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Halter Lab
  • Halter Lab Home
  • Research Areas
    • Image Guidance Technology
    • Impedance Based Technology
  • Publications
  • Resources
    • Cadaver Head Holder
    • EIS & EIT Datasets
    • Injectable Tumor Phantoms
    • Details of Segmentation Protocol
  • People
  • Lab News
  • Lab Photos
  • Contact
  • More
    • Halter Lab Home
    • Research Areas
      • Image Guidance Technology
      • Impedance Based Technology
    • Publications
    • Resources
      • Cadaver Head Holder
      • EIS & EIT Datasets
      • Injectable Tumor Phantoms
      • Details of Segmentation Protocol
    • People
    • Lab News
    • Lab Photos
    • Contact




Injectable Tumor Phantoms

Michael Sramek | Yuan Shi | Erick Quintanilla | Xiaotian Wu PhD | Aravind Ponukumati 

David Pastel MD | Ryan Halter PhD | Joseph Paydarfar MD

Overview Video 

Overview Video

If using or refining this methodology, please cite these articles: 

  1. Tumor phantom for training and research in transoral surgery  (Investigative Otolaryngology)

  2. Development of a novel tumor phantom model for head and neck squamous cell carcinoma and its applications (SPIE Digital Library)

Syringe Adaptor Download

3D-Printable Syringe Adaptor

Download 3D Printable Syringe Adaptor

A 3D-printable syringe adaptor designed in Solidworks as two separate files .

Click on the images (yellow) to download 3D-Printable .Stl files

Printing Recommendations

For printing the syringe adaptor, it is recommended to use a high-resolution, resin, 3D printer. We employed a Formlabs Form 2 SLA printer with durable resin. The orientation below allows the optimization of the Luer Lock threads during printing. Our print was at a resolution of 50 microns and took approximately 20 hours to complete. Images below were generated with the Pre-form software prior to printing. 

Front View

Side View

Back View

Materials and Methods

Preparation of Tumor Phantom

Materials

Table 1 lists the ingredients with measured quantity to prepare the tumor phantom.

Tumor Phantom Preparation

The flowchart and text below give a step-by-step instruction on how to prepare and inject the tumor phantom with the syringe adaptor. 

  • Step 1: Prepare Ingredients

    1. Dilute iohexol in DI water by a 1:7-7.5 ratio* measured in mL

    2. Dilute 25% glutaraldehyde in DI water to 4%

  • Step 2: Making Tumor Phantom Base Solution

    1. Weigh 0.6 g agar and 2.4 g gelatin

    2. Measure and combine 30 mL chicken stock and 30 mL DI water

    3. Add agar and gelatin in the mixture

    4. Add 4 drops of food coloring in the mixture*

    5. Stir the mixture vigorously until uniform color and texture

    6. Heat the mixture until boiling 

    7. Add diluted iohexol to heated solution and mix vigorously

    8. Maintain it at 45-50ºC until ready to mix with the glutaraldehyde

  • Step 3: Load Materials for Injection

    1. Draw up 10 mL base solution in a 10 mL syringe and attach to syringe adaptor

    2. Draw up 1 mL glutaraldehyde in a 1 mL syringe and attach to syringe adaptor

    3. Finish assembly with connection of the plunger

    4. Assemble a needle if needed (17G spinal needle is used for cadaver injections)

  • Step 4: Inject into Cadaver (or other non-living tissue model)

    1. Slowly depress the master plunger and apply uniform pressure on both syringes

    2. Prime the syringe adaptor before injection to remove air

    3. Inject!!!

    4. Rinse the syringe adaptor with water promptly after the injection to avoid clogging the mixing channel

* The ratio of food coloring and iohexol could be adjusted as needed to affect tumor appearance and enhancement on imaging, respectively. 

Warning: Glutaraldehyde safety data sheet can be found here

Injection Technique

It is recommended that a constant low but even pressure be applied to the plunger during injection of tumor phantoms. This is to prevent intra-barrel solidification; however, too much pressure will cause hydrodissection. 

  • Prime the barrel so a few drops of TP is seen flowing out of the needle.

  • Insert into the submucosa and advance ~5mm. 

  • Slowly, putting even pressure on the plunger, inject tumor phantom material until the desired morphological change is observed. 

  • Withdraw the injector but keeping even pressure on the plunger to prevent blockage of the barrel. 

  • Rinse the barrel with an extra 10mL syringe filled with water attached to the location where the base was previously. 

  • Prepare for the next injection.

A. Assembled syringe adaptor post injection. B. Injection of cadaver head utilizing suspension laryngoscopy. C. Tonsil prior to injection. D.  Tonsil during injection. E. Tonsil post injection. 

Modeling in Cadaver

  • Access location with Lindholm laryngoscope or oral retractor.  Follow the steps of the injection technique.

Examples of injections in various sub-sites

Special Considerations

Storage of specimens:

  • Notably, the specimens appeared well after freeze-thaw cycle however there was a significant loss of radiodensity. 

    • We recommend, if you plan to use imaging as part of your training regimen to image the same day of injection or store in a morgue or refrigerator to limit radiographic loss.  

Below: before and after freeze-thaw of tonsillar injection. 

Contact us with questions:

Please contact Mike for further information or questions. 

Triological Presentation Video Coronado CA 2020

A video of the same presentation Mike Sramek gave at the Triological Society Combined Sections Meeting in Coronado, CA 2020


Triological Presentation
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