BETHESDA, Md.   –   Inside a quiet lab at Walter Reed National Military Medical Center, engineers and clinicians are reshaping how surgeons prepare for some of the hospital’s most complex procedures by working one layer at a time.

The hospital’s 3D Medical Applications Center (3D MAC) uses advanced imaging, design software and 3D printing to create patient-specific models, surgical guides and custom implants that support clinical decision-making and improve surgical outcomes.

While the lab does not directly treat patients, its work plays a critical role behind the scenes.

“We’re really indirect patient care,” said Peter Liacouras, PH.D., director of services for the 3D MAC. “What we provide is something surgeons can use to plan for surgery or use during surgery. That preparation can make a significant difference for both the provider and the patient.”

Using CT imaging data, the team reconstructs detailed 3D models of a patient’s anatomy. These models allow surgeons to visualize complex anatomy, practice procedures and, in some cases, design implants tailored to the individual patient.

One of the lab’s most advanced capabilities is in-house production of custom titanium cranial implants. When a patient has a skull defect caused by trauma, surgery or disease, engineers design an implant that matches the patient’s anatomy, often using mirror imaging from the unaffected side of the skull.

“The goal is to create an implant that fits as close to perfect as possible the first time,” Liacouras said. “That means less time in surgery and fewer adjustments in the operating room.”

Beyond cranial implants, 3D MAC supports prosthetics, dental procedures, surgical simulation and medical research. The lab produces training models for suturing and root canals, adapters for prosthetic limbs, and anatomical models for tumor, vascular and orthopedic cases.

Having these capabilities on site helps Walter Reed provide care that might otherwise require outside vendors or referrals.

“When you can design, modify and produce devices in house, it gives the hospital flexibility,” Liacouras said. “It also allows us to support more complex cases and keep care within the Military Health System.”

That capability can attract both providers and patients seeking advanced treatment options.

Looking ahead, the lab is working toward Food and Drug Administration (FDA) clearance for its custom titanium cranial implant. The team has implemented a quality management system and recently submitted its device for FDA review.

“If we receive clearance, we believe we would be the first hospital in the United States with FDA authorization for an in-house 3D-printed titanium cranial implant,” Liacouras said.

FDA clearance could eventually allow the lab to share devices across the Department of War and Department of Veterans Affairs, further expanding access to advanced 3D-printed medical solutions.

“We’re building for the future,” Liacouras said. “Our goal is to make sure Walter Reed remains at the forefront of medical innovation and patient-centered care.”