Abstract
PurposeThis case series represents an initial experience with implementing 3‐dimensional (3D) surface scanning, digital design, and 3D printing for bolus fabrication for patients with complex surface anatomy where traditional approaches are challenging.Methods and MaterialsFor 10 patients requiring bolus in regions with complex contours, bolus was designed digitally from 3D surface scanning data or computed tomography (CT) images using either a treatment planning system or mesh editing software. Boluses were printed using a fused deposition modeling printer with polylactic acid. Quality assurance tests were performed for each printed bolus to verify density and shape.ResultsFor 9 of 10 patients, digitally designed boluses were used for treatment with no issues. In 1 case, the bolus was not used because dosimetric requirements were met without the bolus. QA tests revealed that the bulk density was within 3% of the reference value for 9 of 12 prints, and with more judicious selection of print settings this could be increased. For these 9 prints, density uniformity was as good as or better than our traditional sheet bolus material. The average shape error of the pieces was less than 0.5 mm, and no issues with fit or comfort were encountered during use.ConclusionsThis study demonstrates that new technologies such as 3D surface scanning, digital design and 3D printing can be safely and effectively used to modernize bolus fabrication.
Highlights
Traditional mold rooms have been used in radiation therapy for decades to design and fabricate the various devices required for radiation treatment including immobilization, shielding, and bolus
To date a handful of authors have investigated their use for patient position monitoring,[1] improving the extended field‐of‐ view in computed tomography (CT)[2] and total body irradiation (TBI) compensator design.[3]
From the CT number histogram in [Fig. 4(a)] we see that the modal CT number is close to the expected value of 120 Hounsfield units (HU), with a tail that extends down past 0 HU
Summary
Traditional mold rooms have been used in radiation therapy for decades to design and fabricate the various devices required for radiation treatment including immobilization, shielding, and bolus. For bolus fabrication this traditionally entailed use of technologies such as plaster of Paris, beeswax, and synthetic gel sheets. To date a handful of authors have investigated their use for patient position monitoring,[1] improving the extended field‐of‐ view in computed tomography (CT)[2] and total body irradiation (TBI) compensator design.[3] We have previously documented the use of this technology to help streamline our lead shielding fabrication process for orthovoltage treatments.[4]
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