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Shi W, Wang J, Gao J, Zou X, Dong Q, Huang Z, Sheng J, Guan C, Xu Y, Cui Y, Zhong X. Utilization of 3D printing technology in hepatopancreatobiliary surgery. J Zhejiang Univ Sci B 2024; 25:123-134. [PMID: 38303496 PMCID: PMC10835207 DOI: 10.1631/jzus.b2300175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/23/2023] [Indexed: 02/03/2024]
Abstract
The technology of three-dimensional (3D) printing emerged in the late 1970s and has since undergone considerable development to find numerous applications in mechanical engineering, industrial design, and biomedicine. In biomedical science, several studies have initially found that 3D printing technology can play an important role in the treatment of diseases in hepatopancreatobiliary surgery. For example, 3D printing technology has been applied to create detailed anatomical models of disease organs for preoperative personalized surgical strategies, surgical simulation, intraoperative navigation, medical training, and patient education. Moreover, cancer models have been created using 3D printing technology for the research and selection of chemotherapy drugs. With the aim to clarify the development and application of 3D printing technology in hepatopancreatobiliary surgery, we introduce seven common types of 3D printing technology and review the status of research and application of 3D printing technology in the field of hepatopancreatobiliary surgery.
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Affiliation(s)
- Wujiang Shi
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Jiangang Wang
- Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xian 710032, China
| | - Jianjun Gao
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Xinlei Zou
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Qingfu Dong
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Ziyue Huang
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Jialin Sheng
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Canghai Guan
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
| | - Yi Xu
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China. ,
- Key Laboratory of Basic Pharmacology of Ministry of Education, Zunyi Medical University, Zunyi 563006, China. ,
- Key Laboratory of Functional and Clinical Translational Medicine, Fujian Province University, Xiamen Medical College, Xiamen 361000, China. ,
- Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China. ,
- Jiangsu Province Engineering Research Center of Tumor Targeted Nano Diagnostic and Therapeutic Materials, Yancheng Teachers University, Yancheng 224007, China. ,
- Key Laboratory of Biomarkers and In Vitro Diagnosis Translation of Zhejiang Province, Hangzhou 310053, China. ,
- Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, School of Basic Medical Sciences, Fujian Medical University, Fuzhou 350122, China. ,
- Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin 150086, China. ,
| | - Yunfu Cui
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China. ,
| | - Xiangyu Zhong
- Department of Hepatopancreatobiliary Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China.
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Segedin B, Kobav M, Zobec Logar HB. The Use of 3D Printing Technology in Gynaecological Brachytherapy-A Narrative Review. Cancers (Basel) 2023; 15:4165. [PMID: 37627193 PMCID: PMC10452889 DOI: 10.3390/cancers15164165] [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: 07/29/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Radiation therapy, including image-guided adaptive brachytherapy based on magnetic resonance imaging, is the standard of care in locally advanced cervical and vaginal cancer and part of the treatment in other primary and recurrent gynaecological tumours. Tumour control probability increases with dose and brachytherapy is the optimal technique to increase the dose to the target volume while maintaining dose constraints to organs at risk. The use of interstitial needles is now one of the quality indicators for cervical cancer brachytherapy and needles should optimally be used in ≥60% of patients. Commercially available applicators sometimes cannot be used because of anatomical barriers or do not allow adequate target volume coverage due to tumour size or topography. Over the last five to ten years, 3D printing has been increasingly used for manufacturing of customised applicators in brachytherapy, with gynaecological tumours being the most common indication. We present the rationale, techniques and current clinical evidence for the use of 3D-printed applicators in gynaecological brachytherapy.
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Affiliation(s)
- Barbara Segedin
- Department of Radiation Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (M.K.); (H.B.Z.L.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Manja Kobav
- Department of Radiation Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (M.K.); (H.B.Z.L.)
