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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

#21

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.

> explaining that such masses were common among women, and suggested Scott have it checked again in a year.

I know this sounds insane, but menigiomas (which I'd guess is what the neurologist suspected it was) are almost always benign and shockingly common - many post-mortems find these guys just kind of hanging out in/around the brain. The corollary is that any kind of cranial surgery has enormous risks. Point being, if a doctor sees what appears to be a (surprisingly) common event on a chart, they're not going to necessarily recommend further action other than observation UNLESS there's a change to the patient (which, as kitbrennan pointed out, almost certainly accompanied the "get it checked again in a year").

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

#23
post #20
post #16

Earlier quoted context omitted.

>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…

Yeah, I wasn't trying to be disagreeable, just pointing out that this is a very active area of research still, and there is always room for improvement. I work mostly with segmentation and shape analysis instead of registration, but I am involved with a project on multi-modal image fusion, which is even harder (and more interesting).

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

#25

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.

From your wording, it seems like your brain might have slipped gears when talking about probabilities, from 'science' mode to 'homo sapiens sapiens hardwired quantity estimator' mode.

When you say that "you can get that 25% increase purely by chance" do you mean (a) in better circumstances this should be formally impossible, or (b) the intra-observer variability is so high that there is significant (by some definition) possibility ___ of falsely detecting a 25% increase?

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

#26

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 dose…

Devil's advocate: one man's cure is another's demise. The vast majority of people know how to regulate their consumption of those not-so-bad things, but regulating their consumption of healing technology without understanding the potential downsides is what the powers at be are concerned about.

But I generally agree with you, it is an allocation problem, and the best way to allocate resources is removing arbitrary barriers to trade and promoting specialization. We're overly concerned about what might kill us and hardly concerned about improving the overall quality of our lives. The latter makes the former easier to deal with, but the need to feel safe and taken care of trumps freedom, I guess.

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

#28
Great story--I think one thing to highlight is 3D Slicer (the publicly-funded open source medical imaging tool used for all this):

http://www.slicer.org

More doctors should be using tools like this. Hopefully stories like this will help to overcome the inertia in adoption.

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

#29
post #23
post #20

Earlier quoted context omitted.

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…

Yeah, I wasn't trying to be disagreeable, just pointing out that this is a very active area of research still, and there is always room for improvement. I work mostly with segmentation and shape analysis instead of registration, but I am involved with a project on multi-modal image fusion, which is even harder (and more interesting).

Awesome, we use a lot of PET/CT/MRI fusion imaging for computer assisted surgery and have an EOS scanner (statistical shape modeling). Just really awesome tech. Good ultrasound -> CT fusion would, I think, be indeed be a major breakthrough, allowing easy matching / guided procedures everywhere in the body but also for us as a secondary check on CAS / robotic accuracy.
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