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Basaula D, Hay B, Wright M, Hall L, Easdon A, McWiggan P, Yeo A, Ungureanu E, Kron T. Additive manufacturing of patient specific bolus for radiotherapy: large scale production and quality assurance. Phys Eng Sci Med 2024; 47:551-561. [PMID: 38285272 PMCID: PMC11166743 DOI: 10.1007/s13246-024-01385-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/07/2024] [Indexed: 01/30/2024]
Abstract
Bolus is commonly used to improve dose distributions in radiotherapy in particular if dose to skin must be optimised such as in breast or head and neck cancer. We are documenting four years of experience with 3D printed bolus at a large cancer centre. In addition to this we review the quality assurance (QA) program developed to support it. More than 2000 boluses were produced between Nov 2018 and Feb 2023 using fused deposition modelling (FDM) printing with polylactic acid (PLA) on up to five Raise 3D printers. Bolus is designed in the radiotherapy treatment planning system (Varian Eclipse), exported to an STL file followed by pre-processing. After checking each bolus with CT scanning initially we now produce standard quality control (QC) wedges every month and whenever a major change in printing processes occurs. A database records every bolus printed and manufacturing details. It takes about 3 days from designing the bolus in the planning system to delivering it to treatment. A 'premium' PLA material (Spidermaker) was found to be best in terms of homogeneity and CT number consistency (80 HU +/- 8HU). Most boluses were produced for photon beams (93.6%) with the rest used for electrons. We process about 120 kg of PLA per year with a typical bolus weighing less than 500 g and the majority of boluses 5 mm thick. Print times are proportional to bolus weight with about 24 h required for 500 g material deposited. 3D printing using FDM produces smooth and reproducible boluses. Quality control is essential but can be streamlined.
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Affiliation(s)
- Deepak Basaula
- Peter MacCallum Cancer Centre, Department of Physical Sciences, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Barry Hay
- Peter MacCallum Cancer Centre, Department of Radiation Engineering, Melbourne, Australia
| | - Mark Wright
- Peter MacCallum Cancer Centre, Department of Radiation Engineering, Melbourne, Australia
| | - Lisa Hall
- Peter MacCallum Cancer Centre, Department of Radiation Therapy, Melbourne, Australia
| | - Alan Easdon
- Peter MacCallum Cancer Centre, Department of Radiation Engineering, Melbourne, Australia
| | - Peter McWiggan
- Peter MacCallum Cancer Centre, Department of Radiation Engineering, Melbourne, Australia
| | - Adam Yeo
- Peter MacCallum Cancer Centre, Department of Physical Sciences, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- School of Applied Sciences, RMIT University, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Elena Ungureanu
- Peter MacCallum Cancer Centre, Department of Physical Sciences, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Tomas Kron
- Peter MacCallum Cancer Centre, Department of Physical Sciences, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
- School of Applied Sciences, RMIT University, Melbourne, Australia.
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia.
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
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Gugliandolo SG, Pillai SP, Rajendran S, Vincini MG, Pepa M, Pansini F, Zaffaroni M, Marvaso G, Alterio D, Vavassori A, Durante S, Volpe S, Cattani F, Jereczek-Fossa BA, Moscatelli D, Colosimo BM. 3D-printed boluses for radiotherapy: influence of geometrical and printing parameters on dosimetric characterization and air gap evaluation. Radiol Phys Technol 2024; 17:347-359. [PMID: 38351260 PMCID: PMC11128404 DOI: 10.1007/s12194-024-00782-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 05/27/2024]
Abstract
The work investigates the implementation of personalized radiotherapy boluses by means of additive manufacturing technologies. Boluses materials that are currently used need an excessive amount of human intervention which leads to reduced repeatability in terms of dosimetry. Additive manufacturing can solve this problem by eliminating the human factor in the process of fabrication. Planar boluses with fixed geometry and personalized boluses printed starting from a computed tomography scan of a radiotherapy phantom were produced. First, a dosimetric characterization study on planar bolus designs to quantify the effects of print parameters such as infill density and geometry on the radiation beam was made. Secondly, a volumetric quantification of air gap between the bolus and the skin of the patient as well as dosimetric analyses were performed. The optimization process according to the obtained dosimetric and airgap results allowed us to find a combination of parameters to have the 3D-printed bolus performing similarly to that in conventional use. These preliminary results confirm those in the relevant literature, with 3D-printed boluses showing a dosimetric performance similar to conventional boluses with the additional advantage of being perfectly conformed to the patient geometry.
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Affiliation(s)
- Simone Giovanni Gugliandolo
- Department of Mechanical Engineering, Politecnico di Milano, Via La Masa, 1, 20156, Milano, Italy
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133, Milano, Italy
| | | | - Shankar Rajendran
- Department of Mechanical Engineering, Politecnico di Milano, Via La Masa, 1, 20156, Milano, Italy
| | - Maria Giulia Vincini
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
| | - Matteo Pepa
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
- Clinical Department, Bioengineering Unit, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Floriana Pansini
- Unit of Medical Physics, IEO European Institute of Oncology, IRCCS, Milano, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
| | - Giulia Marvaso
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Daniela Alterio
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
| | - Andrea Vavassori
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
| | - Stefano Durante
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
| | - Stefania Volpe
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
| | - Federica Cattani
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
- Unit of Medical Physics, IEO European Institute of Oncology, IRCCS, Milano, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO European Institute of Oncology, IRCCS, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milano, Italy
| | - Davide Moscatelli
- Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Piazza Leonardo da Vinci, 32, 20133, Milano, Italy
| | - Bianca Maria Colosimo
- Department of Mechanical Engineering, Politecnico di Milano, Via La Masa, 1, 20156, Milano, Italy.
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Sourvanos D, Sun H, Zhu TC, Dimofte A, Byrd B, Busch TM, Cengel KA, Neiva R, Fiorellini JP. Three-dimensional printing of the human lung pleural cavity model for PDT malignant mesothelioma. Photodiagnosis Photodyn Ther 2024; 46:104014. [PMID: 38346466 DOI: 10.1016/j.pdpdt.2024.104014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE The primary aim was to investigate emerging 3D printing and optical acquisition technologies to refine and enhance photodynamic therapy (PDT) dosimetry in the management of malignant pleural mesothelioma (MPM). MATERIALS AND METHODS A rigorous digital reconstruction of the pleural lung cavity was conducted utilizing 3D printing and optical scanning methodologies. These reconstructions were systematically assessed against CT-derived data to ascertain their accuracy in representing critical anatomic features and post-resection topographical variations. RESULTS The resulting reconstructions excelled in their anatomical precision, proving instrumental translation for precise dosimetry calculations for PDT. Validation against CT data confirmed the utility of these models not only for enhancing therapeutic planning but also as critical tools for educational and calibration purposes. CONCLUSION The research outlined a successful protocol for the precise calculation of light distribution within the complex environment of the pleural cavity, marking a substantive advance in the application of PDT for MPM. This work holds significant promise for individualizing patient care, minimizing collateral radiation exposure, and improving the overall efficiency of MPM treatments.
