One of my favourite things about my work is that it’s never quite the same week by week. Whether that’s driving between the different hospitals of Lincolnshire to test X-ray equipment, the occasional stints of learning at Newcastle University or the one-off trips to various meetings and conferences, a change of scene is always exciting.
However, possibly the most exciting adventure of the STP is the chance to go on an elective. This privilege, typically afforded to medical students midway through university, is also granted to trainee NHS clinical scientists. It allows us up to six weeks away from work, to go anywhere we like and experience something – anything – of science and/or healthcare that’s not our everyday 9-5.
So, given all the freedom in the world, of course the natural choice was to spend a February in the tropical climes of Belfast, Northern Ireland…
Okay, so it may not be the Caribbean, but Belfast is home to axial3D – an innovative, creative company who are making real waves in healthcare, transforming the ways in which we use medical imaging. They create 3D printed models directly from CT and MRI data, providing clinicians with a bespoke physical representation of a patient’s anatomy to aid pre-operative decision-making.
After just a couple of emails I’d confirmed my visit. I was excited to experience the world of medical 3D printing more, after getting a flavour of it on a summer placement at the Royal Hallamshire Hospital in 2016. I was intrigued to find out the mechanics behind producing quality prints, and explore the concept of 3D printing as an extension to the medical imaging services already routinely provided in the NHS. I was also looking forward to meeting new people, experiencing a different work culture and exploring a new city!
When I arrived at axial3D, half of the office was piled high with boxes ahead of a move to bigger premises; the other half was buzzing with business as usual, while interviews for new recruits were also being conducted over the road. It certainly didn’t take me long to learn that it was all systems go here! Amidst all the goings-on, the Operations team were brilliant at making me feel at home so quickly. I was soon involved with producing 3D prints, gradually learning the whole process from CT/MRI scan to final product.
The process starts with a clinician in a hospital, uploading medical images to the company’s secure online portal which strips away any patient-identifiable tags. The images are fed through an algorithm, which broadly highlights the relevant anatomy for printing. A number of these algorithms are currently under development using machine learning techniques; as these advance, they have the potential to dramatically speed up the process, but for now, it’s down to the Ops team to refine the selection until the exact anatomy the clinician wants is highlighted. This is done using software – I enjoyed a bit of virtual colouring-in!
Once the selection is perfected, most models need some reinforcement if they are to stay together once printed. In another piece of software, dowels can be added to keep everything in one piece. Connecting dowels and holes, like interlocking jigsaw pieces, can also be added if a model is too big for the printer – I really enjoyed the puzzle of how to print a whole foot in separate parts and rebuild it later!
Models then need extra, temporary support to survive the printing process. Support structures ensure that there are no weak points that might cause the print to fail or collapse as it forms. Once these are generated, the plan is sent from the computer to the 3D printer.
Next, the printer can start creating! One layer at a time, a laser selectively cures liquid resin from the tank to gradually build up the shape of the model. Depending on the size of the model, this can typically take up to 24 hours as thousands of tiny layers are incrementally made.
When the print is ready it is washed, then cured under UV light until the plastic is fully hardened.
To reveal the model in all its glory, all the supporting structures need to be removed. This can be a messy job, with bits of plastic having the tendency to fly off in all directions – I soon learnt that smart clothes weren’t always the best option! Once the supports are mostly gone, the model is sanded down to make sure there are no remnants left.
For some models, that’s the end of the process, but others need colour adding to highlight particular regions of interest to the surgeon. I had a go at painting blood vessels, and injecting coloured resin into hollow cavities to highlight tumours and muscles. I enjoyed having a bit of creativity to get stuck into – time flew doing this!
A final clean up sees the finished product shiny and ready to go – a CT scan like I’d never seen it before, to go and help surgeons deliver life-changing medical care. I was amazed at the impact some of these models really had; on my first day, I painted the blood vessels of a model that helped a surgeon plan how to treat a complex aneurysm. It was also used to explain the procedure to the patient, visually demonstrating the steps the doctors took while he was under the knife. It was brilliant to work on something that had had such an impact elsewhere – the full story for this individual case is on the axial3D website here.
I really enjoyed contributing to patient care in a completely different way, swapping an NHS hospital for a lively, startup company. I was able to share my perspective as well as learn from the others, and it was brilliant to make connections together between what we do. Work aside, highlights also included Fridays’ bacon breakfasts and star visitor…
I loved exploring Belfast, an area of the world I have never been to before. I was lucky to share most of my weekends with my husband, who I think might have single-handedly kept Flybe afloat for the last month of their existence… he became very familiar with Belfast City Airport! I had a brilliant weekend when my parents and brother came to visit too, braving the bitter winds of the north coast and the Giant’s Causeway amidst a raging storm Dennis!
I am so grateful for the hospitality I received in Northern Ireland. I shared church with wonderful people just a stone’s throw from the Airbnb I stayed in, dinner with strangers who are now friends, and many coffees and lunches with my temporary colleagues who made me feel anything but temporary. Even my parents were welcomed in to join the new office-warming party!
The elective was such a brilliant opportunity to learn new things, get a fresh perspective and enjoy an adventure. Until next time Belfast – you’ve been fab. Who needs the Caribbean?