PixelPrint: a 3D printing platform for creating lifelike patient-based CT phantoms - Abstract. While CT remains the most highly utilized diagnostic tool in clinical practice, its technology still calls for research and development along the entire imaging chain to improve diagnostic accuracy and patient outcomes. The clinical translation of such developments must be safe, efficient, and timely; however, it remains a challenge to the community how to precisely predict performance during and after the development phase. Technology development can be aided by CT phantoms, which are specialized tools used to calibrate, test, and evaluate scanners. Most existing CT phantoms are relatively expensive and lack accurate representations of anatomy and diagnostic tasks. There is a lack of patient-based phantoms that fully represent attenuation profiles and textures seen in clinical CT acquisitions, which this proposal aims to address. As a result of its ability to create accurate and detailed physical models at a fraction of the cost of traditional methods, three-dimensional (3D) printing has become increasingly popular in medicine. CT phantom 3D printing studies include manufacturing geometrically accurate organ models, generating realistic texture samples, and generating accurate attenuation profiles. Although these approaches produce phantoms that are more similar to actual anatomical structures, several limitations remain, such as the loss of the natural look and feel of anatomical and pathological features. Recently, we proposed a 3D printing solution, called PixelPrint, that can achieve accurate organ geometry, image texture, and attenuation profiles while eliminating the complexities and limitations of previous methods. Our solution is a one-step method for translating CT or simulated images into printer instructions. As a preliminary study shows, isolated organs can be replicated so lifelike that an expert reader can't tell the difference between the CT scan and the original. Our proposal aims to develop 3D printing hardware and software that will be capable of creating patient-based phantoms with accurate spectral x-ray characteristics and a natural look and feel of anatomical and pathological structures. By completing the following aims, we aim to provide a more efficient and cost-effective method for developing and validating novel CT technology: (i) to design and construct a dedicated multi-material, quad extruder 3D printer for CT phantoms, (ii) to develop algorithms to preprocess and translate spectral CT images into instructions for 3D printing, and (iii) to evaluate the performance and reproducibility of patient-based CT phantoms. The academic and clinical CT community will benefit from a rapid and inexpensive manufacturing process. To drive dissemination of our development, we will, as part of this project, distribute dedicated patient-based phantoms to academic institutions. Our research environment and our team’s unique breadth of expertise are perfectly placed to execute this project. By utilizing the proposed phantoms, the community will be able to facilitate the translation of novel CT technologies for various diagnostic tasks into clinical practice.