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Affiliation(s)
- Dennis Sourvanos
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA; Center for Innovation and Precision Dentistry (CiPD), School of Dental Medicine, School of Engineering, University of Pennsylvania, PA, USA.
| | - Hongjing Sun
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Timothy C Zhu
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Andreea Dimofte
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Brook Byrd
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Theresa M Busch
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Keith A Cengel
- Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, PA, USA
| | - Rodrigo Neiva
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA
| | - Joseph P Fiorellini
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, PA, USA
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Kropla F, Winkler D, Lindner D, Knorr P, Scholz S, Grunert R. Development of 3D printed patient-specific skull implants based on 3d surface scans. 3D Print Med 2023; 9:19. [PMID: 37389692 DOI: 10.1186/s41205-023-00183-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/24/2023] [Indexed: 07/01/2023] Open
Abstract
Sometimes cranioplasty is necessary to reconstruct skull bone defects after a neurosurgical operation. If an autologous bone is unavailable, alloplastic materials are used. The standard technical approach for the fabrication of cranial implants is based on 3D imaging by computed tomography using the defect and the contralateral site. A new approach uses 3D surface scans, which accurately replicate the curvature of the removed bone flap. For this purpose, the removed bone flap is scanned intraoperatively and digitized accordingly. When using a design procedure developed for this purpose creating a patient-specific implant for each bone flap shape in short time is possible. The designed skull implants have complex free-form surfaces analogous to the curvature of the skull, which is why additive manufacturing is the ideal manufacturing technology here. In this study, we will describe the intraoperative procedure for the acquisition of scanned data and its further processing up to the creation of the implant.
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Affiliation(s)
- Fabian Kropla
- Department of Neurosurgery, University of Leipzig, 04103, Leipzig, SN, Germany.
- Department of Neurosurgery, University of Leipzig Medical Center, Liebigstr. 20, 04103, Leipzig, Germany.
- Department of Neurosurgery, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
| | - Dirk Winkler
- Department of Neurosurgery, University of Leipzig, 04103, Leipzig, SN, Germany
| | - Dirk Lindner
- Department of Neurosurgery, University of Leipzig, 04103, Leipzig, SN, Germany
| | - Patrick Knorr
- Department for Automotive and Mechanical Engineering, University of Applied Sciences Zwickau, 08056, Zwickau, SN, Germany
| | - Sebastian Scholz
- Fraunhofer Institute for Machine Tools and Forming Technology, 02763, Zittau, SN, Germany
| | - Ronny Grunert
- Department of Neurosurgery, University of Leipzig, 04103, Leipzig, SN, Germany
- Fraunhofer Institute for Machine Tools and Forming Technology, 02763, Zittau, SN, Germany
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Dąbrowska-Szewczyk E, Zawadzka A, Kowalczyk P, Podgórski R, Saworska G, Głowacki M, Kukołowicz P, Brzozowska B. Low-density 3D-printed boluses with honeycomb infill 3D-printed boluses in radiotherapy. Phys Med 2023; 110:102600. [PMID: 37167778 DOI: 10.1016/j.ejmp.2023.102600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/05/2023] [Accepted: 04/30/2023] [Indexed: 05/13/2023] Open
Abstract
PURPOSE Dosimetric characteristics of 3D-printed plates using different infill percentage and materials was the purpose of our study. METHODS Test plates with 5%, 10%, 15% and 20% honeycomb structure infill were fabricated using TPU and PLA polymers. The Hounsfield unit distribution was determined using a Python script. Percentage Depth Dose (PDD) distribution in the build-up region was measured with the Markus plane-parallel ionization chamber for an open 10x10 cm2 field of 6 MV. PDD was measured at a depth of 1 mm, 5 mm, 10 mm and 15 mm. Measurements were compared with Eclipse treatment planning system calculations using AAA and Acuros XB algorithms. RESULTS The mean HU for CT scans of 3D-printed TPU plates increased with percentage infill increase from -739 HU for 5% to -399 HU for 20%. Differences between the average HU for TPU and PLA did not exceed 2% for all percentage infills. Even using a plate with the lowest infill PDD at 1 mm depth increase from 44.7% (without a plate) to 76.9% for TPU and 76.6% for PLA. Infill percentage did not affect the dose at depths greater than 5 mm. Differences between measurements and TPS calculations were less than 4.1% for both materials, regardless of the infill percentage and depth. CONCLUSIONS The use of 3D-printed light boluses increases the dose in the build-up region, which was shown based on the dosimetric measurements and TPS calculations.
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Affiliation(s)
- Edyta Dąbrowska-Szewczyk
- Biomedical Physics Division, Faculty of Physics, University of Warsaw, 5 L. Pasteur Street, 02-093 Warsaw, Poland; Medical Physics Department, The Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw, 5 WK Roentgen Street, 02-781 Warsaw, Poland
| | - Anna Zawadzka
- Medical Physics Department, The Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw, 5 WK Roentgen Street, 02-781 Warsaw, Poland
| | - Piotr Kowalczyk
- Warsaw University of Technology, Faculty of Chemical and Process Engineering, Department of Biotechnology and Bioprocess Engineering, Waryńskiego 1, 00-645 Warsaw, Poland; Centre of Advanced Materials and Technologies CEZAMAT, Poleczki 19, 02-822 Warsaw, Poland
| | - Rafał Podgórski
- Warsaw University of Technology, Faculty of Chemical and Process Engineering, Department of Biotechnology and Bioprocess Engineering, Waryńskiego 1, 00-645 Warsaw, Poland
| | - Gabriela Saworska
- Biomedical Physics Division, Faculty of Physics, University of Warsaw, 5 L. Pasteur Street, 02-093 Warsaw, Poland
| | - Maksymilian Głowacki
- Biomedical Physics Division, Faculty of Physics, University of Warsaw, 5 L. Pasteur Street, 02-093 Warsaw, Poland
| | - Paweł Kukołowicz
- Medical Physics Department, The Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw, 5 WK Roentgen Street, 02-781 Warsaw, Poland
| | - Beata Brzozowska
- Biomedical Physics Division, Faculty of Physics, University of Warsaw, 5 L. Pasteur Street, 02-093 Warsaw, Poland.
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Miéville FA, Pitteloud N, Achard V, Lamanna G, Pisaturo O, Tercier PA, Allal AS. Post-mastectomy radiotherapy: Impact of bolus thickness and irradiation technique on skin dose. Z Med Phys 2023:S0939-3889(23)00041-7. [PMID: 37150728 DOI: 10.1016/j.zemedi.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/27/2023] [Accepted: 03/08/2023] [Indexed: 05/09/2023]
Abstract
PURPOSE To determine 10 MV IMRT and VMAT based protocols with a daily bolus targeting a skin dose of 45 Gy in order to replace the 6 MV tangential fields with a 5 mm thick bolus on alternate days method for post-mastectomy radiotherapy. METHOD We measured the mean surface dose along the chest wall PTV as a function of different bolus thicknesses for sliding window IMRT and VMAT plans. We analyzed surface dose profiles and dose homogeneities and compared them to our standard 6 MV strategy. All measurements were performed on a thorax phantom with Gafchromic films while dosimetric plans were computed using the Acuros XB algorithm (Varian). RESULTS We obtained the best compromise between measured surface dose (mean dose and homogeneity) and skin toxicity threshold obtained from the literature using a daily 3 mm thick bolus. Mean surface doses were 91.4 ± 2.8% [85.7% - 95.4%] and 92.2 ± 2.3% [85.6% - 95.2%] of the prescribed dose with IMRT and VMAT techniques, respectively. Our standard 6 MV alternate days 5 mm thick bolus leads to 89.0 ± 3.7% [83.6% - 95.5%]. Mean dose differences between measured and TPS results were < 3.2% for depths as low as 2 mm depth. CONCLUSION 10 MV IMRT-based protocols with a daily 3 mm thick bolus produce a surface dose comparable to the standard 6 MV 5 mm thick bolus on alternate days method but with an improved surface dose homogeneity. This allows for a better control of skin toxicity and target volume coverage.
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Affiliation(s)
- Frédéric A Miéville
- Department of Radiation Oncology, Hôpital Fribourgeois, 2-6 Chemin des Pensionnats, 1752 Villars-sur-Glâne, Fribourg, Switzerland.
| | - Nicolas Pitteloud
- Department of Radiation Oncology, Hôpital Fribourgeois, 2-6 Chemin des Pensionnats, 1752 Villars-sur-Glâne, Fribourg, Switzerland
| | - Vérane Achard
- Department of Radiation Oncology, Hôpital Fribourgeois, 2-6 Chemin des Pensionnats, 1752 Villars-sur-Glâne, Fribourg, Switzerland
| | - Giorgio Lamanna
- Department of Radiation Oncology, Hôpital Fribourgeois, 2-6 Chemin des Pensionnats, 1752 Villars-sur-Glâne, Fribourg, Switzerland
| | - Olivier Pisaturo
- Department of Radiation Oncology, Hôpital Fribourgeois, 2-6 Chemin des Pensionnats, 1752 Villars-sur-Glâne, Fribourg, Switzerland
| | - Pierre-Alain Tercier
- Department of Radiation Oncology, Hôpital Fribourgeois, 2-6 Chemin des Pensionnats, 1752 Villars-sur-Glâne, Fribourg, Switzerland
| | - Abdelkarim S Allal
- Department of Radiation Oncology, Hôpital Fribourgeois, 2-6 Chemin des Pensionnats, 1752 Villars-sur-Glâne, Fribourg, Switzerland
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Paraffin gauze bolus as tissue compensator in photon irradiation for mycosis fungoides – regarding a case study. JOURNAL OF RADIOTHERAPY IN PRACTICE 2023. [DOI: 10.1017/s1460396923000109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Abstract
Introduction:
Total skin electron beam therapy is a treatment option in patients with mycosis fungoides (MF) affecting a significant amount of the body surface. For patients with involvement of soles and interdigital folds, however, this approach is ineffective, requiring alternatives such as localised radiotherapy (RT). Although electron beams are well suited for superficial lesions, on irregular surfaces it provides inadequate tumour coverage and excess dose variance, requiring photon irradiation with tissue compensation.
Methods:
We present the case of a patient with extensive cutaneous MF with skin lesions spread over both lower limbs and treated on these affected areas with photon beam RT. Long sheets of paraffin gauze dressings were used to create a 0·5-cm-thick bolus. The patient received a single fraction of 8 Gy. In vivo dosimetry using Gafchromic films was performed.
Results:
After 3 months, a complete response was achieved. In this case, paraffin gauze bolus proved to be an inexpensive, convenient, effective and flexible method for irregular superficial cancer irradiations.
Conclusion:
Paraffin gauze bolus is a suitable option for irregular contours.
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Gong P, Dai G, Wu X, Wang X, Xie L, Xu S, Zhong R. Application of thermoplastic elastomer (TPE) bolus in postmastectomy radiotherapy. Breast 2022; 66:317-323. [PMID: 36463642 PMCID: PMC9719108 DOI: 10.1016/j.breast.2022.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/10/2022] [Accepted: 11/27/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To assess the planned dose, in vivo dosimetry, acute skin toxicity, pain, and distress using Thermoplastic Elastomer (TPE) bolus for postmastectomy radiotherapy (PMRT). MATERIAL AND METHODS Thirty-two PMRT patients with TPE bolus (17 patients for 25 fractions, 15 patients for the first 20 fractions) were selected for the study. The acute skin toxicity, pain, and psychological distress were assessed from the first treatment week to the fourth week after the end of treatment. At the first treatment, the MOSFET was used in vivo dosimetry measurement. RESULTS In vivo dosimetry with the bolus, the dose deviation ranged from -6.22% to -1.56% for 5 points. The presence of grade 1 and 2 skin toxicity reached its peak (70.0% and 13.3%) in the sixth week. Two patients (6.6%) with 25 fractions bolus experienced moist desquamation in the fifth and seventh week, with pain score 2 and 3, and interruptions of 3 and 5 days, respectively. The incidence of pain score 1, 2, and 3 peaked in the fifth (33.3%), fourth (33.3%), and seventh (10.0%) week. No patients experienced grade 3 skin toxicity and severe pain. One patient had significant anxiety, and two patients had significant depression. CONCLUSION The TPE bolus can accurately fit skin and improve the surface dose to more than 90%. Twenty fractions with TPE bolus had similar skin toxicity and pain to those without bolus and did not increase patients' distress and clinical workload, compared with the literature's data, which is an alternative to the 3D printing bolus for PMRT.
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Affiliation(s)
- Pan Gong
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Guyu Dai
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Xiaoyu Wu
- Department of Respiratory Critical Care Medicine/Thoracic Surgery, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Xuetao Wang
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Li Xie
- Department of Radiotherapy/Department of Head and Neck Oncology, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Shuni Xu
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China
| | - Renming Zhong
- Radiotherapy Physics and Technology Center, Cancer Center, West China School of Medicine, West China Hospital of Sichuan University, Chengdu, 610041, PR China.
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Crowe S, Luscombe J, Maxwell S, Simpson‐Page E, Poroa T, Wilks R, Li W, Cleland S, Chan P, Lin C, Kairn T. Evaluation of optical 3D scanning system for radiotherapy use. J Med Radiat Sci 2022; 69:218-226. [PMID: 34877819 PMCID: PMC9163482 DOI: 10.1002/jmrs.562] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/12/2021] [Accepted: 11/25/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Optical three-dimensional scanning devices can produce geometrically accurate, high-resolution models of patients suitable for clinical use. This article describes the use of a metrology-grade structured light scanner for the design and production of radiotherapy medical devices and synthetic water-equivalent computer tomography images. METHODS Following commissioning of the device by scanning objects of known properties, 173 scans were performed on 26 volunteers, with observations of subjects and operators collected. RESULTS The fit of devices produced using these scans was assessed, and a workflow for the design of complex devices using a treatment planning system was identified. CONCLUSIONS Recommendations are provided on the use of the device within a radiation oncology department.
