From 3-Dimensional Printing to 5-Dimensional Printing: Enhancing Thoracic Surgical Planning and Resection of Complex Tumors.
OBJECTIVE
Three-dimensional (3D) printing of anatomic models for complex surgical cases improves patient and resident education, operative team planning, and guides the operation. Our group describes two additional dimensions.


METHODS
The process of 5-dimensional (5D) printing was developed for surgical planning. Pretreatment computed tomography and positron emission tomography scans were reformatted and fused. Selected anatomy from these studies, along with posttreatment computed tomography and magnetic resonance images, were coregistered and segmented. This fused anatomy was converted into stereolithography files for 3D printing.


RESULTS
A patient presenting with a complex thoracic tumor was selected for 5D printing. 3D and 5D models were prepared to allow surgical teams to directly evaluate and compare the added benefits of information provided by printing in 5 dimensions.


CONCLUSIONS
Printing 5D models in patients with complex thoracic pathology facilitates surgical planning, selecting margins for resection, anticipating potential difficulties, teaching for learners, and education for patients.
Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
Erin A
EA
Gillaspie
Division of Radiology, Mayo Clinic, Rochester, Minnesota.
Jane S
JS
Matsumoto
Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
Natalie E
NE
Morris
Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Robert J
RJ
Downey
Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
K Robert
KR
Shen
Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota.
Mark S
MS
Allen
Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: blackmon.shanda@mayo.edu.
Shanda H
SH
Blackmon
D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008953:Models, Anatomic; D066330:Printing, Three-Dimensional; D013899:Thoracic Neoplasms / Q000473:pathology / Q000601:surgery*; D019616:Thoracic Surgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed