scholarly journals 3D Printed Patient-Specific Applicator for HDR Brachytherapy of the Orbit

2020 ◽  
Author(s):  
Ergys David Subashi ◽  
Corbin Jacobs ◽  
Rodney Hood ◽  
David Kirsch ◽  
Oana Craciunescu
Keyword(s):  
Quality Assurance ◽  
Target Volume ◽  
The Body ◽  
Patient Specific ◽  
Clinical Use ◽  
Hdr Brachytherapy ◽  
Orbital Cavity ◽  
Body Contour ◽  
Tumor Bed ◽  
3D Printed

Abstract BACKGROUND This report describes a process for designing a 3D printed patient-specific applicator for HDR brachytherapy of the orbit. CASE PRESENTATION A 34-year-old man with recurrent melanoma of the orbit was referred for consideration of re-irradiation. An applicator for HDR brachytherapy was designed based on the computed tomography (CT) of patient anatomy. The body contour was used to generate an applicator with a flush fit against the patient’s skin while the planning target volume (PTV) was used to devise channels that allow for access and coverage of the tumor bed. An end-to-end quality assurance test was devised to determine feasibility for clinical use. The applicator was designed to conform to the volume and contours inside the orbital cavity. Support wings placed flush with the patient skin provided stability and reproducibility, while 16 source channels of varying length were needed for sufficient access to the target. A solid sheath, printed as an outer support-wall for each channel, prevented bending or accidental puncturing of the surface of the applicator. CONCLUSIONS Quality assurance tests demonstrated feasibility for clinical use. Our experience with available 3D printing technology used to generate an applicator for the orbit may provide guidance for how materials of suitable biomechanical and radiation properties can be used in brachytherapy.

scholarly journals A Design Process for a 3D Printed Patient-Specific Applicator for HDR Brachytherapy of the Orbit

2020 ◽  
Author(s):  
Ergys David Subashi ◽  
Corbin Jacobs ◽  
Rodney Hood ◽  
David Kirsch ◽  
Oana Craciunescu
Keyword(s):  
Target Volume ◽  
The Body ◽  
Patient Specific ◽  
Clinical Use ◽  
Hdr Brachytherapy ◽  
Orbital Cavity ◽  
Body Contour ◽  
Tumor Bed ◽  
Varying Length ◽  
3D Printed

Abstract BACKGROUND: This report describes a process for designing a 3D printed patient-specific applicator for HDR brachytherapy of the orbit. CASE PRESENTATION: A 34-year-old man with recurrent melanoma of the orbit was referred for consideration of re-irradiation. An applicator for HDR brachytherapy was designed based on the computed tomography (CT) of patient anatomy. The body contour was used to generate an applicator with a flush fit against the patient’s skin while the planning target volume (PTV) was used to devise channels that allow for access and coverage of the tumor bed. An end-to-end dosimetric test was devised to determine feasibility for clinical use. The applicator was designed to conform to the volume and contours inside the orbital cavity. Support wings placed flush with the patient skin provided stability and reproducibility, while 16 source channels of varying length were needed for sufficient access to the target. A solid sheath, printed as an outer support-wall for each channel, prevented bending or accidental puncturing of the surface of the applicator. CONCLUSIONS: Quality assurance tests demonstrated feasibility for clinical use. Our experience with available 3D printing technology used to generate an applicator for the orbit may provide guidance for how materials of suitable biomechanical and radiation properties can be used in brachytherapy.

scholarly journals Patient-Specific Quality Assurance Using a 3D-Printed Chest Phantom for Intraoperative Radiotherapy in Breast Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Yeonho Choi ◽  
Ik Jae Lee ◽  
Kwangwoo Park ◽  
Kyung Ran Park ◽  
Yeona Cho ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Soft Tissue ◽  
Three Dimensional ◽  
Intraoperative Radiotherapy ◽  
Hounsfield Unit ◽  
Patient Specific ◽  
Depth Dose ◽  
Dose Comparison ◽  
3D Printed ◽  
The Mean

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.

scholarly journals Feasibility of a 3D-printed anthropomorphic patient-specific head phantom for patient-specific quality assurance of intensity-modulated radiotherapy

PLoS ONE ◽  
2017 ◽  
Vol 12 (7) ◽  
pp. e0181560 ◽  
Author(s):  
Ji Woon Yea ◽  
Jae Won Park ◽  
Sung Kyu Kim ◽  
Dong Youn Kim ◽  
Jae Gu Kim ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Intensity Modulated Radiotherapy ◽  
Patient Specific ◽  
Intensity Modulated ◽  
3D Printed

Patient specific 3D printed phantom for IMRT quality assurance

2014 ◽  
Vol 59 (19) ◽  
pp. 5763-5773 ◽  
Author(s):  
Eric D Ehler ◽  
Brett M Barney ◽  
Patrick D Higgins ◽  
Kathryn E Dusenbery
Keyword(s):  
Quality Assurance ◽  
Patient Specific ◽  
3D Printed

Characterization of a novel 3D printed patient specific phantom for quality assurance in cranial stereotactic radiosurgery applications

