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Man saves wife’s sight by 3D printing her brain tumor

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Re: Man saves wife’s sight by 3D printing her brain tumor

#11

This is an amazing story - and pretty much my worst nightmare. Not necessarily cancer itself, but the feeling and anxiety that you're not being treated and taken care of properly and that someone might be missing something. That doctors are (rightfully) unable to pay proper attention to everyone and everything just due to the sheer number of patients they must see. I know I'm prone to hypochondria, and it doesn't hel…

I share your concerns with the US medical system. It is a bunch of busy, reasonably bright people caught up in an insane circus. It on average produces adequate care, but you shouldn't expect much more. Having an active and informed advocate can make an enormous difference.

On the other hand, I agree that more data isn't necessarily better. There are plenty of examples. E.g.:

http://www.bloomberg.com/news/2012-05-21/prostate-cancer-tes...

If you do early prostate screening, you get worse medical outcomes than when you don't screen. Or consider whole-body scans:

http://www.radiologyinfo.org/en/news/newdetarget.cfm?ID=5

They will detect a lot of stuff that doesn't matter, but proving that it doesn't matter will be expensive and possibly harmful.

You see a similar phenomenon in investing. As Fooled by Randomness explains well, for most people the best strategy is to set your investments and look at them very rarely. If you watch the investment news all day and trade actively, you may not do better, you could easily do worse, and you'll certainly be much more stressed. But still, there is an endless supply of day-traders.

Re: Man saves wife’s sight by 3D printing her brain tumor

#12
In a similar vein, the chap in this article 3d printed his kidney stone to help surgeons:

http://www.bbc.co.uk/news/uk-england-hampshire-30801273

Ironically, he passed out due to the pain from his kidney stone when presenting to surgeons on the benefits of 3d printing.

Re: Man saves wife’s sight by 3D printing her brain tumor

#13

This is an amazing story - and pretty much my worst nightmare. Not necessarily cancer itself, but the feeling and anxiety that you're not being treated and taken care of properly and that someone might be missing something. That doctors are (rightfully) unable to pay proper attention to everyone and everything just due to the sheer number of patients they must see. I know I'm prone to hypochondria, and it doesn't hel…

>That doctors are (rightfully) unable to pay proper attention to everyone and everything just due to the sheer number of patients they must see.

Why are we excusing this? This is an allocation and resource problem.

Frankly, I never understood why I need to schedule an appointment with a doctor and also visit a pharmacy to get drugs like anti-acids, allergy medicine, short doses of painkillers, antibiotics, short doses of anti-anxiety drugs, anti-depressants, etc. My doctor spends, what I imagine, most of his time on trivial issues and I sympathize with those who have non-trivial issues. It doesn't seem fair to them that they get the same 30 minutes I get for my minor issues.

I think society needs to ask itself if we need a full-fledged doctor for many of these tasks. The politics of healthcare are really ugly. Sorry, but a lot of this level 1 stuff could be done by a non-expert. I should be able to just buy these things. Or, at worst, pharmacists should be able to prescribe this stuff. The system as-is is designed to maximize labor, thus billable hours, for doctors. Its a mess when it comes to actually providing care.

I understand there's potential for abuse here but I kinda don't care. In my society you have the freedom to stuff your face with Big Macs 3x a day, smoke, become an alcoholic, and soon smoke pot all day. Those all have major risks and are completely legal and mainstream. Yet when I want to heal myself, suddenly the regulators, rent-seekers, and moralists come out of the woodwork.

Re: Man saves wife’s sight by 3D printing her brain tumor

#14

This makes me doubt the reliability of cancer diagnosis: >They were understandably terrified, but neurologists who read the radiology report seemed unconcerned, explaining that such masses were common among women, and suggested Scott have it checked again in a year. Yet at the end of the article they say >if she had waited six months, she would have had severe, and possibly permanent, degradation of her sight.

It's important to remember that this article is probably simplifying the doctor's advice. I imagine the neurologist ended with: "However, please come back immediately if you feel worse or notice any other symptoms."

Obviously that 'may' have been a critical delay, and therefore Scott and her husband were certainly right in hindsight to be proactive about Scott's health.

Re: Man saves wife’s sight by 3D printing her brain tumor

#15
> Balzer used Photoshop to layer the new DICOM files on top of the old images, and realized that the tumor hadn’t grown at all — the radiologist had just measured from a different point on the image.

Think about the some of the implications of that statement for a while.

