3D Printing of Diffuse Low-Grade Gliomas Involving Eloquent Cortical Areas and Subcortical Functional Pathways: Technical Note.

ABSTRACT Background Surgical resection of diffuse low-grade gliomas (DLGG) involving cortical eloquent areas and subcortical functional pathways represents a challenge in neurosurgery. Patient-specific 3D-printed models of head and brain structures have emerged in recent years as an educational and clinical tool for patients, doctors, and surgical residents. Methods Using multimodal high-definition MRI data, that incorporates information from specific task-based functional neuroimaging and DTI tractography and rapid prototyping technologies with specialized software and “in-house” 3D printing, we were able to generate 3D-printed head models that were used for preoperative patient education and consultation, surgical planning, and resident training in two complicated DLGG surgeries. Results This 3D-printed model is rapid-prototyped and shows a means to model individualized DLLG in 3D space with respect to cortical eloquent areas and subcortical pathways. Survey results from eight surgeons with different levels of expertise strongly support the use of this model for surgical planning, intraoperative surgical guidance, doctor-patient communication, and surgical training (>95% acceptance). Conclusions Spatial proximity of DLGG to cortical eloquent areas and subcortical tracts can be readily assessed in patient-specific 3D printed models with high fidelity. 3D printed multimodal models could be helpful in preoperative patient consultation, surgical planning, and resident training.