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Affiliation(s)
- Scott Crowe
- Cancer Care ServicesRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
- Herston Biofabrication InstituteMetro North Hospital and Health ServiceHerstonQueenslandAustralia
- School of Information Technology and Electrical EngineeringUniversity of QueenslandSt. LuciaQueenslandAustralia
- School of Chemistry and PhysicsQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Jenna Luscombe
- Cancer Care ServicesRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
| | - Sarah Maxwell
- Cancer Care ServicesRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
| | - Emily Simpson‐Page
- Cancer Care ServicesRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
| | - Tania Poroa
- Cancer Care ServicesRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
| | - Rachael Wilks
- Cancer Care ServicesRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
- Herston Biofabrication InstituteMetro North Hospital and Health ServiceHerstonQueenslandAustralia
- School of Information Technology and Electrical EngineeringUniversity of QueenslandSt. LuciaQueenslandAustralia
| | - Weizheng Li
- School of Information Technology and Electrical EngineeringUniversity of QueenslandSt. LuciaQueenslandAustralia
| | - Susannah Cleland
- Radiation Oncology Princess Alexandra Raymond TerraceSouth BrisbaneQueenslandAustralia
| | - Philip Chan
- Cancer Care ServicesRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
- School of MedicineUniversity of QueenslandSt. LuciaQueenslandAustralia
| | - Charles Lin
- Cancer Care ServicesRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
- School of MedicineUniversity of QueenslandSt. LuciaQueenslandAustralia
| | - Tanya Kairn
- Cancer Care ServicesRoyal Brisbane and Women’s HospitalHerstonQueenslandAustralia
- Herston Biofabrication InstituteMetro North Hospital and Health ServiceHerstonQueenslandAustralia
- School of Information Technology and Electrical EngineeringUniversity of QueenslandSt. LuciaQueenslandAustralia
- School of Chemistry and PhysicsQueensland University of TechnologyBrisbaneQueenslandAustralia
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10
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Computed tomography tissue equivalence of 3D printing materials. Radiography (Lond) 2022; 28:788-792. [DOI: 10.1016/j.radi.2022.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/22/2022]
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Tan HQ, Koh CWY, Tan LKR, Lew KS, Chua CGA, Ang KW, Lee JCL, Park SY. A transit portal dosimetry method for respiratory gating quality assurance with a dynamic 3D printed tumor phantom. J Appl Clin Med Phys 2022; 23:e13560. [PMID: 35147283 PMCID: PMC9121038 DOI: 10.1002/acm2.13560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/27/2021] [Accepted: 01/29/2022] [Indexed: 11/21/2022] Open
Abstract
Backgrounds Respiratory gating is one of the motion management techniques that is used to deliver radiation dose to a tumor at a specific position under free breathing. However, due to the dynamic feedback process of this approach, regular equipment quality assurance (QA) and patient‐specific QA checks need to be performed. This work proposes a new QA methodology using electronic portal imaging detector (EPID) to determine the target localization accuracy of phase gating. Methods QA tools comprising 3D printed spherical tumor phantoms, programmable stages, and an EPID detector are characterized and assembled. Algorithms for predicting portal dose (PD) through moving phantoms are developed and verified using gamma analysis for two spherical tumor phantoms (2 cm and 4 cm), two different 6 MV volumetric modulated arc therapy plans, and two different gating windows (30%–70% and 40%–60%). Comparison between the two gating windows is then performed using the Wilcoxon signed‐rank test. An optimizer routine, which is used to determine the optimal window, based on maximal gamma passing rate (GPR), was applied to an actual breathing curve and breathing plan. This was done to ascertain if our method yielded a similar result with the actual gating window. Results High GPRs of more than 97% and 91% were observed when comparing the predicted PD with the measured PD in moving phantom at 2 mm/2% and 1 mm/1% levels, respectively. Analysis of gamma heatmaps shows an excellent agreement with the tumor phantom. The GPR of 40%–60% PD was significantly lower than that of the 30%–70% PD at the 1 mm/1% level (p = 0.0064). At the 2 mm/2% level, no significant differences were observed. The optimizer routine could accurately predict the center of the gating window to within a 10% range. Conclusion We have successfully performed and verified a new method for QA with the use of a moving phantom with EPID for phase gating with real‐time position management.
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Affiliation(s)
- Hong Qi Tan
- Division of Radiation Oncology, National Cancer Centre, Singapore, Singapore
| | - Calvin Wei Yang Koh
- Division of Radiation Oncology, National Cancer Centre, Singapore, Singapore
| | - Lloyd Kuan Rui Tan
- Division of Radiation Oncology, National Cancer Centre, Singapore, Singapore
| | - Kah Seng Lew
- Division of Radiation Oncology, National Cancer Centre, Singapore, Singapore
| | | | - Khong Wei Ang
- Division of Radiation Oncology, National Cancer Centre, Singapore, Singapore
| | - James Cheow Lei Lee
- Division of Radiation Oncology, National Cancer Centre, Singapore, Singapore.,Division of Physics and Applied Physics, Nanyang Technological University, Singapore, Singapore
| | - Sung Yong Park
- Division of Radiation Oncology, National Cancer Centre, Singapore, Singapore.,Oncology Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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12
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Endarko E, Aisyah S, Carina CCC, Nazara T, Sekartaji G, Nainggolan A. Evaluation of Dosimetric Properties of Handmade Bolus for Megavoltage Electron and Photon Radiation Therapy. J Biomed Phys Eng 2021; 11:735-746. [PMID: 34904070 PMCID: PMC8649160 DOI: 10.31661/jbpe.v0i0.2004-1108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/10/2020] [Indexed: 11/25/2022]
Abstract
Background: The use of boluses for radiation therapy is very necessary to overcome the problem of sending inhomogeneous doses in the target volume due to irregularities on the surface of the skin.
The bolus materials for radiation therapy need to be evaluated. Objective: The present study aims to evaluate some handmade boluses for megavoltage electron and photon radiation therapy. Several dosimetric properties of the synthesized boluses,
including relative electron density (RED), transmission factor, mass attenuation coefficient, percentage depth dose (PDD), and percentage surface dose (PSD) were investigated. Material and Methods: In this experimental study, we evaluated natural rubber, silicone rubber mixed either with aluminum or bismuth, paraffin wax, red plasticine, and play-doh as soft tissue equivalent.
CT-simulator, in combination with ECLIPSE software, was used to determine bolus density. Meanwhile, Linear Accelerator (Linac) Clinac iX (Varian Medical Systems, Palo Alto), solid water phantom,
and Farmer ionization chamber were used to measure and analyze of dosimetric properties. Results: The RED result analysis has proven that all synthesized boluses are equivalent to the density of soft tissue such as fat, breast, lung, and liver. The dosimetric evaluation also shows that all
synthesized boluses have a density similar to the density of water and can increase the surface dose with a value ranging from 6-20% for electron energy and 30-50% for photon energy. Conclusion: In general, all synthesized boluses have an excellent opportunity to be used as an alternative tissue substitute in the surface area of the body when using megavoltage electron and photon energy.
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Affiliation(s)
- Endarko Endarko
- PhD, Department of Physics, Institut Teknologi Sepuluh Nopember, Kampus ITS - Sukolilo Surabaya 60111, East Java, Indonesia
| | - Siti Aisyah
- BSc, Department of Physics, Institut Teknologi Sepuluh Nopember, Kampus ITS - Sukolilo Surabaya 60111, East Java, Indonesia
| | - Chycilia Clara Chandra Carina
- BSc, Department of Physics, Institut Teknologi Sepuluh Nopember, Kampus ITS - Sukolilo Surabaya 60111, East Java, Indonesia
| | - Trimawarti Nazara
- BSc, Department of Physics, Institut Teknologi Sepuluh Nopember, Kampus ITS - Sukolilo Surabaya 60111, East Java, Indonesia
| | - Gandes Sekartaji
- BSc, Department of Physics, Institut Teknologi Sepuluh Nopember, Kampus ITS - Sukolilo Surabaya 60111, East Java, Indonesia
| | - Andreas Nainggolan
- MSc, Mochtar Riady Comprehensive Cancer Center Siloam Hospitals Semanggi, Jakarta, Indonesia
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13
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Larochelle RD, Mann SE, Ifantides C. 3D Printing in Eye Care. Ophthalmol Ther 2021; 10:733-752. [PMID: 34327669 PMCID: PMC8320416 DOI: 10.1007/s40123-021-00379-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022] Open
Abstract
Three-dimensional printing enables precise modeling of anatomical structures and has been employed in a broad range of applications across medicine. Its earliest use in eye care included orbital models for training and surgical planning, which have subsequently enabled the design of custom-fit prostheses in oculoplastic surgery. It has evolved to include the production of surgical instruments, diagnostic tools, spectacles, and devices for delivery of drug and radiation therapy. During the COVID-19 pandemic, increased demand for personal protective equipment and supply chain shortages inspired many institutions to 3D-print their own eye protection. Cataract surgery, the most common procedure performed worldwide, may someday make use of custom-printed intraocular lenses. Perhaps its most alluring potential resides in the possibility of printing tissues at a cellular level to address unmet needs in the world of corneal and retinal diseases. Early models toward this end have shown promise for engineering tissues which, while not quite ready for transplantation, can serve as a useful model for in vitro disease and therapeutic research. As more institutions incorporate in-house or outsourced 3D printing for research models and clinical care, ethical and regulatory concerns will become a greater consideration. This report highlights the uses of 3D printing in eye care by subspecialty and clinical modality, with an aim to provide a useful entry point for anyone seeking to engage with the technology in their area of interest.
