Model Medicine
By Glen Warchol

Imagine using a computer program to pop out three-dimensional models, including precise copies of your bones, brain and heart, as easily as printing out a letter.

With newly developed rapid prototype software and corresponding "three-dimensional printers" that layer and shape ceramics and plastics, a physician can hold in her hands an exact pre-surgical model of a tumor patient's brain in a matter of hours. She can rehearse her surgical performance before opening the patient's skull. An orthopedic surgeon can manipulate precise replicas of his patient's bones - down to the striations - before doing a hip replacement.

"It's almost magic," technology consultant Terry Wohlers says.

Javelin 3D, a Salt Lake industrial design company, on May 1 will release a software program it believes will make rapid prototyping technology simple and inexpensive enough to allow medical professionals to create their own models rather than depending on expensive third-party industrial design firms.

The 15-year-old company will offer a demo of the Velocity2 software online beginning May 1 at http://www.javelin3d.com.

"We are really at the birth of this," says Alair Emory, a partner at Javelin 3D.

Velocity2 takes data from medical CT or MRI scanners and converts it for use by model-making machines. It runs on a conventional laptop and is as easy to use as a digital photo program, Javelin 3D partner Scott McMillin says.

Despite a development investment of $3 million, an academic version of Velocity2 will be available in early May for only about $1,000, the commercial version for $1,700 and $5,000 for a research-grade product, Emory says.

Because rapid prototyping is in its infancy, a volume market for Velocity2 will have to be created as it is distributed, Emory says. Javelin 3D hopes distributing Velocity2 cheaply over the Internet will seed creativity for additional uses.

Right now, rapid prototyping is used in industry to manufacture everything from fighter jet assemblies to Nike sneakers. But the growth in the medical world has lagged, Emory says.

Often, it is a patient who first sees the possibilities of the technology. One befuddled heart bypass patient had Javelin 3D make a model of his own heart, so his cardiologist could better explain the surgery. His doctor was fascinated.

"We are talking to more and more people," Javelin partner Scott McMillin says. "Some physicians ask for a model right after their patient comes in with one of ours."

Fort Collins, Colo.-based consultant Wohlers, who follows the industry, says the costs of rapid prototyping are plummeting.

"As time goes on and these machines become cheaper, those devices will be going into hospitals and clinics," Wohlers said. The machines, which use various technologies, including firing lasers into caldrons of liquid plastic to build models layer by layer, once cost upward of $500,000. Now the prices are dropping to $25,000-$30,000 - about the price of a good office copying machine.

"The U.S. leads in the development of the technology on the industrial side," Wohlers says. "But it's a little flip-flopped when it comes to medical applications. Europe and Asia are leading there."

One reason is that insurance companies balk at paying for medical models. A history of cost-saving benefits of the technology has yet to be established.

"Payment for the models is an issue," Wohlers says. "But if you can reduce OR [operating room] time by an hour with a $1,500 model, you can save $15,000."

A pioneer in the field is Medical Modeling in Golden, Colo. The company has made models to guide surgeons in separating conjoined twins. The models are sometimes beautiful. The skulls of Egyptian twins who were operated on in Dallas in 2003 are reproduced in translucent ivory with a web of scarlet blood vessels.

"It is still difficult to get insurance companies to understand the value of it," Medical Modeling's Andy Christiansen says. "We have been somewhat creative to get reimbursement. Part of the challenge is to come up with some compelling evidence to show to insurance companies why the models are needed."

Medical Modeling donated the $70,000 worth of models it produced for four co-joined twins surgeries.

Despite the possibilities, Christiansen is skeptical about how broad a market exists for Javelin's software. For one thing, even the most user-friendly software needs a knowledgable technician to produce a usable model, he says.

"If you have perfect data, it can be fairly simple. But some of the models we make you could never do automatically. They need quite a bit of user intervention."

McMillian acknowledges the limitations, "The weakest link is the data supplied by the CT or MRI."

But Javelin 3D figures hospitals already have hundreds of highly skilled anatomists who quickly can be trained to operate the software.

And though medical rapid prototyping makes headlines in complex surgical cases, its real market may be in mundane medical procedures, such as making hearing aids, installing simple implants and fabricating bone fracture repair parts.

Insurance companies "can justify the cost when it's used in many simpler procedures," Christiansen says.

Already, surgeons use Javelin 3D's tactilely accurate models to practice implanting coch- lear implants. "The success in the operation depends on how accurately it is delivered to the cochlea," Emory says. "The model mimics the touch and feel of the delivery system."

Typical of high tech ventures emerging from the recent recession, Velcocity2's debut marks the end of a long struggle for Javelin 3D, which Emory started with a $6,000 loan against her retirement account.

"Everything we have done has been bootstrap," she says, joking, "Sometimes, we couldn't even afford boots - it was just straps."

glenwarchol@sltrib.com

Javelin 3D's Velocity2

What is it? Medical modeling software

Development cost: $3 million

Retail price: $1,000 for the academic version, $1,700 commercial version, $5,000 for a research-grade product.

Release: Early May.

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