TMC PULSE

4 t m c » p u l s e | j u ly 2 0 1 9 A 3D Model for Global Health Students are creating a low-cost training tool for cervical cancer screening W aheed Mia sits on a bench in Blantyre, Malawi, a tiny paintbrush in his hand. He holds a small cylindrical figure between his fingers, already covered in bright pink paint, and flicks tiny red and white squiggles onto its surface with careful brush strokes. Then he sets it down and starts another. He is satisfied with his work. At the end of the day, the surfaces look just like cancerous and precancerous lesions of the cervix. Mia hopes they will also save lives. Nine thousand miles away, undergraduate students at Rice University are busy perfecting another part of that same project, a prototype that they and Mia, along with another student from Malawi Polytechnic, initiated during a summer internship in 2016. Made of 3D-printed material, wood, PVC pipe, water-resistant fabric and foam, as well as easy-to-source hardware, the final product is a low-cost, durable and comprehensive training tool for pelvic examinations. Known as LUCIA—a loose acronym for "low- cost universal cervical cancer instructional appa- ratus"—the completed kit includes a standalone "pelvis" and more than 20 3D printed cylindrical cervical models, which allow trainees to exam- ine and detect a range of potential conditions, including cancer. Clinicians-in-training can peer into the model vaginal canal using a speculum, just as they would in clinical practice. Inside, they will encounter one of the cervical models, which fits into a special holder. Eight of the models are designed to change color when swabbed with hot water—mimicking exactly what might happen in an OB-GYN setting during a colposcopy or visual inspection with acetic acid. "In real life, clinicians put acetic acid onto the cervix and, when you have abnormal areas, they turn white," explained Kathleen Schmeler, M.D., associate professor in the department of gynecologic oncology and reproductive medicine at The University of Texas MD Anderson Cancer Center and the clinical lead on the project. "We actually use hot water instead of vinegar for the models, and they made the models temperature-sensitive, so there are small areas that will turn white when exposed to hot water, and then the other areas will stay pink, simulating what really happens." The prototype is a tool for both practicing clinical screening and also for recognizing when areas are abnormal—as well as treating some of the most common conditions. The team has created additional components for the kit that include gel-based models for practicing biop- sies or performing a LEEP, a procedure in which abnormal cells are removed via a small electrical wire loop. The students are also designing tools to allow for the simulation of cryotherapy and thermocoagulation techniques, which are both procedures for removing precancerous lesions. Sonia Gomez Parra, who earned a Ph.D. in bioengineering from Rice this spring and returns to medical school in August to complete her train- ing in obstetrics and gynecology, mentored the undergraduate students throughout the project. Multiple clinicians have expressed interest in the model, she said, for training purposes and also for their patients. "A lot of people have said, 'You know, this would be really helpful for my patients because, when I talk to them, they don't know what a cervix is, they don't know what is happening during a procedure. I can show them with these models exactly what I'm planning to do, what's going on, and just further educate them on why it's Above: Sonia Gomez Parra, left, who earned a Ph.D. in bioengineering from Rice this spring, uses the LUCIA model during a training course in cervical cancer prevention in Beira, Mozambique. Right: Trays hold cervical models designed to depict a range of potential conditions. The models are part of a low-cost, durable and comprehensive training tool for pelvic examinations. B y A l e x a n d r a B e c k e r Credit: Courtesy photo

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