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A customized bolus produced using a 3-dimensional printer for radiotherapy.

Kim SW, Shin HJ, Kay CS, Son SH - PLoS ONE (2014)

Bottom Line: Boluses are used in high-energy radiotherapy in order to overcome the skin sparing effect.In practice though, commonly used flat boluses fail to make a perfect contact with the irregular surface of the patient's skin, resulting in air gaps.The dosimetric parameters of the resulting 3D printed flat bolus showed that it was a useful dose escalating material, equivalent to a commercially available flat bolus.

View Article: PubMed Central - PubMed

Affiliation: Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

ABSTRACT

Objective: Boluses are used in high-energy radiotherapy in order to overcome the skin sparing effect. In practice though, commonly used flat boluses fail to make a perfect contact with the irregular surface of the patient's skin, resulting in air gaps. Hence, we fabricated a customized bolus using a 3-dimensional (3D) printer and evaluated its feasibility for radiotherapy.

Methods: We designed two kinds of bolus for production on a 3D printer, one of which was the 3D printed flat bolus for the Blue water phantom and the other was a 3D printed customized bolus for the RANDO phantom. The 3D printed flat bolus was fabricated to verify its physical quality. The resulting 3D printed flat bolus was evaluated by assessing dosimetric parameters such as D1.5 cm, D5 cm, and D10 cm. The 3D printed customized bolus was then fabricated, and its quality and clinical feasibility were evaluated by visual inspection and by assessing dosimetric parameters such as Dmax, Dmin, Dmean, D90%, and V90%.

Results: The dosimetric parameters of the resulting 3D printed flat bolus showed that it was a useful dose escalating material, equivalent to a commercially available flat bolus. Analysis of the dosimetric parameters of the 3D printed customized bolus demonstrated that it is provided good dose escalation and good contact with the irregular surface of the RANDO phantom.

Conclusions: A customized bolus produced using a 3D printer could potentially replace commercially available flat boluses.

Show MeSH
Dose distributions of the three treatment plans from the Blue water phantom study.(a) Plan without a bolus, (b) plan with the superflab bolus, and (c) plan with the 3-dimensional printed flat bolus. Pink line, 105% isodose contour; yellow line, 100% isodose contour; blue line, 90% isodose contour; cyan line, 70% isodose contour; white line, 50% isodose contour; dark green, 30% isodose contour.
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pone-0110746-g002: Dose distributions of the three treatment plans from the Blue water phantom study.(a) Plan without a bolus, (b) plan with the superflab bolus, and (c) plan with the 3-dimensional printed flat bolus. Pink line, 105% isodose contour; yellow line, 100% isodose contour; blue line, 90% isodose contour; cyan line, 70% isodose contour; white line, 50% isodose contour; dark green, 30% isodose contour.

Mentions: The 3D printed flat bolus was successfully fabricated using the 3D printer (Figure 1e, bottom), and was a good fit against the surface of the Blue water phantom with no air gap between the bolus and the phantom. The dose distribution of the plan without a bolus revealed that the prescribed dose could not be fully delivered to the surface of the Blue water phantom (Figure 2a). The dmax of this plan was calculated with a TPS of 1.48 cm, whereas the plan with the 3D printed flat bolus produced a dmax of 0.63 cm. Thus, the dmax of the plan with the 3D printed flat bolus was shifted 0.85 cm in depth towards the surface of the Blue water phantom, suggesting that the 3D printed flat bolus was also a useful dose escalating material in radiotherapy. Moreover, the dose distributions of the plans with the superflab and the 3D printed flat bolus were similar, as expected (Figure 2b, c). The differences between the calculated dose by the TPS and the measured dose from the ionization chamber at a depth of 1.5 cm, 5 cm, and 10 cm beneath the surface of the phantom are shown in Table 1.


A customized bolus produced using a 3-dimensional printer for radiotherapy.

Kim SW, Shin HJ, Kay CS, Son SH - PLoS ONE (2014)

Dose distributions of the three treatment plans from the Blue water phantom study.(a) Plan without a bolus, (b) plan with the superflab bolus, and (c) plan with the 3-dimensional printed flat bolus. Pink line, 105% isodose contour; yellow line, 100% isodose contour; blue line, 90% isodose contour; cyan line, 70% isodose contour; white line, 50% isodose contour; dark green, 30% isodose contour.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4206462&req=5

pone-0110746-g002: Dose distributions of the three treatment plans from the Blue water phantom study.(a) Plan without a bolus, (b) plan with the superflab bolus, and (c) plan with the 3-dimensional printed flat bolus. Pink line, 105% isodose contour; yellow line, 100% isodose contour; blue line, 90% isodose contour; cyan line, 70% isodose contour; white line, 50% isodose contour; dark green, 30% isodose contour.
Mentions: The 3D printed flat bolus was successfully fabricated using the 3D printer (Figure 1e, bottom), and was a good fit against the surface of the Blue water phantom with no air gap between the bolus and the phantom. The dose distribution of the plan without a bolus revealed that the prescribed dose could not be fully delivered to the surface of the Blue water phantom (Figure 2a). The dmax of this plan was calculated with a TPS of 1.48 cm, whereas the plan with the 3D printed flat bolus produced a dmax of 0.63 cm. Thus, the dmax of the plan with the 3D printed flat bolus was shifted 0.85 cm in depth towards the surface of the Blue water phantom, suggesting that the 3D printed flat bolus was also a useful dose escalating material in radiotherapy. Moreover, the dose distributions of the plans with the superflab and the 3D printed flat bolus were similar, as expected (Figure 2b, c). The differences between the calculated dose by the TPS and the measured dose from the ionization chamber at a depth of 1.5 cm, 5 cm, and 10 cm beneath the surface of the phantom are shown in Table 1.

Bottom Line: Boluses are used in high-energy radiotherapy in order to overcome the skin sparing effect.In practice though, commonly used flat boluses fail to make a perfect contact with the irregular surface of the patient's skin, resulting in air gaps.The dosimetric parameters of the resulting 3D printed flat bolus showed that it was a useful dose escalating material, equivalent to a commercially available flat bolus.

View Article: PubMed Central - PubMed

Affiliation: Radiation Oncology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

ABSTRACT

Objective: Boluses are used in high-energy radiotherapy in order to overcome the skin sparing effect. In practice though, commonly used flat boluses fail to make a perfect contact with the irregular surface of the patient's skin, resulting in air gaps. Hence, we fabricated a customized bolus using a 3-dimensional (3D) printer and evaluated its feasibility for radiotherapy.

Methods: We designed two kinds of bolus for production on a 3D printer, one of which was the 3D printed flat bolus for the Blue water phantom and the other was a 3D printed customized bolus for the RANDO phantom. The 3D printed flat bolus was fabricated to verify its physical quality. The resulting 3D printed flat bolus was evaluated by assessing dosimetric parameters such as D1.5 cm, D5 cm, and D10 cm. The 3D printed customized bolus was then fabricated, and its quality and clinical feasibility were evaluated by visual inspection and by assessing dosimetric parameters such as Dmax, Dmin, Dmean, D90%, and V90%.

Results: The dosimetric parameters of the resulting 3D printed flat bolus showed that it was a useful dose escalating material, equivalent to a commercially available flat bolus. Analysis of the dosimetric parameters of the 3D printed customized bolus demonstrated that it is provided good dose escalation and good contact with the irregular surface of the RANDO phantom.

Conclusions: A customized bolus produced using a 3D printer could potentially replace commercially available flat boluses.

Show MeSH