A design process for a 3D printed patient-specific applicator for HDR brachytherapy of the orbit

Springer Science and Business Media LLC - Tập 6 Số 1 - 2020
Ergys Subashi1, Corbin Jacobs2, Rodney Hood2, David G. Kirsch3,2, Oana Craciunescu
1Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA
2Department of Radiation Oncology, Duke University Medical Center, Durham, USA
3Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, USA

Tóm tắt

Abstract Background This report describes a process for designing a 3D printed patient-specific applicator for HDR brachytherapy of the orbit. Case presentation A 34-year-old man with recurrent melanoma of the orbit was referred for consideration of re-irradiation. An applicator for HDR brachytherapy was designed based on the computed tomography (CT) of patient anatomy. The body contour was used to generate an applicator with a flush fit against the patient’s skin while the planning target volume (PTV) was used to devise channels that allow for access and coverage of the tumor bed. An end-to-end dosimetric test was devised to determine feasibility for clinical use. The applicator was designed to conform to the volume and contours inside the orbital cavity. Support wings placed flush with the patient skin provided stability and reproducibility, while 16 source channels of varying length were needed for sufficient access to the target. A solid sheath, printed as an outer support-wall for each channel, prevented bending or accidental puncturing of the surface of the applicator. Conclusions Quality assurance tests demonstrated feasibility for clinical use. Our experience with available 3D printing technology used to generate an applicator for the orbit may provide guidance for how materials of suitable biomechanical and radiation properties can be used in brachytherapy.

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