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E1518. Patient-Specific 3D Printed Models for Management and Education of Fibrodysplasia Ossificans Progressiva
Authors
  1. Michelle Ho; Thomas Jefferson University Hospital
  2. Michael Kramer; Thomas Jefferson University Hospital
  3. J. Fields; Thomas Jefferson University Hospital
  4. Vishal Desai; Thomas Jefferson University Hospital
Background
Fibrodysplasia ossificans progressiva (FOP) is a rare, autosomal dominant disease, characterized by heterotopic bone growth, where over 80% of patients have been given an incorrect initial diagnosis. For patients living with FOP minor trauma connective tissue secondary to events such as falls, intramuscular immunizations, or bruising can lead to heterotopic ossification. Early diagnosis and education are important to ensuring patients receive the proper resources at home, school, and in their community. Patient-specific three-dimensional (3D) models can be designed and printed to aid with education and clinical management. Compared to traditional two-dimensional imaging, 3D models allow more intuitive visualization of heterotopic bone growth and tracheobronchial tree.

Educational Goals / Teaching Points
The epidemiology and clinical features of FOP will be discussed. Common imaging findings including early malformations, soft tissue flares, and heterotopic ossification will be covered. A comprehensive overview of the 3D printing process including image acquisition, segmentation, design, file transfer, material selection, and printer selection will be reviewed. Finally, the exhibit will focus on examples of 3D models for patients with FOP and how they have been used for management, multidisciplinary conference, and education.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Characteristic radiologic findings of FOP include ossification of ligaments, joint fusion, valgus deformity of first metatarsal, and muscle edema. While characteristic heterotopic ossification is best detailed using computer tomographic (CT) imaging, magnetic resonance (MR) imaging is more sensitive for detection of edema secondary to flare-ups. Printing of 3D models for patients with FOP requires important considerations including segmentation of heterotopic ossification and tracheobronchial tree, design of connecting rods to eliminate floating objects, and selection of material and 3D printer with support and multicolor capability.

Conclusion
Patients with rare diseases face many barriers to accurate diagnosis and management. Our experience illustrates how radiologists can play an important role in characterization of disease progression and education through interpretation of studies and printing of 3D models for patients with a rare disease. Familiarity with the materials, workflow, and applications of 3D printing can ensure radiologists maintain an important role in multidisciplinary work and promote patient-centered care.