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Evaluation of the Usefulness of Patient Customized Shielding Block Made with 3D Printer in the Skin Cancer Electron Beam Therapy

전자선치료 시 3D 프린터로 제작한 환자 맞춤형 차폐체의 유용성 평가

  • Ahn, Ki-Song (Department of Radiologic Technology Daegu Health College) ;
  • Jung, Woo-Chan (Department of Radiologic Technology Daegu Health College) ;
  • Kim, Dae-Hyun (Department of Radiation Oncology, Kangbuk Samsung Hospital) ;
  • Kim, Moo-Sub (Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, Catholic University of Korea) ;
  • Yoon, Do-Kun (Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, Catholic University of Korea) ;
  • Shim, Jae-Goo (Department of Radiologic Technology Daegu Health College) ;
  • Suh, Tae-Suk (Department of Biomedical Engineering and Research Institute of Biomedical Engineering, College of Medicine, Catholic University of Korea)
  • 안기송 (대구보건대학교 방사선과) ;
  • 정우찬 (대구보건대학교 방사선과) ;
  • 김대현 (강북삼성병원 방사선종양학과) ;
  • 김무섭 (가톨릭대학교 의공학교실) ;
  • 윤도군 (가톨릭대학교 의공학교실) ;
  • 심재구 (대구보건대학교 방사선과) ;
  • 서태석 (가톨릭대학교 의공학교실)
  • Received : 2019.12.05
  • Accepted : 2019.12.26
  • Published : 2019.12.31

Abstract

In order to improve and supplement the shielding method for electron beam treatment, we designed a patient-specific shielding method using a 3D printer, and evaluated the usefulness by comparing and analyzing the distribution of electron beam doses to adjacent organs. In order to treat 5 cm sized superficial tumors around the lens, a CT Simulator was used to scan the Alderson Rando phantom and the DICOM file was converted into an STL file. The converted STL file was used to design a patient-specific shield and mold that matched the body surface contour of the treatment site. The thickness of the shield was 1 cm and 1.5 cm, and the mold was printed using a 3D printer, and the patient customized shielding block (PCSB) was fabricated with a cerrobend alloy with a thickness of 1 cm and 1.5 cm. The dosimetry was performed by attaching an EBT3 film on the surface of the Alderson Rando phantom eyelid and measuring the dose of 6, 9, and 12 MeV electron beams on the film using four shielding methods. Shielding rates were 83.89%, 87.14%, 87.39% at 6, 9, and 12 MeV without shielding, 1 cm (92.04%, 87.48%, 86.49%), 1.5 cm (91.13%, 91.88% with PSCB), 92.66%) The shielding rate was measured as 1 cm (90.7%, 92.23%, 88.08%) and 1.5 cm (88.31%, 90.66%, 91.81%) when the shielding block and the patient-specific shield were used together. PCSB fabrication improves shielding efficiency over conventional shielding methods. Therefore, PSCB may be useful for clinical application.

