A Novel Flow Model for Demonstrating and Simulating Chemosaturation with Percutaneous Hepatic Perfusion in Unresectable Liver Metastasis.

RATIONALE AND OBJECTIVES: Diffuse unresectable liver metastasis of varying dignity are complex to manage and are associated with poor overall survival. Given the wide spectrum of liver-directed therapies including surgery, ablation, radiotherapy, brachytherapy, chemoembolization and chemosaturation an interdisciplinary approach is essential. Chemosaturation with percutaneous hepatic perfusion (CS-PHP) has shown promising developments in the treatment of metastasized uveal melanoma and colorectal carcinoma. However, the procedure is technically complex, involving isolation of hepatic circulation, targeted chemotherapy application and extracorporeal filtration, making it difficult to comprehend and teach not only the physician, but also the entire team, as well as aspiring students. We aimed to develop a simulator enabling demonstration and training of all procedural steps involved in CS-PHP. MATERIALS AND METHODS: Commercially available flow models were combined with custom 3D-printed liver and vascular models fabricated using our in-house 3d printer. Red dye was used as a surrogate for the chemotherapeutic agent to simulate delivery and filtration. RESULTS: The CS-PHP procedure could be successfully replicated ex-vivo in our laboratory. We deployed the setup at "The Cube" event of the European Congress of Radiology 2025 with overwhelmingly positive feedback from more than a 100 users. CONCLUSION: We successfully designed and implemented a flow model that realistically simulates CS-PHP. The model proved useful for demonstrating chemosaturation to both novice and experienced interventional physicians. It has potential applications in patient education, angiography team training, workflow and communication optimization, ultimately contributing to improved safety and outcomes.