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Tino RB, Yeo AU, Brandt M, Leary M, Kron T. A customizable anthropomorphic phantom for dosimetric verification of 3D-printed lung, tissue, and bone density materials. Med Phys 2021; 49:52-69. [PMID: 34796527 DOI: 10.1002/mp.15364] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/26/2021] [Accepted: 10/30/2021] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To design and manufacture a customized thoracic phantom slab utilizing the 3D printing process, also known as additive manufacturing, consisting of different tissue density materials. Here, we demonstrate the 3D-printed phantom's clinical feasibility for imaging and dosimetric verification of volumetric modulated arc radiotherapy (VMAT) plans for lung and spine stereotactic ablative body radiotherapy (SABR) through end-to-end dosimetric verification. METHODS A customizable anthropomorphic phantom slab was designed using the CT dataset of a commercial phantom (adult female ATOM dosimetry phantom, CIRS Inc.). Material extrusion 3D printing was utilized to manufacture the phantom slab consisting of acrylonitrile butadiene styrene material for the lung and the associated lesion, polylactic acid (PLA) material for soft tissue and spinal cord, and both PLA and iron-reinforced PLA materials for bone. CT images were acquired for both the commercial phantom and 3D-printed phantom for HU comparison. VMAT plans were generated for spine and lung SABR scenarios and were delivered as per departmental SABR protocols using a Varian TrueBeam STx linear accelerator. End-to-end dosimetry was implemented with radiochromic films, analyzed with gamma criteria of 5% dose difference, and a distance-to-agreement of 1 mm, at a 10% low-dose threshold by comparing with calculated dose using the Acuros algorithm of the Eclipse treatment planning system (v15.6). RESULTS 3D-printed phantom inserts were observed to produce HU ranging from -750 to 2100. The 3D-printed phantom slab was observed to achieve a similar range of HU from the commercial phantom including a mean HU of -760 for lung tissue, a mean HU of 50 for soft tissue, and a mean HU of 220 and 630 for low- and high-density bone, respectively. Film dosimetry results show 2D-gamma passing rates for lung SABR (internal and superior) and spine SABR (inferior and superior) over 98% and 90%, respectively. CONCLUSIONS The end-to-end testing of VMAT plans for spine and lung SABR suggests the clinical feasibility of the 3D-printed phantom, consisting of different tissue density materials that emulate lung, soft tissue, and bone in kV imaging and megavoltage photon dosimetry. Further investigation of the proposed 3D printing techniques for manufacturability and reproducibility will enable the development of clinical 3D-printed phantoms in radiotherapy.
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Affiliation(s)
- Rance Bolislis Tino
- RMIT Centre for Additive Manufacturing, School of Engineering, RMIT University, Melbourne, Victoria, Australia.,Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Queensland, Brisbane, Australia
| | - Adam Unjin Yeo
- School of Applied Sciences, RMIT University, Melbourne, Victoria, Australia.,Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Milan Brandt
- RMIT Centre for Additive Manufacturing, School of Engineering, RMIT University, Melbourne, Victoria, Australia.,ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Queensland, Brisbane, Australia
| | - Martin Leary
- RMIT Centre for Additive Manufacturing, School of Engineering, RMIT University, Melbourne, Victoria, Australia.,ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Queensland, Brisbane, Australia
| | - Tomas Kron
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.,ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Queensland, Brisbane, Australia.,Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, Australia
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Additive manufacturing (3D printing) in superficial brachytherapy. J Contemp Brachytherapy 2021; 13:468-482. [PMID: 34484363 PMCID: PMC8407265 DOI: 10.5114/jcb.2021.108602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022] Open
Abstract
The aim of this work is to provide an overview of the current state of additive manufacturing (AM), commonly known as 3D printing, within superficial brachytherapy (BT). Several comprehensive database searches were performed to find publications linked to AM in superficial BT. Twenty-eight core publications were found, which can be grouped under general categories of clinical cases, physical and dosimetric evaluations, proof-of-concept cases, design process assessments, and economic feasibility studies. Each study demonstrated a success regarding AM implementation and collectively, they provided benefits over traditional applicator fabrication techniques. Publications of AM in superficial BT have increased significantly in the last 5 years. This is likely due to associated efficiency and consistency benefits; though, more evidences are needed to determine the true extent of these benefits.
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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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Choi Y, Lee IJ, Park K, Park KR, Cho Y, Kim JW, Lee H. Patient-Specific Quality Assurance Using a 3D-Printed Chest Phantom for Intraoperative Radiotherapy in Breast Cancer. Front Oncol 2021; 11:629927. [PMID: 33791216 PMCID: PMC8005710 DOI: 10.3389/fonc.2021.629927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
This study aims to confirm the usefulness of patient-specific quality assurance (PSQA) using three-dimensional (3D)-printed phantoms in ensuring the stability of IORT and the precision of the treatment administered. In this study, five patient-specific chest phantoms were fabricated using a 3D printer such that they were dosimetrically equivalent to the chests of actual patients in terms of organ density and shape around the given target, where a spherical applicator was inserted for breast IORT treatment via the INTRABEAM™ system. Models of lungs and soft tissue were fabricated by applying infill ratios corresponding to the mean Hounsfield unit (HU) values calculated from CT scans of the patients. The two models were then assembled into one. A 3D-printed water-equivalent phantom was also fabricated to verify the vendor-provided depth dose curve. Pieces of an EBT3 film were inserted into the 3D-printed customized phantoms to measure the doses. A 10 Gy prescription dose based on the surface of the spherical applicator was delivered and measured through EBT3 films parallel and perpendicular to the axis of the beam. The shapes of the phantoms, CT values, and absorbed doses were compared between the expected and printed ones. The morphological agreement among the five patient-specific 3D chest phantoms was assessed. The mean differences in terms of HU between the patients and the phantoms was 2.2 HU for soft tissue and −26.2 HU for the lungs. The dose irradiated on the surface of the spherical applicator yielded a percent error of −2.16% ± 3.91% between the measured and prescribed doses. In a depth dose comparison using a 3D-printed water phantom, the uncertainty in the measurements based on the EBT3 film decreased as the depth increased beyond 5 mm, and a good agreement in terms of the absolute dose was noted between the EBT3 film and the vendor data. These results demonstrate the applicability of the 3D-printed chest phantom for PSQA in breast IORT. This enhanced precision offers new opportunities for advancements in IORT.
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Affiliation(s)
- Yeonho Choi
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Ik Jae Lee
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Kwangwoo Park
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyung Ran Park
- Department of Radiation Oncology, Kosin University College of Medicine, Busan, South Korea
| | - Yeona Cho
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jun Won Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Ho Lee
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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Ghosh S, Burks AC, Akulian JA. Customizable airway stents-personalized medicine reaches the airways. J Thorac Dis 2019; 11:S1129-S1131. [PMID: 31245062 DOI: 10.21037/jtd.2019.03.100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Sohini Ghosh
- Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allen Cole Burks
- Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jason A Akulian
- Section of Interventional Pulmonology, Division of Pulmonary and Critical Care, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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