Cobalt compensator-based IMRT device: A treatment planning study of head and neck cases

Sengupta, Bishwambhar; Oh, Kyuhak; Sponseller, Patricia A.; Zaki, Peter; Eastman, Boryana M.; Dinh, Tru-Khang T.; Cárdenas, Carlos; Court, Laurence E.; Parvathaneni, Upendra; Ford, Eric

doi:10.1016/j.ejmp.2023.102526

Cited by 1 publication

(2 citation statements)

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“…14 There are broad applications of three-dimensional (3D) printed treatment aids in radiotherapy, including patient-specific custom bolus. 15,16 Custom bolus using 3D-printed molds offers the potential to reduce air gaps, increase clinical efficiency, and help achieve uniform dose to the scalp. 17,18 An investigation of this technique where liquid polyurethane resin was poured into a 3D-printed mold produced a patient-specific custom bolus with enhanced target homogeneity in comparison to commercial bolus.…”

Section: Introductionmentioning

confidence: 99%

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Total scalp irradiation: A study comparing multiple types of bolus and VMAT optimization techniques

Davis,

Luca,

Sudmeier

et al. 2024

J Applied Clin Med Phys

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PurposeTo investigate bolus design and VMAT optimization settings for total scalp irradiation.MethodsThree silicone bolus designs (flat, hat, and custom) from .decimal were evaluated for adherence to five anthropomorphic head phantoms. Flat bolus was cut from a silicone sheet. Generic hat bolus resembles an elongated swim cap while custom bolus is manufactured by injecting silicone into a 3D printed mold. Bolus placement time was recorded. Air gaps between bolus and scalp were quantified on CT images. The dosimetric effect of air gaps on target coverage was evaluated in a treatment planning study where the scalp was planned to 60 Gy in 30 fractions. A noncoplanar VMAT technique based on gEUD penalties was investigated that explored the full range of gEUD alpha values to determine which settings achieve sufficient target coverage while minimizing brain dose. ANOVA and the t‐test were used to evaluate statistically significant differences (threshold = 0.05).ResultsThe flat bolus took 32 ± 5.9 min to construct and place, which was significantly longer (p < 0.001) compared with 0.67 ± 0.2 min for the generic hat bolus or 0.53 ± 0.10 min for the custom bolus. The air gap volumes were 38 ± 9.3 cc, 32 ± 14 cc, and 17 ± 7.0 cc for the flat, hat, and custom boluses, respectively. While the air gap differences between the flat and custom boluses were significant (p = 0.011), there were no significant dosimetric differences in PTV coverage at V57Gy or V60Gy. In the VMAT optimization study, a gEUD alpha of 2 was found to minimize the mean brain dose.ConclusionsTwo challenging aspects of total scalp irradiation were investigated: bolus design and plan optimization. Results from this study show opportunities to shorten bolus fabrication time during simulation and create high quality treatment plans using a straightforward VMAT template with simple optimization settings.

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Section: Introductionmentioning

confidence: 99%

“…There are broad applications of three‐dimensional (3D) printed treatment aids in radiotherapy, including patient‐specific custom bolus 15,16 . Custom bolus using 3D‐printed molds offers the potential to reduce air gaps, increase clinical efficiency, and help achieve uniform dose to the scalp 17,18 .…”

Section: Introductionmentioning

confidence: 99%