Introduction: Coronary artery disease is the third most common cause of death in the world. Invasive coronary angiography is the primary imaging modality used for both diagnosis and treatment of narrowed or occluded coronary arteries. X-ray phantoms play a crucial role in learning coronary artery anatomy and projections used in coronary angiography. Three-dimensional printing offers a novel approach to develop specific, inexpensive and anatomically accurate phantoms that can improve the learning process in various medical fields, including interventional radiology. Purpose: The purpose of the study was to create an anatomically accurate radiographic phantom showing the heart and coronary arteries that can be used as a teaching tool for learning anatomy and image projections in invasive coronary angiography. Methods: Descriptive and experimental methods were used in the study. The literature review was used to create the theoretical background. The process of model development included four phases: Planning, Concept development, model designing and validation. The computed tomography images were segmented using 3D Slicer software, resulting in a three-dimensional model of the heart. The model was printed using the polylactic acid filament and fused deposition modelling technique. Visualization of the coronary arteries was achieved by applying a mixture of ultraviolet gel and metal powder. Radiographs (on a C-arm) were also taken and the resulting images were compared with reference coronary angiograms from the literature. Results: A hollow, anatomically accurate heart model with clearly visible coronary artery pathways was successfully produced. The X-ray images of the phantom showed good comparability with reference images from the literature. Discussion and conclusion: The study confirms that an anatomically accurate model suitable for teaching anatomy and learning projection techniques in coronary angiography can be produced using computed tomography image segmentation and three-dimensional printing. Despite the successful implementation, certain limitations remain, particularly in the visualization of the coronary arteries. It would therefore make sense to automate this step. In the future, different materials simulating tissue-equivalent properties can also be investigated, which could allow a more realistic representation of the organ and other structures on X-ray images.
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