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Affiliation(s)
- Ryan D Larochelle
- Department of Ophthalmology, University of Colorado, Sue Anschutz-Rodgers Eye Center, 1675 Aurora Court, F731, Aurora, CO, 80045, USA
| | - Scott E Mann
- Department of Otolaryngology, University of Colorado, Aurora, CO, USA
- Department of Surgery, Denver Health Medical Center, Denver, CO, USA
| | - Cristos Ifantides
- Department of Ophthalmology, University of Colorado, Sue Anschutz-Rodgers Eye Center, 1675 Aurora Court, F731, Aurora, CO, 80045, USA.
- Department of Surgery, Denver Health Medical Center, Denver, CO, USA.
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14
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Lu Y, Song J, Yao X, An M, Shi Q, Huang X. 3D Printing Polymer-based Bolus Used for Radiotherapy. Int J Bioprint 2021; 7:414. [PMID: 34805595 PMCID: PMC8600301 DOI: 10.18063/ijb.v7i4.414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022] Open
Abstract
Bolus is a kind of auxiliary device used in radiotherapy for the treatment of superficial lesions such as skin cancer. It is commonly used to increase skin dose and overcome the skin-sparing effect. Despite the availability of various commercial boluses, there is currently no bolus that can form full contact with irregular surface of patients' skin, and incomplete contact would result in air gaps. The resulting air gaps can reduce the surface radiation dose, leading to a discrepancy between the delivered dose and planned dose. To avoid this limitation, the customized bolus processed by three-dimensional (3D) printing holds tremendous potential for making radiotherapy more efficient than ever before. This review mainly summarized the recent development of polymers used for processing bolus, 3D printing technologies suitable for polymers, and customization of 3D printing bolus. An ideal material for customizing bolus should not only have the feature of 3D printability for customization, but also possess radiotherapy adjuvant performance as well as other multiple compound properties, including tissue equivalence, biocompatibility, antibacterial activity, and antiphlogosis.
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Affiliation(s)
- Ying Lu
- Laboratory of Biomaterial Surface and Interface, School of Materials Science and Engineering, Taiyuan University of Technology, Taiyuan 030024, Shanxi Province, China.,Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China
| | - Jianbo Song
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China
| | - Xiaohong Yao
- Laboratory of Biomaterial Surface and Interface, School of Materials Science and Engineering, Taiyuan University of Technology, Taiyuan 030024, Shanxi Province, China
| | - Meiwen An
- Institute of Applied Mechanics and Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, Shanxi Province, China
| | - Qinying Shi
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan 030032, Shanxi Province, China
| | - Xiaobo Huang
- Laboratory of Biomaterial Surface and Interface, School of Materials Science and Engineering, Taiyuan University of Technology, Taiyuan 030024, Shanxi Province, China
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15
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Development of a new poly-ε-caprolactone with low melting point for creating a thermoset mask used in radiation therapy. Sci Rep 2021; 11:20409. [PMID: 34650081 PMCID: PMC8516973 DOI: 10.1038/s41598-021-00005-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/01/2021] [Indexed: 12/03/2022] Open
Abstract
This study aimed to develop a poly-ε-caprolactone (PCL) material that has a low melting point while maintaining the deformation ability. The new PCL (abbreviated as 4b45/2b20) was fabricated by mixing two types of PCL with different molecular weights, numbers of branches, and physical properties. To investigate the melting point, crystallization temperature, elastic modulus, and elongation at break for 4b45/2b20 and three commercially available masks, differential scanning calorimetry and tensile tests were performed. The melting point of 4b45/2b20 was 46.0 °C, and that of the commercially available masks was approximately 56.0 °C (55.7 °C–56.5 °C). The elastic modulus at 60 °C of 4b45/2b20 was significantly lower than the commercially available masks (1.1 ± 0.3 MPa and 46.3 ± 5.4 MPa, p = 0.0357). In addition, the elongation at break of 4b45/2b20 were significantly larger than the commercially available masks (275.2 ± 25.0% and 216.0 ± 15.2%, p = 0.0347). The crystallization temperature of 4b45/2b20 (22.1 °C) was clinically acceptable and no significant difference was found in the elastic modulus at 23 °C (253.7 ± 24.3 MPa and 282.0 ± 44.3 MPa, p = 0.4). As a shape memory-based thermoset material, 4b45/2b20 has a low melting point and large deformation ability. In addition, the crystallization temperature and strength are within the clinically acceptable standards. Because masks made using the new PCL material are formed with less pressure on the face than commercially available masks, it is a promising material for making a radiotherapy mask that can reduce the burden on patients.
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16
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Kairn T, Talkhani S, Charles PH, Chua B, Lin CY, Livingstone AG, Maxwell SK, Poroa T, Simpson-Page E, Spelleken E, Vo M, Crowe SB. Determining tolerance levels for quality assurance of 3D printed bolus for modulated arc radiotherapy of the nose. Phys Eng Sci Med 2021; 44:1187-1199. [PMID: 34529247 DOI: 10.1007/s13246-021-01054-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
Given the existing literature on the subject, there is obviously a need for specific advice on quality assurance (QA) tolerances for departments using or implementing 3D printed bolus for radiotherapy treatments. With a view to providing initial suggested QA tolerances for 3D printed bolus, this study evaluated the dosimetric effects of changes in bolus geometry and density, for a particularly common and challenging clinical situation: specifically, volumetric modulated arc therapy (VMAT) treatment of the nose. Film-based dose verification measurements demonstrated that both the AAA and the AXB algorithms used by the Varian Eclipse treatment planning system (Varian Medical Systems, Palo Alto, USA) were capable of providing sufficiently accurate dose calculations to allow this planning system to be used to evaluate the effects of bolus errors on dose distributions from VMAT treatments of the nose. Thereafter, the AAA and AXB algorithms were used to calculate the dosimetric effects of applying a range of simulated errors to the design of a virtual bolus, to identify QA tolerances that could be used to avoid clinically significant effects from common printing errors. Results were generally consistent, whether the treatment target was superficial and treated with counter-rotating coplanar arcs or more-penetrating and treated with noncoplanar arcs, and whether the dose was calculated using the AAA algorithm or the AXB algorithm. The results of this study suggest the following QA tolerances are advisable, when 3D printed bolus is fabricated for use in photon VMAT treatments of the nose: bolus relative electron density variation within [Formula: see text] (although an action level at [Formula: see text] may be permissible); bolus thickness variation within [Formula: see text] mm (or 0.5 mm variation on opposite sides); and air gap between bolus and skin [Formula: see text] mm. These tolerances should be investigated for validity with respect to other treatment modalities and anatomical sites. This study provides a set of baselines for future comparisons and a useful method for identifying additional or alternative 3D printed bolus QA tolerances.