| | - Helena Barbara Zobec Logar
- Department of Radiation Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia; (M.K.); (H.B.Z.L.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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Zeng P, Shen D, Shu W, Min S, Shu M, Yao X, Wang Y, Chen R. Identification of a novel peptide targeting TIGIT to evaluate immunomodulation of 125I seed brachytherapy in HCC by near-infrared fluorescence. Front Oncol 2023; 13:1143266. [PMID: 37124530 PMCID: PMC10141647 DOI: 10.3389/fonc.2023.1143266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/28/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction Hepatocellular carcinoma (HCC) has very poor prognosis due to its immunosuppressive properties. An effective measure to regulate tumor immunity is brachytherapy, which uses 125I seeds planted into tumor. T cell immune receptors with immunoglobulin and ITIM domains (TIGIT) is highly expressed in HCC. The TIGIT-targeted probe is expected to be an effective tool for indicating immunomodulation of 125I seed brachytherapy in HCC. In this study, We constructed a novel peptide targeting TIGIT to evaluate the immune regulation of 125I seed brachytherapy for HCC by near-infrared fluorescence (NIRF). Methods Expression of TIGIT by immunofluorescence (IF) and flow cytometry (FCM) in different part and different differentiated human liver cancer tissues was verified. An optical fluorescence probe (Po-12) containing a NIRF dye and TIGIT peptide was synthesized for evaluating the modulatory effect of 125I seed brachytherapy. Lymphocytes uptake by Po-12 were detected by FCM and confocal microscopy. The distribution and accumulation of Po-12 in vivo were explored by NIRF imaging in subcutaneous and orthotopic tumors. IHC and IF staining were used to verify the expression of TIGIT in the tumors. Results TIGIT was highly expressed in HCC and increased with tumor differentiation. The dye-labeled peptide (Po-12) retained a stable binding affinity for the TIGIT protein in vitro. Accumulation of fluorescence intensity (FI) increased with time extended in subcutaneous H22 tumors, and the optimal point is 1 h. TIGIT was highly expressed on lymphocytes infiltrated in tumors and could be suppressed by 125I seed brachytherapy. Accumulation of Po-12-Cy5 was increased in tumor-bearing groups while declined in 125I radiation group.
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Affiliation(s)
- Peng Zeng
- Department of Oncology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Duo Shen
- Department of Gastroenterology, The Second People’s Hospital of Changzhou, Nanjing Medical University, Changzhou, Jiangsu, China
| | - Wenbin Shu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Shudan Min
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Min Shu
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Xijuan Yao
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Yong Wang
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
| | - Rong Chen
- Department of Oncology, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu, China
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Zhang B, Li S, Liu ZY, Peiris KGK, Song LF, Liu MC, Luo P, Shang D, Bi W. Successful multimodality treatment of metastatic gallbladder cancer: A case report and review of literature. World J Clin Cases 2022; 10:3856-3865. [PMID: 35647145 PMCID: PMC9100720 DOI: 10.12998/wjcc.v10.i12.3856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/25/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gallbladder cancer is the most common malignant tumor in the biliary system, and it is characterized by high aggressiveness and an extremely poor prognosis. Current treatment for advanced gallbladder cancer remains unsatisfactory. Here, we report a patient with advanced gallbladder cancer who was cured by multidisciplinary treatment.
CASE SUMMARY A 73-year-old male presented to our hospital with right abdominal pain for 3 d and was diagnosed with stage IVB gallbladder cancer with multiple liver metastases, peritoneum metastasis, diaphragm metastasis and lymph node metastases. The patient initially received chemotherapy, targeted therapy, 125I seed implantation and immunotherapy, as there were no specific indications for radical surgery. During these palliative therapies, the level of tumor markers gradually decreased but remained higher than the normal level, lymph node metastases gradually disappeared, and liver metastasis was gradually limited to the left liver. Finally, the patient received radical surgery with left hepatectomy, radical lymphadenectomy and partial diaphragmatic resection. To date, the patient has survived for more than six years posttreatment, the levels of tumor markers are normal, and imaging examinations show no signs of tumor recurrence.
CONCLUSION Currently, the prognosis of advanced gallbladder cancer remains unsatisfactory. A single treatment method is not sufficient for patients with advanced gallbladder cancer. Multidisciplinary individualized treatment is essential and should be utilized for advanced gallbladder cancer patients to further improve prognosis.