Keywords

References

  1. Group IMRTCW. Intensity-modulated radiotherapy: Current status and issues of interest. International Journal of Radiation Oncology. 2001;51(4):880-914. https://doi.org/10.1016/S0360-3016(01)01749-7
  2. Jette D, Walker S. Electron dose calculation using multiple‐scattering theory: Evaluation of a new model for inhomogeneities. Medical Physics. 1992;19(5):1241-54. https://doi.org/10.1118/1.596756
  3. Verhaegen F, Symonds-Tayler R, Liu H, Nahum A. Backscatter towards the monitor ion chamber in high-energy photon and electron beams: charge integration versus Monte Carlo simulation. Physics in Medicine & Biology. 2000;45(11):3159. https://doi.org/10.1088/0031-9155/45/11/304
  4. Khan FM, Doppke KP, Hogstrom KR, Kutcher GJ, Nath R, Prasad SC, et al. Clinical electron‐beam dosimetry: report of AAPM radiation therapy committee task group No. 25. Medical physics. 1991;18(1):73-109. https://doi.org/10.1118/1.596695
  5. Bentel GC, Nelson CE, Noell KT. Treatment planning and dose calculation in radiation oncology. Elsevier; 2014.
  6. Sharma S, Johnson M. Surface dose perturbation due to air gap between patient and bolus for electron beams. Medical Physics. 1993;20(2):377-8. https://doi.org/10.1118/1.597079
  7. Kong M, Holloway L. An investigation of central axis depth dose distribution perturbation due to an air gap between patient and bolus for electron beams. Australasian Physics & Engineering Sciences in Medicine. 2007;30(2):111. https://doi.org/10.1007/BF03178415
  8. Khan Y, Villarreal-Barajas JE, Udowicz M, Sinha R, Muhammad W, Abbasi AN, et al. Clinical and dosimetric implications of air gaps between bolus and skin surface during radiation therapy. Journal of Cancer Therapy. 2013;4(7):1251. https://doi.org/10.4236/jct.2013.47147
  9. Dubey A, Sharma A, Leylek A, Harris C, Sasaki D, Butler J, et al. Using optical scanner and 3-dimensional printer technology to create lead shielding for radiation therapy of facial skin cancer with low-energy photons: An exciting innovation. International Journal of Radiation Oncology. 2016;96(2):E712-E3.
  10. Yeung W, Luk N, Yu K. Current tools of radiation therapy in treatment of skin cancer. Hong Kong Journal of Dermatology & Venereology. 2009;17(2):79-86.
  11. Ouhib Z, Kasper M, Calatayud JP, Rodriguez S, Bhatnagar A, Pai S, et al. Aspects of dosimetry and clinical practice of skin brachytherapy: The American Brachytherapy Society working group report. Brachytherapy. 2015;14(6):840-58. https://doi.org/10.1016/j.brachy.2015.06.005
  12. Fuller SM, Butz DR, Vevang CB, Makhlouf MV. Application of 3-dimensional printing in hand surgery for production of a novel bone reduction clamp. The Journal of Hand Surgery. 2014;39(9):1840-5. https://doi.org/10.1016/j.jhsa.2014.06.009
  13. Dong Z, Li Q, Bai S, Zhang L. Application of 3-dimensional printing technology to Kirschner wire fixation of adolescent condyle fracture. Journal of Oral and Maxillofacial Surgery. 2015;73(10):1970-6. https://doi.org/10.1016/j.joms.2015.04.005
  14. Noh KS, Seo HW, Kim TY, Lee YG. Development of a G-Code generator for color gradation generations in a mixing chamber FDM 3D printers. Korean Journal of Computational Design and Engineering. 2017;22(1):10-7. https://doi.org/10.7315/CDE.2017.010
  15. Jung SM, Yang JH, Lee SH, Kim JU, Yeom DS. A Study on Developing Customized Bolus using 3D Printers. The Journal of Korean Society for Radiation Therapy. 2015;27(1):61-71.
  16. Devic S, Seuntjens J, Abdel‐Rahman W, Evans M, Olivares M, Podgorsak EB, et al. Accurate skin dose measurements using radiochromic film in clinical applications. Medical Physics. 2006;33(4):1116-24. https://doi.org/10.1118/1.2179169
  17. Quach K, Morales J, Butson M, Rosenfeld AB, Metcalfe PE. Measurement of radiotherapy x‐ray skin dose on a chest wall phantom. Medical Physics. 2000;27(7):1676-80. https://doi.org/10.1118/1.599035
  18. Han SH. Evaluation of shielding rate of bismuth depending on the type of medical radioisotope. Journal of the Korea Convergence Society. 2018;9(7):87-93. https://doi.org/10.15207/JKCS.2018.9.7.087
  19. Radiation Therapeutics 4th Edition. Chung-Gu Publishier; 2016.
  20. Lee SH, Cha SY, Lee SY. Aluminum, copper and lead as shielding materials in 6 MeV electron therapy. The Journal of the Korea Contents Association. 2014;14(2):457-66. https://doi.org/10.5392/JKCA.2014.14.02.457
  21. Lee SH, Kwak KT, Park JK, Kim YS, Cha SY, Lee SH, et al. A study on the dose variation according to atomic number and field size of shielding materials in MeV electron beam. Korean Journal of Radiation Therapy. 2013;25(2):145-51.
  22. Arenas M, Sabater S, Sintas A, Arguis M, Hernandez V, Arquez M, et al. Individualized 3D scanning and printing for non-melanoma skin cancer brachytherapy: A financial study for its integration into clinical workflow. Journal of Contemporary Brachytherapy. 2017;9(3):270.