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Affiliation(s)
- T Kairn
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. .,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia. .,School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, QLD, Australia. .,School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD, Australia.
| | - S Talkhani
- School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD, Australia
| | - P H Charles
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia.,School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, QLD, Australia.,School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD, Australia
| | - B Chua
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - C Y Lin
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - A G Livingstone
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - S K Maxwell
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - T Poroa
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - E Simpson-Page
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - E Spelleken
- GenesisCare Rockhampton, Rockhampton Hospital, Rockhampton, QLD, Australia
| | - M Vo
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - S B Crowe
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.,Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia.,School of Information Technology and Electrical Engineering, University of Queensland, Brisbane, QLD, Australia.,School of Chemistry and Physics, Queensland University of Technology, Brisbane, QLD, Australia
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17
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McCallum S, Maresse S, Fearns P. Evaluating 3D-printed Bolus Compared to Conventional Bolus Types Used in External Beam Radiation Therapy. Curr Med Imaging 2021; 17:820-831. [PMID: 33530912 DOI: 10.2174/1573405617666210202114336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND When treating superficial tumors with external beam radiation therapy, bolus is often used. Bolus increases surface dose, reduces dose to underlying tissue, and improves dose homogeneity. INTRODUCTION The conventional bolus types used clinically in practice have some disadvantages. The use of Three-Dimensional (3D) printing has the potential to create more effective boluses. CT data is used for dosimetric calculations for these treatments and often to manufacture the customized 3D-printed bolus. PURPOSE The aim of this review is to evaluate the published studies that have compared 3D-printed bolus against conventional bolus types. METHODS AND RESULTS A systematic search of several databases and a further appraisal for relevance and eligibility resulted in the 14 articles used in this review. The 14 articles were analyzed based on their comparison of 3D-printed bolus and at least one conventional bolus type. CONCLUSION The findings of this review indicated that 3D-printed bolus has a number of advantages. Compared to conventional bolus types, 3D-printed bolus was found to have equivalent or improved dosimetric measures, positional accuracy, fit, and uniformity. 3D-printed bolus was also found to benefit workflow efficiency through both time and cost effectiveness. However, factors such as patient comfort and staff perspectives need to be further explored to support the use of 3Dprinted bolus in routine practice.
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Affiliation(s)
- Stephanie McCallum
- Medical Radiation Science, Faculty of Science and Engineering, Curtin University, Perth, Australia
| | - Sharon Maresse
- Medical Radiation Science, Faculty of Science and Engineering, Curtin University, Perth, Australia
| | - Peter Fearns
- Medical Radiation Science, Faculty of Science and Engineering, Curtin University, Perth, Australia
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18
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Sakai Y, Tanooka M, Okada W, Sano K, Nakamura K, Shibata M, Ueda Y, Mizuno H, Tanaka M. Characteristics of a bolus created using thermoplastic sheets for postmastectomy radiation therapy. Radiol Phys Technol 2021; 14:179-185. [PMID: 33837911 DOI: 10.1007/s12194-021-00618-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/19/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Abstract
This study applied a "shell bolus," an immobilizing thermoplastic shell locally thickened with extra layers over the radiation target, during postmastectomy radiation therapy (PMRT). We performed ion chamber and film measurements for a solid water phantom for thermoplastic sheets and a gel bolus for dosimetric characterization using a 6-MV X-ray flattening-filter-free (FFF) beam. The air gaps between the body surface for the gel and shell bolus were measured using computed tomography (CT) images in patients who underwent PMRT. This included seven and 13 patients treated with the gel and shell boluses, respectively. A comparison of the dose differences between a 10-mm gel bolus and a 9.6-mm-thick thermoplastic sheet at the surface and 5 cm below the surface showed a 4.2% higher surface dose and 0.5% lower dose at 5-cm depth for the thermoplastic sheet compared to those for the gel bolus. The mean (p = 0.029) and maximum (p < 0.001) air gaps of the shell bolus were significantly thinner than those of the gel bolus. Thus, the shell bolus provided a close fit and robust bolus effect. In addition, the shell bolus reduced respiratory motion and eliminated the need for skin marking. Therefore, this system can be effectively used as a bolus for PMRT.
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Affiliation(s)
- Yusuke Sakai
- Radiation Therapy Center, Takarazuka City Hospital, 4-5-1 Kohama, Takarazuka, Hyogo, 665-0827, Japan.
| | - Masao Tanooka
- Radiation Therapy Center, Takarazuka City Hospital, 4-5-1 Kohama, Takarazuka, Hyogo, 665-0827, Japan
| | - Wataru Okada
- Radiation Therapy Center, Takarazuka City Hospital, 4-5-1 Kohama, Takarazuka, Hyogo, 665-0827, Japan
| | - Keisuke Sano
- Radiation Therapy Center, Takarazuka City Hospital, 4-5-1 Kohama, Takarazuka, Hyogo, 665-0827, Japan
| | - Kenji Nakamura
- Radiation Therapy Center, Takarazuka City Hospital, 4-5-1 Kohama, Takarazuka, Hyogo, 665-0827, Japan
| | - Mayuri Shibata
- Radiation Therapy Center, Takarazuka City Hospital, 4-5-1 Kohama, Takarazuka, Hyogo, 665-0827, Japan
| | - Yoshihiro Ueda
- Department of Radiation Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 537-8567, Japan
| | - Hirokazu Mizuno
- Division of Central Radiology, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Masahiro Tanaka
- Radiation Therapy Center, Takarazuka City Hospital, 4-5-1 Kohama, Takarazuka, Hyogo, 665-0827, Japan
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19
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Characterization of 3D-printed bolus produced at different printing parameters. Med Dosim 2020; 46:157-163. [PMID: 33172711 DOI: 10.1016/j.meddos.2020.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/17/2020] [Accepted: 10/20/2020] [Indexed: 11/20/2022]
Abstract
We aimed to analyze the effects of printing parameters on characterization of three-dimensional (3D) printed bolus used in external beam radiotherapy. Two sets of measurements were performed to investigate the dosimetric and physical characterization of 3D-printed bolus at different printing parameters. In the first step, boluses were produced at different infill-percentages, infill-patterns and printing directions. Two-dimensional (2D) dose measurements were performed in Elekta Versa HD linear accelerator using 6 MV photon energy. Measured 2D dose maps for both printed and reference bolus materials were compared using the 2D gamma analysis method. Additionally, patient-specific bolus was produced with defined optimum printing parameters for anthropomorphic head and neck phantom. Then, point dose measurements were performed to evaluate the feasibility of printed bolus in clinical use. In the second step, physical measurements were carried out to evaluate the printing accuracy, the mean hounsfield unit (HU) value and the weight of 3D-printed boluses. According to our measurement, infill-percentage, infill-pattern and printing direction significantly changed the dosimetric and physical properties of the 3D-printed bolus independently. Maximum gamma passing rate at 1.5 and 5 cm depths were found as 93.8% and 98.8%, respectively, for 60% infill-percentage, sunglass fill infill-pattern and horizontal printing direction. The printing accuracy of the products was within 0.4 mm. Dosimetric and physical properties of the printed bolus material changed significantly with the selected printing parameters. Therefore, it is important to note that each combination of these printing parameters that will be used in the production of patient-specific bolus should be investigated separately.
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20
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Aoyama T, Uto K, Shimizu H, Ebara M, Kitagawa T, Tachibana H, Suzuki K, Kodaira T. Physical and dosimetric characterization of thermoset shape memory bolus developed for radiotherapy. Med Phys 2020; 47:6103-6112. [PMID: 33012062 PMCID: PMC7821231 DOI: 10.1002/mp.14516] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE We developed a thermoset shape memory bolus (shape memory bolus) made from poly-ε-caprolactone (PCL) polymer. This study aimed to investigate whether the shape memory bolus can be applied to radiotherapy as a bolus that conformally adheres to the body surface, can be created in a short time, and can be reused. METHODS The shape memory bolus was developed by cross-linking tetrabranch PCL with reactive acrylate end groups. Dice similarity coefficient (DSC) was used to evaluate shape memory characterization before deformation and after restoration. In addition, the degree of adhesion to the body surface and crystallization time were calculated. Moreover, dosimetric characterization was evaluated using the water equivalent phantom and an Alderson RANDO phantom. RESULTS The DSC value between before deformation and after restoration was close to 1. The degree of adhesion of the shape memory bolus (1.9%) was improved compared with the conventional bolus (45.6%) and was equivalent to three-dimensional (3D) printer boluses (1.3%-3.5%). The crystallization time was approximately 1.5 min, which was clinically acceptable. The dose calculation accuracy, dose distribution, and dose index were the equivalent compared with 3D boluses. CONCLUSION The shape memory bolus has excellent adhesion to the body surface, can be created in a short time, and can be reused. In addition, the shape memory bolus needs can be made from low-cost materials and no quality control systems are required for individual clinical departments, and it is useful as a bolus for radiotherapy.
