\n\u003cp\u003eCAD \u0026ndash; Computer Aided Design\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"3d-printing-in-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"tdpm","sideBox":"Learn more about [3D Printing in Medicine](https://threedmedprint.biomedcentral.com/)","snPcode":"41205","submissionUrl":"https://submission.nature.com/new-submission/41205/3","title":"3D Printing in Medicine","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"gynecology, patient specific, scoping review, 3D printing","lastPublishedDoi":"10.21203/rs.3.rs-2530895/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2530895/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cu\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e\u003c/u\u003e Developments in 3-dimensional (3D) printing technology has made it possible to produce high quality, affordable 3D printed models for use in medicine. As a result, there is a growing assessment of this approach being published in the medical literature. The objective of this study was to outline the clinical applications of individualized 3D printing in gynecology through a scoping review.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eData Sources:\u003c/strong\u003e\u003c/u\u003e Four medical databases (Medline, Embase, Cochrane CENTRAL, Scopus) and grey literature were searched for publications meeting eligibility criteria up to 31 May 2021.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eStudy Eligibility Criteria:\u003c/strong\u003e\u003c/u\u003e Publications were included if they were published in English, had a gynecologic context, and involved production of patient specific 3D printed product(s).\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eStudy Appraisal and Synthesis Methods:\u003c/strong\u003e\u003c/u\u003e Studies were manually screened and assessed for eligibility by two independent reviewers and data were extracted using pre-established criteria using Covidence software.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/u\u003e\u003cu\u003e:\u003c/u\u003e Overall, 32 studies (15 abstracts,17 full text articles) were included in the scoping review. Most studies were either case reports (12/32,38%) or case series (15/32,47%). Gynecologic sub-specialties in which the 3D printed models were intended for use included: gynecologic oncology (21/32,66%), benign gynecology (6/32,19%), pediatrics (2/32,6%), urogynecology (2/32,6%) and reproductive endocrinology and infertility (1/32,3%). Twenty studies (63%) printed 5 or less models, 6/32 (19%) printed greater than 5 (up to 50 models). Types of 3D models printed included: anatomical models (11/32,34%), medical devices, (2/32,6%) and template/guide/cylindrical applicators for brachytherapy (19/32,59%).\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/u\u003e\u003cu\u003e:\u003c/u\u003e Our scoping review has outlined novel clinical applications for individualized 3D printed models in gynecology. To date, they have mainly been used for production of patient specific 3D printed brachytherapy guides/applicators in patients with gynecologic cancer. However, individualized 3D printing shows great promise for utility in surgical planning, surgical education, and production of patient specific devices, across gynecologic subspecialties. Evidence supporting the clinical value of individualized 3D printing in gynecology is limited by studies with small sample size and non-standardized reporting, which should be the focus of future studies.\u003c/p\u003e","manuscriptTitle":"Individualized medicine using 3D printing technology in gynecology: a scoping review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2023-02-02 16:57:14","doi":"10.21203/rs.3.rs-2530895/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Accepted","date":"2023-02-17T16:25:17+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-02-01T06:43:31+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-02-01T06:43:30+00:00","index":"","fulltext":""},{"type":"submitted","content":"3D Printing in Medicine","date":"2023-01-30T18:13:31+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"3d-printing-in-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"tdpm","sideBox":"Learn more about [3D Printing in Medicine](https://threedmedprint.biomedcentral.com/)","snPcode":"41205","submissionUrl":"https://submission.nature.com/new-submission/41205/3","title":"3D Printing in Medicine","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d55b1714-314d-4e5d-9d68-1087ff86f534","owner":[],"postedDate":"February 2nd, 2023","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-10-16T20:08:39+00:00","versionOfRecord":{"articleIdentity":"rs-2530895","link":"https://doi.org/10.1186/s41205-023-00169-9","journal":{"identity":"3d-printing-in-medicine","isVorOnly":false,"title":"3D Printing in Medicine"},"publishedOn":"2023-03-17 20:02:39","publishedOnDateReadable":"March 17th, 2023"},"versionCreatedAt":"2023-02-02 16:57:14","video":"","vorDoi":"10.1186/s41205-023-00169-9","vorDoiUrl":"https://doi.org/10.1186/s41205-023-00169-9","workflowStages":[]},"version":"v1","identity":"rs-2530895","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2530895","identity":"rs-2530895","version":["v1"]},"buildId":"GqpaHPwrfC8PjnIFayRh5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}