Capturing 3D patient features for rapid prototyping in radiotherapy prior to simulation
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ORIGINAL RESEARCH
Capturing 3D patient features for rapid prototyping in radiotherapy prior to simulation Emi J. Yoshida 1 & Justin M. Low 2 & Nicole J. H. Lee 3 & Priya V. Borker 4 & Berthold Shin 5 & Arthur J. Olch 6,7 & Rajkumar Venkatramani 8,9 & Alexander Bruno 10 & Adam Kolawa 7 & Omar Ragab 7 & Kenneth K. Wong 6,7 Received: 24 October 2019 / Accepted: 16 March 2020 / Published online: 30 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective When superficial tumors are treated with radiotherapy, bolus may be needed to ensure adequate dose delivery to target tissue. The bolus is typically fabricated at the time of computed tomography (CT) simulation, but in many cases, creating a bolus prior to simulation can be more efficient. Therefore, we devised a workflow that would allow for 3D patient scanning at the initial consultation so that bolus can be fabricated by rapid prototyping before CT simulation. Methods A 3D-printed bolus was fabricated using surface scans of a head phantom that were obtained from a Microsoft Kinect. After processing the scans, a commercially printed 3D bolus was made. To test the feasibility and conformity of the process, masks were made for patients using the above method. Results 3D-printed bolus created using the rapid scanning technique proved to be the most conformal when compared with bolus made of VPS and SuperFlab. The printed masks also showed that they were formed fitting and comfortable to wear. Conclusion We present a new workflow that combines current known methods of both rapidly scanning a patient’s surface and the subsequent rapid creation of bolus that then increases bolus conformity, improves comfort and the patient experience, reduces simulation time, and may decrease exposure to radiation. Keywords Printing . Three-dimensional . Radiotherapy . Simulation . Rapid prototyping . Surface scanning
Introduction Radiation therapy of superficial tumors requires adequate dose to the target. To achieve this, a tissue equivalent material, called bolus, is placed on the skin surface to counteract the skin-sparing properties of high-energy beams [1]. Despite the pliability of the most commonly used bolus, SuperFlab (Mick
* Kenneth K. Wong [email protected] 1
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Radio-Nuclear Instruments, Mount Vernon, NY), molding to the skin is rarely perfectly conformal. Air gaps often will lead to hot and cold spots within the skin surface. It is particularly challenging to create a bolus that molds to the facial surface due to the highly irregular surface contours around the forehead, eyes, nose, and mouth. More conformal boluses have been fabricated with 3D printing utilizing CT scans as the
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Department of Psychiatry, University of Hawaii, Honolulu, HI, USA
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Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
Radiation Oncology Program, Children’s Hospital Los Angeles, Los Angeles, CA, USA
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Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
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