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Affiliation(s)
- Biao Zhang
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Shuang Li
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Zhao-Yi Liu
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | | | - Li-Fu Song
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Mu-Cang Liu
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Peng Luo
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Dong Shang
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Wei Bi
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China
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Christou CD, Tsoulfas G. Role of three-dimensional printing and artificial intelligence in the management of hepatocellular carcinoma: Challenges and opportunities. World J Gastrointest Oncol 2022; 14:765-793. [PMID: 35582107 PMCID: PMC9048537 DOI: 10.4251/wjgo.v14.i4.765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/24/2021] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) constitutes the fifth most frequent malignancy worldwide and the third most frequent cause of cancer-related deaths. Currently, treatment selection is based on the stage of the disease. Emerging fields such as three-dimensional (3D) printing, 3D bioprinting, artificial intelligence (AI), and machine learning (ML) could lead to evidence-based, individualized management of HCC. In this review, we comprehensively report the current applications of 3D printing, 3D bioprinting, and AI/ML-based models in HCC management; we outline the significant challenges to the broad use of these novel technologies in the clinical setting with the goal of identifying means to overcome them, and finally, we discuss the opportunities that arise from these applications. Notably, regarding 3D printing and bioprinting-related challenges, we elaborate on cost and cost-effectiveness, cell sourcing, cell viability, safety, accessibility, regulation, and legal and ethical concerns. Similarly, regarding AI/ML-related challenges, we elaborate on intellectual property, liability, intrinsic biases, data protection, cybersecurity, ethical challenges, and transparency. Our findings show that AI and 3D printing applications in HCC management and healthcare, in general, are steadily expanding; thus, these technologies will be integrated into the clinical setting sooner or later. Therefore, we believe that physicians need to become familiar with these technologies and prepare to engage with them constructively.
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Affiliation(s)
- Chrysanthos D Christou
- Department of Transplantation Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54622, Greece
| | - Georgios Tsoulfas
- Department of Transplantation Surgery, Hippokration General Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki 54622, Greece
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Kermavnar T, Shannon A, O'Sullivan KJ, McCarthy C, Dunne CP, O'Sullivan LW. Three-Dimensional Printing of Medical Devices Used Directly to Treat Patients: A Systematic Review. 3D PRINTING AND ADDITIVE MANUFACTURING 2021; 8:366-408. [PMID: 36655011 PMCID: PMC9828627 DOI: 10.1089/3dp.2020.0324] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Until recently, three-dimensional (3D) printing/additive manufacturing has not been used extensively to create medical devices intended for actual clinical use, primarily on patient safety and regulatory grounds. However, in recent years there have been advances in materials, printers, and experience, leading to increased clinical use. The aim of this study was to perform a structured systematic review of 3D-printed medical devices used directly in patient treatment. A search of 13 databases was performed to identify studies of 3D-printed medical devices, detailing fabrication technology and materials employed, clinical application, and clinical outcome. One hundred and ten papers describing one hundred and forty medical devices were identified and analyzed. A considerable increase was identified in the use of 3D printing to produce medical devices directly for clinical use in the past 3 years. This is dominated by printing of patient-specific implants and surgical guides for use in orthopedics and orthopedic oncology, but there is a trend of increased use across other clinical specialties. The prevailing material/3D-printing technology used were titanium alloy/electron beam melting for implants, and polyamide/selective laser sintering or polylactic acid/fused deposition modeling for surgical guides and instruments. A detailed analysis across medical applications by technology and materials is provided, as well as a commentary regarding regulatory aspects. In general, there is growing familiarity with, and acceptance of, 3D printing in clinical use.
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Affiliation(s)
| | - Alice Shannon
- School of Design, University of Limerick, Limerick, Ireland
| | | | - Conor McCarthy
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Colum P. Dunne
- Confirm Smart Manufacturing Centre, University of Limerick, Limerick, Ireland
| | - Leonard W. O'Sullivan
- School of Design, University of Limerick, Limerick, Ireland
- School of Medicine, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Address correspondence to: Leonard W. O'Sullivan, School of Design, University of Limerick, Limerick V94 T9PX, Ireland
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Song WY, Robar JL, Morén B, Larsson T, Carlsson Tedgren Å, Jia X. Emerging technologies in brachytherapy. Phys Med Biol 2021; 66. [PMID: 34710856 DOI: 10.1088/1361-6560/ac344d] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/28/2021] [Indexed: 01/15/2023]
Abstract
Brachytherapy is a mature treatment modality. The literature is abundant in terms of review articles and comprehensive books on the latest established as well as evolving clinical practices. The intent of this article is to part ways and look beyond the current state-of-the-art and review emerging technologies that are noteworthy and perhaps may drive the future innovations in the field. There are plenty of candidate topics that deserve a deeper look, of course, but with practical limits in this communicative platform, we explore four topics that perhaps is worthwhile to review in detail at this time. First, intensity modulated brachytherapy (IMBT) is reviewed. The IMBT takes advantage ofanisotropicradiation profile generated through intelligent high-density shielding designs incorporated onto sources and applicators such to achieve high quality plans. Second, emerging applications of 3D printing (i.e. additive manufacturing) in brachytherapy are reviewed. With the advent of 3D printing, interest in this technology in brachytherapy has been immense and translation swift due to their potential to tailor applicators and treatments customizable to each individual patient. This is followed by, in third, innovations in treatment planning concerning catheter placement and dwell times where new modelling approaches, solution algorithms, and technological advances are reviewed. And, fourth and lastly, applications of a new machine learning technique, called deep learning, which has the potential to improve and automate all aspects of brachytherapy workflow, are reviewed. We do not expect that all ideas and innovations reviewed in this article will ultimately reach clinic but, nonetheless, this review provides a decent glimpse of what is to come. It would be exciting to monitor as IMBT, 3D printing, novel optimization algorithms, and deep learning technologies evolve over time and translate into pilot testing and sensibly phased clinical trials, and ultimately make a difference for cancer patients. Today's fancy is tomorrow's reality. The future is bright for brachytherapy.