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Affiliation(s)
- Takahiro Aoyama
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan.,Graduate School of Medicine, Aichi Medical University, 1-1 Yazako-karimata, Nagakute, Aichi, 480-1195, Japan
| | - Koichiro Uto
- Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki, 305-0044, Japan
| | - Hidetoshi Shimizu
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan
| | - Mitsuhiro Ebara
- Research Center for Functional Materials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki, 305-0044, Japan
| | - Tomoki Kitagawa
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan
| | - Hiroyuki Tachibana
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan
| | - Kojiro Suzuki
- Department of Radiology, Aichi Medical University, 1-1 Yazako-karimata, Nagakute, Aichi, 480-1195, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-Ku, Nagoya, Aichi, 464-8681, Japan
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21
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Low JM, Lee NJ, Sprow G, Chlebik A, Olch A, Darrow K, Bowlin K, Wong KK. Scalp and Cranium Radiation Therapy Using Modulation (SCRUM) and Bolus. Adv Radiat Oncol 2020; 5:936-942. [PMID: 33083656 PMCID: PMC7557138 DOI: 10.1016/j.adro.2020.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/31/2020] [Accepted: 03/09/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose A bolus is usually required to ensure radiation dose coverage of extensive superficial tumors of the scalp or skull. Oftentimes, these boluses are challenging to make and are nonreproducible, so an easier method was sought. Methods and Materials Thermoplastic sheets are widely available in radiation oncology clinics and can serve as bolus. Two template cutouts were designed for anterior and posterior halves to encompass the cranium of children and adults. Results The created bolus was imaged using computed tomography, which demonstrated good conformity and minimal air gaps. Conclusions Although making a bolus for treating superficial tumors of the scalp or head and neck is challenging, the presented technique enables thermoplastic to be used as a bolus and is quick, easy, and reproducible.
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Affiliation(s)
- Justin M. Low
- Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Texas
| | - Nicole J.H. Lee
- Touro University California College of Osteopathic Medicine, Vallejo, California
| | - Grant Sprow
- Albert Einstein College of Medicine, Bronx, New York
| | - Alisha Chlebik
- Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, California
| | - Arthur Olch
- Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, California
- Department of Radiation Oncology, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Kaleb Darrow
- University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee
| | - Kristine Bowlin
- Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, California
| | - Kenneth K. Wong
- Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, California
- Department of Radiation Oncology, Keck School of Medicine of the University of Southern California, Los Angeles, California
- Corresponding author: Kenneth K. Wong, MD
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22
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Koutsouvelis N, Rouzaud M, Dubouloz A, Nouet P, Jaccard M, Garibotto V, Tournier BB, Zilli T, Dipasquale G. 3D printing for dosimetric optimization and quality assurance in small animal irradiations using megavoltage X-rays. Z Med Phys 2020; 30:227-235. [PMID: 32475758 DOI: 10.1016/j.zemedi.2020.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/17/2020] [Accepted: 03/30/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE New therapeutic options in radiotherapy (RT) are often explored in preclinical in-vivo studies using small animals. We report here on the feasibility of modern megavoltage (MV) linear accelerator (LINAC)-based RT for small animals using easy-to-use consumer 3D printing technology for dosimetric optimization and quality assurance (QA). METHODS In this study we aimed to deliver 5×2Gy to the half-brain of a rat using a 4MV direct hemi-field X-ray beam. To avoid the beam's build-up in the target and optimize dosimetry, a 1cm thick, customized, 3D-printed bolus was used. A 1:1 scale copy of the rat was 3D printed based on the CT dataset as an end-to-end QA tool. The plan robustness to HU changes was verified. Thermoluminescent dosimeters (TLDs), for both MV irradiations and for kV imaging doses, and a gafchromic film were placed within the phantom for dose delivery verifications. The phantom was designed using a standard treatment planning software, and was irradiated at the LINAC with the target aligned using kV on-board imaging. RESULTS The plan was robust (dose difference<1% for HU modification from 0 to 250). Film dosimetry showed a good concordance between planned and measured dose, with the steep dose gradient at the edge of the hemi-field properly aligned to spare the contralateral half-brain. In the treated region, the mean TLDs percentage dose differences (±2 SD) were 1.3% (±3.8%) and 0.9% (±1.7%) beneath the bolus. The mean (±2 SD) out-of-field dose measurements was 0.05Gy (±0.02Gy) for an expected dose of 0.04Gy. Imaging doses (2mGy) still spared the contralateral-brain. CONCLUSIONS Use of consumer 3D-printers enables dosimetry optimization and QA assessment for small animals MV RT in preclinical studies using standard LINACS.
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Affiliation(s)
| | - Michel Rouzaud
- Radiation Oncology, Geneva University Hospital, Geneva, Switzerland
| | - Angele Dubouloz
- Radiation Oncology, Geneva University Hospital, Geneva, Switzerland
| | - Philippe Nouet
- Radiation Oncology, Geneva University Hospital, Geneva, Switzerland
| | - Maud Jaccard
- Radiation Oncology, Geneva University Hospital, Geneva, Switzerland
| | - Valentina Garibotto
- Faculty of Medicine, Geneva University, Geneva, Switzerland; Nuclear Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Benjamin B Tournier
- Faculty of Medicine, Geneva University, Geneva, Switzerland; Adult Psychiatry, Department of Mental Health and Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - Thomas Zilli
- Radiation Oncology, Geneva University Hospital, Geneva, Switzerland; Faculty of Medicine, Geneva University, Geneva, Switzerland
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Low-Cost iPhone-Assisted Processing to Obtain Radiotherapy Bolus Using Optical Surface Reconstruction and 3D-Printing. Sci Rep 2020; 10:8016. [PMID: 32415217 PMCID: PMC7228923 DOI: 10.1038/s41598-020-64967-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/27/2020] [Indexed: 11/08/2022] Open
Abstract
Patient specific boluses can increase the skin dose distribution better for treating tumors located just beneath the skin with high-energy radiation than a flat bolus. We introduce a low-cost, 3D-printed, patient-specific bolus made of commonly available materials and easily produced using the "structure from motion" and a simple desktop 3D printing technique. Nine pictures were acquired with an iPhone camera around a head phantom. The 3D surface of the phantom was generated using these pictures and the "structure from motion" algorithm, with a scale factor calculated by a sphere fitting algorithm. A bolus for the requested position and shape based on the above generated surface was 3D-printed using ABS material. Two intensity modulated radiation therapy plans were designed to simulate clinical treatment for a tumor located under the skin surface with a flat bolus and a printed bolus, respectively. The planned parameters of dose volume histogram, conformity index (CI) and homogeneity index (HI) were compared. The printed bolus plan gave a dose coverage to the tumor with a CI of 0.817 compared to the CI of 0.697 for the plan with flat bolus. The HIs of the plan with printed bolus and flat bolus were 0.910 and 0.887, respectively.