It really is no wonder that the softer sciences have a reproducibility problem.

Re: Man saves wife’s sight by 3D printing her brain tumor

#16
post #4

Interesting article, glad the operation was successful. The most interesting part of the article is not the advance in technology (nothing new, we've been using 3d prints as models for complicated fractures / bone tumours or even custom prostheses for years (academic centre)) but the low use rate of this technology by most hospitals. The trick with overlaying follow-up scans is called image fusion and is easy and can…

>The trick with overlaying follow-up scans is called image fusion and is easy and can be done by one-click applications

Just wanted to point out that image fusion is far from easy. The brain is easier than most areas of the body because the skull provides a good basis for performing a registration, but even then the brain has some small room to shift and you can't get a perfect alignment with only rigid transformations, especially when you're dealing with tumors.

For most other parts of the body you have complications like organs shifting around, gas passing through the digestive system, patients being in slightly different orientations, etc. In these cases you most definitely need to use some kind of deformable registration, which is far from a solved problem, especially when you have things like tumors changing shape/size or even appearing from nowhere from one scan to the next.

Re: Man saves wife’s sight by 3D printing her brain tumor

#17
post #11

This is an amazing story - and pretty much my worst nightmare. Not necessarily cancer itself, but the feeling and anxiety that you're not being treated and taken care of properly and that someone might be missing something. That doctors are (rightfully) unable to pay proper attention to everyone and everything just due to the sheer number of patients they must see. I know I'm prone to hypochondria, and it doesn't hel…

I share your concerns with the US medical system. It is a bunch of busy, reasonably bright people caught up in an insane circus. It on average produces adequate care, but you shouldn't expect much more. Having an active and informed advocate can make an enormous difference. On the other hand, I agree that more data isn't necessarily better. There are plenty of examples. E.g.: http://www.bloomberg.com/news/2012-05-21/…

Brazilian here (and surprised to see they used Brazilian research software in a top HN story!). Couple years ago, my wife had a mass on her throat that turned out to be thyroid-related but (thankfully) benign.

I had the EXACT same feeling as you, and feel we're copying the US in only the wrong aspects. "A bunch of busy, reasonably bright people caught up in an insane circus" sums it up better than I could. I'll digress here and vent about another aspect of it, but I liked your links about too much data, thanks.

Not sure how it is in the US, but what is strange for me here is that it's not only about cutting-edge tech, even old stuff (Email? Messaging of any kind? Hell, phone calls!) is not really used by our hospitals and doctors.

Here, if you do any type of imaging exams, y'll have to wait a few days for the results, get them on the lab - physically -, schedule another doctor appointment, wait an hour or so in the waiting room just so your doctor can take a look at the images and tell you, basically: "Ok, you're fine", or "Hmm, I need these other exams to be sure. Here, take this piece of paper where I describe what I need and get it done".

Seriously, we use instant messages delivered to phones all around the world simultaneously to share pictures of ourselves, of our cats, dogs and dinners, just for a giggle. And we can't do it to save lives!

Re: Man saves wife’s sight by 3D printing her brain tumor

#19
I coauthored a paper a few years ago on the intra-observer variability of measurements of brain tumors when using the bidimensional product. An increase of 25% in the BP is taken as an indicator of brain tumor progression. We found that the intra-observer variability is so high, you can get that 25% increase purely by chance. The first recommendation of the medical team, to wait and see, is understandable.

Re: Man saves wife’s sight by 3D printing her brain tumor

#20
post #16
post #4

Interesting article, glad the operation was successful. The most interesting part of the article is not the advance in technology (nothing new, we've been using 3d prints as models for complicated fractures / bone tumours or even custom prostheses for years (academic centre)) but the low use rate of this technology by most hospitals. The trick with overlaying follow-up scans is called image fusion and is easy and can…

>The trick with overlaying follow-up scans is called image fusion and is easy and can be done by one-click applications Just wanted to point out that image fusion is far from easy. The brain is easier than most areas of the body because the skull provides a good basis for performing a registration, but even then the brain has some small room to shift and you can't get a perfect alignment with only rigid transformatio…

Yes it was a bit of a generalization, but i mean the practical use of the tool. The technology behind it is wonderful! For my specialty its relatively easy (bone being a rigid body). But this type of software already works quite well for lung, liver etc. With careful manual alignment it can work for soft tissue sarcoma (muscle) and other types of more movable tissue, providing a quick overview. Volume measurement is also an option. But as you say its always complimentary to standard workflow.
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