Gorka Gomez1, Montserrat Baeza2, Juan Carlos Mateos2, Jose Antonio Rivas2, Florencio Javier Luis Simon2, Diego Mesta Ortega3, María de Los Ángeles Flores Carrión4, Eleonor Rivin Del Campo5, Tomas Gómez-Cía6,7, Jose Luis Lopez Guerra3,6. 1. Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville (IBIS)/Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain. 2. Radiation Physics, University Hospital Virgen del Rocio, Seville, Spain. 3. Department of Radiation Oncology, University Hospital Virgen del Rocio, Seville, Spain. 4. Department of Radiation Oncology, Juan Ramón Jiménez Hospital, Huelva, Spain. 5. Department of Radiation Oncology, Tenon University Hospital, Hôpitaux Universitaires Est Parisien, Sorbonne University Medical Faculty, Paris, France. 6. Instituto de Biomedicina de Sevilla (IBIS/HUVR/CSIC/Universidad de Sevilla), Seville, Spain. 7. Department of Plastic Surgery, University Hospital Virgen del Rocio, Seville, Spain.
Abstract
BACKGROUND: The skin-sparing effect of megavoltage-photon beams in radiotherapy (RT) reduces the target coverage of superficial tumours. Consequently, a bolus is widely used to enhance the target coverage for superficial targets. This study evaluates a three-dimensional (3D)-printed customized bolus for a very irregular surface, the outer ear. MATERIALS AND METHODS: We fabricated a bolus using a computed tomography (CT) scanner and evaluated its efficacy. The head of an Alderson Rando phantom was scanned with a CT scanner. Two 3D boluses of 5- and 10-mm thickness were designed to fit on the surface of the ear. They were printed by the Stratasys Objet260 Connex3 using the malleable "rubber-like" photopolymer Agilus. CT simulations of the Rando phantom with and without the 3D and commercial high density boluses were performed to evaluate the dosimetric properties of the 3D bolus. The prescription dose to the outer ear was 50 Gy at 2 Gy/fraction. RESULTS: We observed that the target coverage was slightly better with the 3D bolus of 10mm compared with the commercial one (D98% 98.2% vs. 97.6%).The maximum dose was reduced by 6.6% with the 3D bolus and the minimum dose increased by 5.2% when comparing with the commercial bolus. In addition, the homogeneity index was better for the 3D bolus (0.041 vs. 0.073). CONCLUSION: We successfully fabricated a customized 3D bolus for a very irregular surface. The target coverage and dosimetric parameters were at least comparable with a commercial bolus. Thus, the use of malleable materials can be considered for the fabrication of customized boluses in cases with complex anatomy.
BACKGROUND: The skin-sparing effect of megavoltage-photon beams in radiotherapy (RT) reduces the target coverage of superficial tumours. Consequently, a bolus is widely used to enhance the target coverage for superficial targets. This study evaluates a three-dimensional (3D)-printed customized bolus for a very irregular surface, the outer ear. MATERIALS AND METHODS: We fabricated a bolus using a computed tomography (CT) scanner and evaluated its efficacy. The head of an Alderson Rando phantom was scanned with a CT scanner. Two 3D boluses of 5- and 10-mm thickness were designed to fit on the surface of the ear. They were printed by the Stratasys Objet260 Connex3 using the malleable "rubber-like" photopolymer Agilus. CT simulations of the Rando phantom with and without the 3D and commercial high density boluses were performed to evaluate the dosimetric properties of the 3D bolus. The prescription dose to the outer ear was 50 Gy at 2 Gy/fraction. RESULTS: We observed that the target coverage was slightly better with the 3D bolus of 10mm compared with the commercial one (D98% 98.2% vs. 97.6%).The maximum dose was reduced by 6.6% with the 3D bolus and the minimum dose increased by 5.2% when comparing with the commercial bolus. In addition, the homogeneity index was better for the 3D bolus (0.041 vs. 0.073). CONCLUSION: We successfully fabricated a customized 3D bolus for a very irregular surface. The target coverage and dosimetric parameters were at least comparable with a commercial bolus. Thus, the use of malleable materials can be considered for the fabrication of customized boluses in cases with complex anatomy.
Authors: Israel Valverde; Gorka Gomez-Ciriza; Tarique Hussain; Cristina Suarez-Mejias; Maria N Velasco-Forte; Nicholas Byrne; Antonio Ordoñez; Antonio Gonzalez-Calle; David Anderson; Mark G Hazekamp; Arno A W Roest; Jose Rivas-Gonzalez; Sergio Uribe; Issam El-Rassi; John Simpson; Owen Miller; Enrique Ruiz; Ignacio Zabala; Ana Mendez; Begoña Manso; Pastora Gallego; Freddy Prada; Massimiliano Cantinotti; Lamia Ait-Ali; Carlos Merino; Andrew Parry; Nancy Poirier; Gerald Greil; Reza Razavi; Tomas Gomez-Cia; Amir-Reza Hosseinpour Journal: Eur J Cardiothorac Surg Date: 2017-12-01 Impact factor: 4.191
Authors: B Ashleigh Guadagnolo; Gunar K Zagars; Dejka Araujo; Vinod Ravi; Thomas D Shellenberger; Erich M Sturgis Journal: Head Neck Date: 2010-10-19 Impact factor: 3.147
Authors: Vedang Vyas; Lisa Palmer; Ray Mudge; Runqing Jiang; Andre Fleck; Bryan Schaly; Ernest Osei; Paule Charland Journal: Med Dosim Date: 2013-04-09 Impact factor: 1.482
Authors: James L Robar; Kathryn Moran; James Allan; James Clancey; Tami Joseph; Krista Chytyk-Praznik; R Lee MacDonald; John Lincoln; Parisa Sadeghi; Robert Rutledge Journal: Pract Radiat Oncol Date: 2017-12-24
Authors: Kwangwoo Park; Sungjin Park; Mi-Jin Jeon; Jinhyun Choi; Jun Won Kim; Yoon Jin Cho; Won-Seok Jang; Yo Sup Keum; Ik Jae Lee Journal: Oncotarget Date: 2017-04-11