Institute of Polymer Product Engineering, Johannes Kepler University, Altenberger Str. 69, 4040, Linz, Austria.
Abteilung für Radioonkologie, Ordensklinikum Linz Barmherzige Schwestern, Seilerstätte 4, 4010, Linz, Austria.
Strahlenther Onkol. 2022 Nov;198(11):1032-1041. doi: 10.1007/s00066-022-01963-w. Epub 2022 Jun 13.
For stereotactic radiation therapy of intracranial malignancies, a patient's head needs to be immobilized with high accuracy. Fixation devices such as invasive stereotactic head frames or non-invasive thermoplastic mask systems are often used. However, especially stereotactic high-precision masks often cause discomfort for patients due to a long manufacturing time during which the patient is required to lie still and because the face is covered, including the mouth, nose, eyes, and ears. To avoid these issues, the target was to develop a non-invasive 3D-printable mask system with at least the accuracy of the high-precision masks, for producing masks which can be manufactured in the absence of patients and which allow the eyes, mouth, and nose to be uncovered during therapy.
For four volunteers, a personalized 3D-printed mask based on magnetic resonance imaging (MRI) data was designed and manufactured using fused filament fabrication (FFF). Additionally, for each of the volunteers, a conventional thermoplastic stereotactic high-precision mask from Brainlab AG (Munich, Germany) was fabricated. The intra-fractional fixation accuracy for each mask and volunteer was evaluated using the motion-correction algorithm of functional MRI measurements with and without guided motion.
The average values for the translations and rotations of the volunteers' heads lie in the range between ±1 mm and ±1° for both masks. Interestingly, the standard deviations and the relative and absolute 3D displacements are lower for the 3D-printed masks compared to the Brainlab masks.
It could be shown that the intra-fractional fixation accuracy of the 3D-printed masks was higher than for the conventional stereotactic high-precision masks.
对于颅内恶性肿瘤的立体定向放射治疗，需要将患者的头部高精度固定。通常使用固定装置，如侵入性立体定向头架或非侵入性热塑面罩系统。然而，特别是立体定向高精度面罩由于制造时间长，患者需要保持静止，并且面部被覆盖，包括嘴、鼻子、眼睛和耳朵，因此经常会给患者带来不适。为避免这些问题，目标是开发一种非侵入性的 3D 可打印面罩系统，其精度至少与高精度面罩相当，用于制造可以在没有患者的情况下制造的面罩，并且在治疗过程中允许眼睛、嘴和鼻子暴露。
对于四名志愿者，使用熔丝制造（FFF）基于磁共振成像（MRI）数据设计并制造了个性化的 3D 打印面罩。此外，为每个志愿者制造了一个来自 Brainlab AG（德国慕尼黑）的常规热塑立体定向高精度面罩。使用功能磁共振测量的运动校正算法，在有和没有引导运动的情况下，评估了每个面罩和志愿者的分次内固定精度。
志愿者头部的平移和旋转的平均值在两个面罩的±1mm 和±1°之间。有趣的是，3D 打印面罩的标准偏差以及相对和绝对 3D 位移均低于 Brainlab 面罩。
结果表明，3D 打印面罩的分次内固定精度高于传统的立体定向高精度面罩。