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Affiliation(s)
- William Y Song
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - James L Robar
- Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Björn Morén
- Department of Mathematics, Linköping University, Linköping, Sweden
| | - Torbjörn Larsson
- Department of Mathematics, Linköping University, Linköping, Sweden
| | - Åsa Carlsson Tedgren
- Radiation Physics, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology Pathology, Karolinska Institute, Stockholm, Sweden
| | - Xun Jia
- Innovative Technology Of Radiotherapy Computations and Hardware (iTORCH) Laboratory, Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
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Chen E, Zhang Y, Zhang H, Jia C, Liang Y, Wang J. Dosimetry study of three-dimensional print template for 125I implantation therapy. Radiat Oncol 2021; 16:115. [PMID: 34167556 PMCID: PMC8223396 DOI: 10.1186/s13014-021-01845-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 06/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background 125I seed implantation has been found to show good therapeutic effects on tumors. Recent studies showed that three-dimensional (3D) print template-assisted 125I seed implantation can optimize radiation dose distribution. This study aimed to compare the dose distribution differences in 125I seed implantation among 3D print noncoplanar template- (3DPNCT), 3D print coplanar template- (3DPCT) assisted implantation and traditional free-hand implantation. Methods We systematically searched the PubMed, EMbase, Cochrane Library, Wan Fang Med Online, China National Knowledge Infrastructure (CNKI) from the earliest to November 2020 without time or language restrictions. And the references of primary literature were also searched. The outcome measures were dosimetry and operation time. This meta-analysis was carried out using Stata 12.0. Results A total of 16 original articles were selected for inclusion. The differences of D90, D100, V90, and V100 values pre- and post-implantation with traditional free-hand implantation showed statistically significant (p < 0.05). The differences of D90, D100, V100, V150, V200, and D2cc of organs at risk (OAR) values pre- and post-implantation with 3D print template showed no statistically significant (p > 0.05). Compared with traditional free-hand implantation without any templates, 3D print template could improve postoperative D90 (Standard mean difference, SMD = 0.67, 95% confidence interval (CI) = 0.35 to 0.98, p < 0.001), D100 (SMD = 0.82, 95%CI = 0.40 to 1.23, p < 0.001), V90 (SMD = 1.48, 95%CI = 0.95 to 2.00, p < 0.001), V100 (SMD = 1.41, 95%CI = 0.96 to 1.86, p < 0.001), and reduce operation time (SMD = − 0.93, 95%CI = − 1.34 to − 0.51, p < 0.001). In three studies, both 3DPNCT and 3DPCT plans were designed for all patients. The prescribed dose and seed activity were same. Pooled analysis of D90, D100, V100, D2cc of OAR, number of seeds and number of needles showed no significant differences between 3DPNCT and 3DPCT groups (p > 0.05). However, in 3DPNCT group, V150 and V200 were increased (SMD = 0.35, 0.49; 95%CI = 0.04 to 0.67, 0.02 to 0.96; p = 0.028, 0.043); the number of through bone needles was reduced (SMD = − 1.03, 95%CI = − 1.43 to − 0.64, p < 0.001). Conclusions Compared with traditional free-hand implantation, 3D print template-assisted 125I seeds implantation can optimize dose distribution and reduce the implantation time at the same time. Compared with 3D print coplanar template, 3D print noncoplanar template can increase the volume of high dose within tumor target and is more safer in the respect of puncture route. Supplementary Information The online version contains supplementary material available at 10.1186/s13014-021-01845-y.