2019 ◽  
Vol 64 (10) ◽  
pp. 105009 ◽  
Author(s):  
D N Makris ◽  
E P Pappas ◽  
E Zoros ◽  
N Papanikolaou ◽  
D L Saenz ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Stereotactic Radiosurgery ◽  
Patient Specific ◽  
3D Printed

scholarly journals A design process for a 3D printed patient-specific applicator for HDR brachytherapy of the orbit

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Ergys Subashi ◽  
Corbin Jacobs ◽  
Rodney Hood ◽  
David G. Kirsch ◽  
Oana Craciunescu
Keyword(s):  
Design Process ◽  
Patient Specific ◽  
Hdr Brachytherapy ◽  
3D Printed

scholarly journals Clinical validation of a commercially available deep learning software for synthetic CT generation for brain

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Minna Lerner ◽  
Joakim Medin ◽  
Christian Jamtheim Gustafsson ◽  
Sara Alkner ◽  
Carl Siversson ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Organs At Risk ◽  
Ct Images ◽  
The Body ◽  
Pass Rate ◽  
Geometric Distortion ◽  
Patient Treatment ◽  
Patient Specific ◽  
Body Contour ◽  
Mean Values

Abstract Background Most studies on synthetic computed tomography (sCT) generation for brain rely on in-house developed methods. They often focus on performance rather than clinical feasibility. Therefore, the aim of this work was to validate sCT images generated using a commercially available software, based on a convolutional neural network (CNN) algorithm, to enable MRI-only treatment planning for the brain in a clinical setting. Methods This prospective study included 20 patients with brain malignancies of which 14 had areas of resected skull bone due to surgery. A Dixon magnetic resonance (MR) acquisition sequence for sCT generation was added to the clinical brain MR-protocol. The corresponding sCT images were provided by the software MRI Planner (Spectronic Medical AB, Sweden). sCT images were rigidly registered and resampled to CT for each patient. Treatment plans were optimized on CT and recalculated on sCT images for evaluation of dosimetric and geometric endpoints. Further analysis was also performed for the post-surgical cases. Clinical robustness in patient setup verification was assessed by rigidly registering cone beam CT (CBCT) to sCT and CT images, respectively. Results All sCT images were successfully generated. Areas of bone resection due to surgery were accurately depicted. Mean absolute error of the sCT images within the body contour for all patients was 62.2 ± 4.1 HU. Average absorbed dose differences were below 0.2% for parameters evaluated for both targets and organs at risk. Mean pass rate of global gamma (1%/1 mm) for all patients was 100.0 ± 0.0% within PTV and 99.1 ± 0.6% for the full dose distribution. No clinically relevant deviations were found in the CBCT-sCT vs CBCT-CT image registrations. In addition, mean values of voxel-wise patient specific geometric distortion in the Dixon images for sCT generation were below 0.1 mm for soft tissue, and below 0.2 mm for air and bone. Conclusions This work successfully validated a commercially available CNN-based software for sCT generation. Results were comparable for sCT and CT images in both dosimetric and geometric evaluation, for both patients with and without anatomical anomalies. Thus, MRI Planner is feasible to use for radiotherapy treatment planning of brain tumours.

scholarly journals Development of Patient Specific Conformal 3D-Printed Devices for Dose Verification in Radiotherapy

2021 ◽  
Vol 11 (18) ◽  
pp. 8657
Author(s):  
Antonio Jreije ◽  
Lalu Keshelava ◽  
Mindaugas Ilickas ◽  
Jurgita Laurikaitiene ◽  
Benas Gabrielis Urbonavicius ◽  
...  
Keyword(s):  
3D Printing ◽  
Radiation Treatment ◽  
Cost Effective ◽  
Skin Surface ◽  
Target Volume ◽  
Dose Assessment ◽  
Patient Specific ◽  
Tumor Control ◽  
Dose Verification ◽  
3D Printed

In radiation therapy, a bolus is used to improve dose distribution in superficial tumors; however, commercial boluses lack conformity to patient surface leading to the formation of an air gap between the bolus and patient surface and suboptimal tumor control. The aim of this study was to explore 3D-printing technology for the development of patient-specific conformal 3D-printed devices, which can be used for the radiation treatment of superficial head and neck cancer (HNC). Two 3D boluses (0.5 and 1.0 cm thick) for surface dose build-up and patient-specific 3D phantom were printed based on reconstruction of computed tomography (CT) images of a patient with HNC. The 3D-printed patient-specific phantom indicated good tissue equivalency (HU = −32) and geometric accuracy (DSC = 0.957). Both boluses indicated high conformity to the irregular skin surface with minimal air gaps (0.4–2.1 mm for 0.5 cm bolus and 0.6–2.2 mm for 1.0 cm bolus). The performed dose assessment showed that boluses of both thicknesses have comparable effectiveness, increasing the dose that covers 99% of the target volume by 52% and 26% for single field and intensity modulated fields, respectively, when compared with no bolus case. The performed investigation showed the potential of 3D printing in development of cost effective, patient specific and patient friendly conformal devices for dose verification in radiotherapy.

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