Biele da Grzegorz, Marach Anna, Boehlke Marek, Zwierzchowski Grzegorz, Malicki Julian
Electroradiology Department, Poznan University of Medical Sciences, Poznan´, Poland.
Medical Physics Department, Greater Poland Cancer Centre, Poznan´, Poland.
J Contemp Brachytherapy. 2021 Oct;13(5):549-562. doi: 10.5114/jcb.2021.110304. Epub 2021 Oct 25.
Brachytherapy is a great alternative for restrictive surgical procedures in facial cancers. Moreover, dose distribution is more beneficial compared with teleradiotherapy during treatment of lesions located on anatomical curves. However, repetitiveness of application is the main issue associated with using commercial applicators. The risk of its displacement is very unfavorable due to large dose gradients in brachytherapy. The aim of this study was to develop a process of preparation of applicators using 3D printing technology.
In planning system, circular volumes near the nose, eye, and ear were determined on transverse layers of an anthropomorphic phantom. Next, boluses with a thickness of 5 mm and 10 mm were designed for each of the layers. Channels in the 10 mm bolus were designed in such a way to place the catheters into the layers. Prepared applicators were printed using polylactic acid (PLA) filament. Plans to irradiate the films for their calibration and plans for treatment prepared in the treatment planning system were conducted. A special phantom was created to calibrate the radiochromic films. Dose distribution around the designed applicators was measured in an anthropomorphic phantom using films within the layers of phantom. Comparison of doses was performed with two-dimensional gamma analysis using OmniPro I'mRT software.
The obtained results confirmed compliance of the planned and measured doses in 92%; the analysis of gamma parameter showed 1%/1 mm for acceptability level of 95%. Moreover, the initial dosimetric analysis for gamma criteria with 2%/2 mm showed compliance at 99%.
The results of the present study confirm potential clinical usefulness of the applicators obtained with the use of 3D printing for brachytherapy.
近距离放射治疗是面部癌症限制性手术的绝佳替代方案。此外,在治疗位于解剖曲线上的病变时,与远距离放射治疗相比,剂量分布更有益。然而,使用商业施源器的主要问题是应用的重复性。由于近距离放射治疗中存在大剂量梯度,其移位风险非常不利。本研究的目的是开发一种使用3D打印技术制备施源器的方法。
在计划系统中,在人体模型的横向层面上确定鼻子、眼睛和耳朵附近的圆形体积。接下来,为每个层面设计厚度为5毫米和10毫米的 bolus。10毫米 bolus 中的通道设计成可将导管放置在各层面中。使用聚乳酸(PLA)细丝打印制备好的施源器。进行了用于校准胶片的照射计划以及在治疗计划系统中制定的治疗计划。创建了一个特殊的人体模型来校准放射变色胶片。使用人体模型各层面内的胶片在人体模型中测量设计施源器周围的剂量分布。使用OmniPro I'mRT软件通过二维伽马分析进行剂量比较。
获得的结果证实计划剂量与测量剂量的符合率为92%;伽马参数分析显示,在95%的可接受水平下为1%/1毫米。此外,对于2%/2毫米伽马标准的初始剂量分析显示符合率为99%。
本研究结果证实了使用3D打印获得的施源器在近距离放射治疗中的潜在临床实用性。