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Affiliation(s)
- Enli Chen
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuwei Zhang
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Hongtao Zhang
- Department of Oncology, Hebei General Hospital, 348 West Heping Road, Shijiazhuang, 050051, Hebei, China
| | - Chenfei Jia
- Graduate School of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yansong Liang
- Department of Oncology, Hebei General Hospital, 348 West Heping Road, Shijiazhuang, 050051, Hebei, China
| | - Juan Wang
- Department of Oncology, Hebei General Hospital, 348 West Heping Road, Shijiazhuang, 050051, Hebei, China.
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Wang Y, Zhu L, Lin X, He C, An Z, Tang J, Lv W, Hu J. [Therapeutic Effect of CT-guided ¹²⁵I Seed Implantation on Advanced Lung Cancer and Pulmonary Metastatic Carcinoma]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2021; 23:424-428. [PMID: 32517444 PMCID: PMC7309549 DOI: 10.3779/j.issn.1009-3419.2020.103.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Primary lung cancer and metastatic lung cancer are common malignant tumors of the lung and are the main cause of cancer-related death. Advanced lung cancer and lung metastatic cancer are mainly treated by systemic therapy, and local treatment is also an effective treatment for the refractory or recurrent lesions in the lungs after systemic treatment. ¹²⁵I radioactive particle implantation, as an efficient conformal radiotherapy, has a certain control effect on localized lung cancer. The purpose of this study was to investigate the clinical efficacy and safety of computed tomography (CT) guided percutaneous puncture of lung tissue with ¹²⁵I radioactive particle implantation in the treatment of advanced lung cancer and lung metastatic cancer. METHODS Continuouslycollectedthe clinical and pathological data of 105 patients with advanced lung cancer and metastatic lung cancer treated by ¹²⁵I radioactive seed implantation in the Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2014 to November 30, 2018. The patients were followed until March, 2019. The clinical efficacy and complications of seedimplantation were analyzed. RESULTS A total of 105 patients were included in the study, 78 patients with advanced lung cancer and 27 patients with lung metastases. The median survival time after seed therapy was 395 days. The 1-year survival rate was about 78.1%, and the 2-year survival rate was about 56.1%. Seed implantation for advanced lung cancer is equivalent to lung metastasis. Seed combined with radiofrequency ablation, microwave ablation, and chemotherapy did not improve seed treatment. However, particle combined with external radiation therapy has a significant survival disadvantage compared with simple seed therapy. CONCLUSIONS The CT-guided ¹²⁵I radioactive seed implantation has controllable complications and can be used as a safe and effective treatment for advanced lung cancer and lung metastases.
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Affiliation(s)
- Yiqing Wang
- Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Linhai Zhu
- Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Xu Lin
- Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Cheng He
- Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Zhou An
- Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jie Tang
- Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Wang Lv
- Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jian Hu
- Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Dosimetric comparison of computed tomography-guided iodine-125 seed implantation assisted with and without three-dimensional printing non-coplanar template in locally recurrent rectal cancer: a propensity score matching study. J Contemp Brachytherapy 2021; 13:18-23. [PMID: 34025732 PMCID: PMC8117706 DOI: 10.5114/jcb.2021.103582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/31/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose To compare post-implant dosimetric parameters of computed tomography (CT)-guided radioactive iodine-125 (125I) seed (RIS) implantation assisted with and without three-dimensional printing non-coplanar template (3D-PNCT) in locally recurrent rectal cancer (LRRC). Material and methods One hundred and fifty-five LRRC patients treated by CT-guided RIS implantation assisted with or without 3D-PNCT from October 2003 to May 2019 were included in this study. Propensity score matching (PSM) method (1 : 1) was used to adjust for differences between the 3D-group (with 3D-PNCT) and the CT-group (without 3D-PNCT). After PSM, dosimetric parameters [D90 (dose that covered 90% of target volume), D100 (dose that covered 100% of target volume), V100 (percentage of gross tumor volume (GTV) receiving 100% of prescription dose), V150 (percentage of GTV receiving 150% of prescription dose), HI (homogeneity index), CI (conformity index), and EI (external index)] of the two groups were compared. Results After PSM, 45 pairs of matched cases were selected for analysis and differences in variables between the two groups were balanced. For the 3D-group, median values of D90, D100, V100, V150, EI, and HI were 142.6 Gy (73.7-218.2 Gy), 73.7 Gy (26.2-169.3 Gy), 94.1% (74.3-100%), 71.8% (35.4-98.3%), 0.7 (0.1-30.7), and 0.20 (0-0.60), respectively, and corresponding values were 119.9 Gy (39.8-159.3 Gy), 47.0 Gy (13.0-200.9 Gy), 89.9% (38.6-100%), 62.8% (14.8-100%), 0.39 (0-11.01), and 0.30 (0-0.95), respectively, for the CT-group. Parameters including D90, D100, V100, V150, and EI in the 3D-group were significantly higher than those in the CT-group (p < 0.001, p < 0.001, p < 0.001, p < 0.001, and p = 0.006, respectively). Conclusions 3D-PNCT can improve the accuracy of radioactive seed implantation by increasing the dose delivered to the tumor and reducing the number of “cold” spots of dose.