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24
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Albantow C, Hargrave C, Brown A, Halsall C. Comparison of 3D printed nose bolus to traditional wax bolus for cost-effectiveness, volumetric accuracy and dosimetric effect. J Med Radiat Sci 2020; 67:54-63. [PMID: 32011102 PMCID: PMC7063257 DOI: 10.1002/jmrs.378] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 12/12/2019] [Accepted: 12/12/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction Three‐dimensional printing technology has the potential to streamline custom bolus production in radiotherapy. This study evaluates the volumetric, dosimetric and cost differences between traditional wax and 3D printed versions of nose bolus. Method Nose plaster impressions from 24 volunteers were CT scanned and planned. Planned virtual bolus was manufactured in wax and created in 3D print (100% and 18% shell infill density) for comparison. To compare volume variations and dosimetry, each constructed bolus was CT scanned and a plan replicating the reference plan fields generated. Bolus manufacture time and material costs were analysed. Results Mean volume differences between the virtual bolus (VB) and wax, and the VB and 18% and 100% 3D shells were −3.05 ± 11.06 cm3, −1.03 ± 8.09 cm3 and 1.31 ± 2.63 cm3, respectively. While there was no significant difference for the point and mean doses between the 100% 3D shell filled with water and the VB plans (P> 0.05), the intraclass coefficients for these dose metrics for the 100% 3D shell filled with wax compared to VB doses (0.69–0.96) were higher than those for the 18% and 100% 3D shell filled with water and the wax (0.48–0.88). Average costs for staff time and materials were higher for the wax ($138.54 and $20.49, respectively) compared with the 3D shell prints ($10.58 and $13.87, respectively). Conclusion Three‐dimensional printed bolus replicated the VB geometry with less cost for manufacture than wax bolus. When shells are printed with 100% infill density, 3D bolus dosimetrically replicates the reference plan.
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Affiliation(s)
- Christine Albantow
- Radiation Therapy, Townsville Cancer Centre, Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Catriona Hargrave
- Radiation Oncology, Princess Alexandra Hospital - Raymond Tce Campus, South Brisbane, Queensland, Australia.,Faculty of Health, School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Amy Brown
- Radiation Therapy, Townsville Cancer Centre, Townsville Hospital and Health Service, Townsville, Queensland, Australia
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Asfia A, Novak JI, Mohammed MI, Rolfe B, Kron T. A review of 3D printed patient specific immobilisation devices in radiotherapy. Phys Imaging Radiat Oncol 2020; 13:30-35. [PMID: 33458304 PMCID: PMC7807671 DOI: 10.1016/j.phro.2020.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND PURPOSE Radiotherapy is one of the most effective cancer treatment techniques, however, delivering the optimal radiation dosage is challenging due to movements of the patient during treatment. Immobilisation devices are typically used to minimise motion. This paper reviews published research investigating the use of 3D printing (additive manufacturing) to produce patient-specific immobilisation devices, and compares these to traditional devices. MATERIALS AND METHODS A systematic review was conducted across thirty-eight databases, with results limited to those published between January 2000 and January 2019. A total of eighteen papers suitably detailed the use of 3D printing to manufacture and test immobilisers, and were included in this review. This included ten journal papers, five posters, two conference papers and one thesis. RESULTS 61% of relevant studies featured human subjects, 22% focussed on animal subjects, 11% used phantoms, and one study utilised experimental test methods. Advantages of 3D printed immobilisers reported in literature included improved patient experience and comfort over traditional methods, as well as high levels of accuracy between immobiliser and patient, repeatable setup, and similar beam attenuation properties to thermoformed immobilisers. Disadvantages included the slow 3D printing process and the potential for inaccuracies in the digitisation of patient geometry. CONCLUSION It was found that a lack of technical knowledge, combined with disparate studies with small patient samples, required further research in order to validate claims supporting the benefits of 3D printing to improve patient comfort or treatment accuracy.
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Affiliation(s)
- Amirhossein Asfia
- School of Engineering, Faculty of Science, Engineering and Built Environment, Deakin University, Geelong, Victoria, Australia
- ARC Industrial Transformation Training Centre in Additive Bio-manufacturing, Brisbane, Queensland, Australia
| | - James I. Novak
- School of Engineering, Faculty of Science, Engineering and Built Environment, Deakin University, Geelong, Victoria, Australia
| | | | - Bernard Rolfe
- School of Engineering, Faculty of Science, Engineering and Built Environment, Deakin University, Geelong, Victoria, Australia
| | - Tomas Kron
- ARC Industrial Transformation Training Centre in Additive Bio-manufacturing, Brisbane, Queensland, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- School of Applied Sciences, RMIT University, Melbourne, Victoria, Australia
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26
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Ruiters S, Mombaerts I. Applications of three-dimensional printing in orbital diseases and disorders. Curr Opin Ophthalmol 2019; 30:372-379. [PMID: 31261186 DOI: 10.1097/icu.0000000000000586] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW To comprehensively review the applications of advanced three-dimensional printing technology in the management of orbital abnormalities. RECENT FINDINGS Three-dimensional printing has added value in the preoperative planning and manufacturing of patient-specific implants and surgical guides in the reconstruction of orbital trauma, congenital defects and tumor resection. In view of the costs and time, it is reserved as strategy for large and complex craniofacial cases, in particular those including the bony contour. There is anecdotal evidence of a benefit of three-dimensional printing in the manufacturing of prostheses for the exenterated and anophthalmic socket, and in the fabrication of patient-specific boluses, applicators and shielding devices for orbital radiation therapy. In addition, three-dimensional printed healthy and diseased orbits as phantom tangible models may augment the teaching and learning process of orbital surgery. SUMMARY Three-dimensional printing allows precision treatment tailored to the unique orbital anatomy of the patient. Advancement in technology and further research are required to support its wider use in orbital clinical practice.
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Affiliation(s)
- Sébastien Ruiters
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
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27
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LeCompte MC, Chung SA, McKee MM, Marshall TG, Frizzell B, Parker M, Blackstock AW, Farris MK. Simple and Rapid Creation of Customized 3-dimensional Printed Bolus Using iPhone X True Depth Camera. Pract Radiat Oncol 2019; 9:e417-e421. [PMID: 30926481 DOI: 10.1016/j.prro.2019.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/06/2019] [Accepted: 03/19/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Three-dimensional printing has produced customized bolus during radiation therapy for superficial tumors along irregular skin surfaces. In comparison, traditional bolus materials are often difficult to manipulate for a proper fit. Current 3-dimensional printed boluses are made from either preexisting computed tomography scans or complex surface scanning methods. Herein, we introduce an inexpensive, convenient approach to generate a 3-dimensional printed bolus from surface scanning technology available in common smartphones. METHODS AND MATERIALS A three-dimensional printed bolus was designed using surface scans from iPhone X true depth cameras and a low-cost 3-dimensional printer. The percentage density infill was adjusted to achieve tissue equivalence. To evaluate the clinical feasibility, fit against the skin surface and radiation dose distribution were compared with those of the traditional bolus. RESULTS We fabricated a customized 3-dimensional printed bolus for different areas of the face using an iPhone X camera and inexpensive commercially available 3-dimensional printer. When printed at 100% density, the bolus material approximated soft tissue/water and provided an equivalent dose distribution to that found with standard bolus materials on direct comparison. The bolus material is inexpensive and produces an ideal fit with the scanned anatomy. CONCLUSIONS We present a simplified method of highly customized bolus production that requires minimal experience with computer modeling programs and can be accomplished with an iPhone true depth camera.
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Affiliation(s)
- Michael C LeCompte
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
| | - Scotty A Chung
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mahta Mirzaei McKee
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Travis G Marshall
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Bart Frizzell
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Mandy Parker
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - A William Blackstock
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael K Farris
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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