Aristei Cynthia, Lancellotta Valentina, Piergentini Marco, Costantini Giacomo, Saldi Simonetta, Chierchini Sara, Cavalli Antonella, Di Renzo Luca, Fiorucci Oscar, Guasticchi Massimo, Bini Vittorio, Ricci Alessandro
Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia and Perugia General Hospital, Italy.
Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia and Perugia General Hospital, Italy.
Brachytherapy. 2019 Jan-Feb;18(1):57-62. doi: 10.1016/j.brachy.2018.09.007. Epub 2018 Nov 7.
High-dose-rate, multicatheter interstitial brachytherapy is technically complex and operator-dependent, requiring lengthy training and specialized skills. Furthermore, until the advent of contouring on computerized tomography (CT) images, difficulties existed in locating the target volume precisely. The present article reports the results of a study that aimed at producing and validating a 3D-printed template to aid in target volume localization for multicatheter interstitial brachytherapy in patients with breast cancer.
Thirteen patients, candidates for accelerated partial breast irradiation or boost, were enrolled in the study. The target volume was defined on CT slices, and a template with empty spaces corresponding to the target volume projection on the patient's skin was produced by a 3D printer. The procedure was compared with the standard method followed in our center (1) visually, by assessing overlap between the target volume projections on the patient's skin, (2) by X-ray findings, and (3) by intraclass correlation coefficient.
Visual assessment and X-ray findings showed the 3D-printed target volume always fell within the standard volume in all 13 patients. The intraclass correlation coefficient indicated moderate agreement for both the medial and the lateral skin projections.
The 3-D printed templates constitute a quick, easy, and reliable method to localize the target volume for high-dose-rate interstitial multicathether brachytherapy in patients with breast cancer and can safely be used in clinical practice.
高剂量率多导管组织间近距离放射治疗技术复杂且依赖操作人员，需要长时间培训和专业技能。此外，在计算机断层扫描（CT）图像上进行轮廓勾画技术出现之前，精确确定靶体积存在困难。本文报告了一项研究结果，该研究旨在制作并验证一种3D打印模板，以辅助乳腺癌患者多导管组织间近距离放射治疗的靶体积定位。
13例拟接受加速部分乳腺照射或追加剂量照射的患者纳入本研究。在CT切片上确定靶体积，然后用3D打印机制作一个模板，模板上的空白区域对应患者皮肤上靶体积的投影。将该方法与我们中心采用的标准方法进行比较：（1）通过视觉评估患者皮肤上靶体积投影的重叠情况；（2）通过X线检查结果；（3）通过组内相关系数。
视觉评估和X线检查结果显示，在所有13例患者中，3D打印的靶体积始终落在标准体积范围内。组内相关系数表明，内侧和外侧皮肤投影均具有中度一致性。
3D打印模板是一种快速、简便且可靠的方法，可用于乳腺癌患者高剂量率组织间多导管近距离放射治疗的靶体积定位，并可安全应用于临床实践。