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Rooney MK, Rosenberg DM, Braunstein S, Cunha A, Damato AL, Ehler E, Pawlicki T, Robar J, Tatebe K, Golden DW. Three-dimensional printing in radiation oncology: A systematic review of the literature. J Appl Clin Med Phys 2020; 21:15-26. [PMID: 32459059 PMCID: PMC7484837 DOI: 10.1002/acm2.12907] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/16/2020] [Accepted: 04/23/2020] [Indexed: 12/21/2022] Open
Abstract
Purpose/objectives Three‐dimensional (3D) printing is recognized as an effective clinical and educational tool in procedurally intensive specialties. However, it has a nascent role in radiation oncology. The goal of this investigation is to clarify the extent to which 3D printing applications are currently being used in radiation oncology through a systematic review of the literature. Materials/methods A search protocol was defined according to preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines. Included articles were evaluated using parameters of interest including: year and country of publication, experimental design, sample size for clinical studies, radiation oncology topic, reported outcomes, and implementation barriers or safety concerns. Results One hundred and three publications from 2012 to 2019 met inclusion criteria. The most commonly described 3D printing applications included quality assurance phantoms (26%), brachytherapy applicators (20%), bolus (17%), preclinical animal irradiation (10%), compensators (7%), and immobilization devices (5%). Most studies were preclinical feasibility studies (63%), with few clinical investigations such as case reports or series (13%) or cohort studies (11%). The most common applications evaluated within clinical settings included brachytherapy applicators (44%) and bolus (28%). Sample sizes for clinical investigations were small (median 10, range 1–42). A minority of articles described basic or translational research (11%) and workflow or cost evaluation studies (3%). The number of articles increased over time (P < 0.0001). While outcomes were heterogeneous, most studies reported successful implementation of accurate and cost‐effective 3D printing methods. Conclusions Three‐dimensional printing is rapidly growing in radiation oncology and has been implemented effectively in a diverse array of applications. Although the number of 3D printing publications has steadily risen, the majority of current reports are preclinical in nature and the few clinical studies that do exist report on small sample sizes. Further dissemination of ongoing investigations describing the clinical application of developed 3D printing technologies in larger cohorts is warranted.
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Affiliation(s)
- Michael K Rooney
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - David M Rosenberg
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Steve Braunstein
- Department of Radiation Oncology, University of California, San Francisco, CA, USA
| | - Adam Cunha
- Department of Radiation Oncology, University of California, San Francisco, CA, USA
| | - Antonio L Damato
- Department Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eric Ehler
- Department of Radiation Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Todd Pawlicki
- Department of Radiation Medicine and Applied Sciences, University of California, San Diego, CA, USA
| | - James Robar
- Department of Radiation Oncology, Dalhousie University, Halifax, Canada.,Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Canada.,Radiation Medicine Program, Princess Margaret Cancer Center, Toronto, ON, Canada
| | - Ken Tatebe
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
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Tino R, Yeo A, Leary M, Brandt M, Kron T. A Systematic Review on 3D-Printed Imaging and Dosimetry Phantoms in Radiation Therapy. Technol Cancer Res Treat 2020; 18:1533033819870208. [PMID: 31514632 PMCID: PMC6856980 DOI: 10.1177/1533033819870208] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Additive manufacturing or 3-dimensional printing has become a widespread technology with many applications in medicine. We have conducted a systematic review of its application in radiation oncology with a particular emphasis on the creation of phantoms for image quality assessment and radiation dosimetry. Traditionally used phantoms for quality assurance in radiotherapy are often constraint by simplified geometry and homogenous nature to perform imaging analysis or pretreatment dosimetric verification. Such phantoms are limited due to their ability in only representing the average human body, not only in proportion and radiation properties but also do not accommodate pathological features. These limiting factors restrict the patient-specific quality assurance process to verify image-guided positioning accuracy and/or dose accuracy in "water-like" condition. METHODS AND RESULTS English speaking manuscripts published since 2008 were searched in 5 databases (Google Scholar, Scopus, PubMed, IEEE Xplore, and Web of Science). A significant increase in publications over the 10 years was observed with imaging and dosimetry phantoms about the same total number (52 vs 50). Key features of additive manufacturing are the customization with creation of realistic pathology as well as the ability to vary density and as such contrast. Commonly used printing materials, such as polylactic acid, acrylonitrile butadiene styrene, high-impact polystyrene and many more, are utilized to achieve a wide range of achievable X-ray attenuation values from -1000 HU to 500 HU and higher. Not surprisingly, multimaterial printing using the polymer jetting technology is emerging as an important printing process with its ability to create heterogeneous phantoms for dosimetry in radiotherapy. CONCLUSION Given the flexibility and increasing availability and low cost of additive manufacturing, it can be expected that its applications for radiation medicine will continue to increase.
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Affiliation(s)
- Rance Tino
- RMIT Centre for Additive Manufacture, Innovative Manufacturing Research Group (Medical Manufacturing), RMIT University, Melbourne, Australia.,ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, Australia.,Physical Sciences Department, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Adam Yeo
- Physical Sciences Department, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Martin Leary
- RMIT Centre for Additive Manufacture, Innovative Manufacturing Research Group (Medical Manufacturing), RMIT University, Melbourne, Australia.,ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, Australia
| | - Milan Brandt
- RMIT Centre for Additive Manufacture, Innovative Manufacturing Research Group (Medical Manufacturing), RMIT University, Melbourne, Australia.,ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, Australia
| | - Tomas Kron
- ARC Industrial Transformation Training Centre in Additive Biomanufacturing, Queensland University of Technology, Brisbane, Australia.,Physical Sciences Department, Peter MacCallum Cancer Centre, Melbourne, Australia
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Huang W, Lu J, Chen KM, Wu ZY, Wang QB, Liu JJ, Gong J, Chen ZJ, Ding XY, Wang ZM. Preliminary application of 3D-printed coplanar template for iodine-125 seed implantation therapy in patients with advanced pancreatic cancer. World J Gastroenterol 2018; 24:5280-5287. [PMID: 30581276 PMCID: PMC6295836 DOI: 10.3748/wjg.v24.i46.5280] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 11/27/2018] [Accepted: 11/27/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate a 3D-printed coplanar template for iodine-125 seed implantation therapy in patients with pancreatic cancer.
METHODS A retrospective analysis of our database was performed, and a total of 25 patients with pancreatic cancer who underwent iodine-125 seed implantation between January 2014 and November 2017 were analyzed. Of these, 12 implantations were assisted by a 3D-printed coplanar template (group A), and 13 implantations performed freehand were selected as a control group (group B). A 3D coplanar template was designed and printed according to a preoperative CT scan and treatment planning system. The iodine-125 seeds were then implanted using the template as a guide. Dosimetric verification was performed after implantation. Pre- and postoperative D90, V100, and V150 were calculated. The success rate of iodine-125 seed implantation, dosimetric parameters, and complications were analyzed and compared between the two groups.
RESULTS Iodine-125 seed implantation was successfully performed in both groups. In group A, the median pre- and postoperative D90 values were 155.32 ± 8.05 Gy and 154.82 ± 16.43 Gy, respectively; the difference between these values was minimal and not statistically significant (P > 0.05). Postoperative V100 and V150 were 91.05% ± 4.06% and 64.54% ± 13.40%, respectively, which met the treatment requirement. A better dosimetric parameter was observed in group A than in group B, and the difference was statistically significant (V100: 91.05% ± 4.06% vs 72.91% ± 13.78%, P < 0.05). No major procedure-related complications were observed in either group. For group A, mild hemorrhage was observed in 1 patient with a peritoneal local hematoma due to mesenteric vein damage from the iodine-125 seed implantation needle. The hematoma resolved spontaneously without treatment. Postoperative blood amylase levels remained within the normal range for all patients.
CONCLUSION A 3D-printed coplanar template appears to be a safe and effective iodine-125 seed implantation guidance tool to improve implantation accuracy and optimize dosimetric distribution.
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Affiliation(s)
- Wei Huang
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jian Lu
- Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
| | - Ke-Min Chen
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zhi-Yuan Wu
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Qing-Bin Wang
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Jing-Jing Liu
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Ju Gong
- Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
| | - Zhi-Jin Chen
- Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200020, China
| | - Xiao-Yi Ding
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Zhong-Min Wang
- Department of Interventional Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Ma X, Yang PZ, Jiang PS, Huo PB, Cao Q, Chai PS, Wang PH. Effectiveness and safety of a robot-assisted 3D personalized template in 125I seed brachytherapy of thoracoabdominal tumors. J Contemp Brachytherapy 2018; 10:368-379. [PMID: 30237820 PMCID: PMC6142644 DOI: 10.5114/jcb.2018.77957] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/10/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE This research aims to evaluate the effectiveness and safety of a robot-assisted 3D personalized template in 125I seed brachytherapy of thoracoabdominal tumors. MATERIAL AND METHODS Forty-three patients with different tumors were involved in this research between 2013 and 2015. They were all eligible to 125I seed implantation based on robot-assisted 3D personalized template. Meanwhile, 51 patients with similar tumors, which were treated with a conventional coplanar template, were involved for comparison. Follow-up was carried out after the surgery to evaluate the therapeutic efficacy, including overall survival (OS) of the patient and local control (LC) of the tumor. Complications were also summarized to evaluate the safety. Besides, statistical analysis was achieved to investigate possible factors associated with the result. RESULTS In the robot-assisted 3D personalized template-guided brachytherapy, the median target volume treated by the prescription dose (V100) was 95.3% (range, 92.4-109.8), and the median dose administered to 90% of the target volume (D90) was 126.1 Gy (range, 114.2-132.0), improved 5% and 8% compared with the conventional template-guided brachytherapy, respectively. The median OS was 30 months (95% CI: 19.4-40.6) and the rates of 2-year OS and LC were 58.1% and 86.0%, respectively. The median OS was prolonged 10 months and the 2-year OS and LC were improved 18.9% and 23.3% compared with the conventional template-guided brachytherapy, respectively. CONCLUSIONS Through analysis of the selected patients with thoracoabdominal tumors, the robot-assisted 3D personalized template in 125I seed brachytherapy was a more effective and safer method. It can achieve a more favorable OS and LC.
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Affiliation(s)
- Xiaodong Ma
- School of Mechanical Engineering, Tianjin University, Tianjin
| | | | | | - Prof. Bin Huo
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qiang Cao
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Prof. Shude Chai
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Prof. Haitao Wang
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
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15
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Dosimetric analysis of rib interference of the CTV during interstitial brachytherapy of lung tumors. J Contemp Brachytherapy 2018; 9:566-571. [PMID: 29441102 PMCID: PMC5807996 DOI: 10.5114/jcb.2017.72359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 12/07/2017] [Indexed: 12/29/2022] Open
Abstract
Purpose In interstitial brachytherapy for lung tumors, the placement and alignment of the source needles are influenced by the ribs, which can affect the dose distribution. This study evaluated the change in dose to the target by comparing the dose between the actual interstitial brachytherapy plan (AIBP, what is deliverable due to anatomic constraints), and the virtual interstitial brachytherapy plan (VIBP, pretreatment-modified dose distribution). Material and methods AIBPs and VIBPs were designed for 20 lung tumors. The VIBP was designed with uniform spacing between needles, regardless of the presence of ribs. The prescription dose was 30 Gy. The percentage of normal ipsilateral lung volume that received a dose ≥ 5 Gy (V5), conformity index (COIN), incremental dose percentage (IDP) to the target, and the dose covering 95% (D95) of the clinical target volume (CTV) were calculated. Results The V5 of the VIBPs was significantly smaller than that of the AIBPs (p < 0.01). The mean COIN value was 0.41 ± 0.12 for the AIBPs, which was significantly smaller than the value 0.54 ± 0.12 for the VIBPs (p < 0.01). The D95 of CTV in VIBP-adjusted was greater than that in AIBPs (p < 0.01). The mean IDP was 44% ± 40%. The Dmax of the ribs was 20.16 Gy ± 15.76 Gy in AIBPs, and 18.57 Gy ± 15.14 Gy in VIBPs, which was not significantly different (p > 0.05). Conclusions The regular geometric alignment of needles is important for increasing the target dose and limiting the normal lung dose in interstitial brachytherapy for thoracic tumors. Thus, we recommend that radiation oncologists attempt to achieve the regular alignment of needles during implantation.
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