Custom Applicator Design and Manufacture Automation for Interstitial Gynecological Brachytherapy

Kudla, Michael; Batchelar, Deidre; Crook, Juanita; Anderson, Danielle; Moore, Jocelyn; Bachand, François

doi:10.1016/j.brachy.2019.04.035

Cited by 3 publications

(4 citation statements)

References 13 publications

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“…Lindegaard et al used a Vienna-style 3D-printed intra-vaginal template (without a ring channel) to combine a tandem with both straight and oblique needles [30]. Several authors reported using 3D-printing to produce intra-vaginal cylindrical templates for curved IS needles with or without the use of a central channel to accommodate a metallic fixation rod or an intra-uterine tandem [31][32][33][34][35][36]. Logar et al modified a T&R IC applicator with a 3D-printed add-on, resulting in a Vienna-style IC/IS applicator with straight and oblique IS needles [37].…”

Section: Purposementioning

confidence: 99%

“…Accura ® ClearVue™ (USP class VI; 3D Systems, South Carolina, USA) and both Dental LT and Dental SG (ISO 10993) (Formlabs, Massachusetts, USA) have been utilized as material for 3D-printed GYN applicators [41,48,59,60]. PEEK is a high temperature thermoplastic material available for FDM 3D-printing, and is appropriate for high temperature steam sterilization [35]. Kudla et al had their patient-specific cylindrical template (PSCT) made of PEEK material validated by an independent contract testing laboratory for a sterility assurance level (SAL) of 10 -6 using a biological indicator overkill method [35].…”

Section: Materials Selection and Cost Evaluationmentioning

confidence: 99%

“…PEEK is a high temperature thermoplastic material available for FDM 3D-printing, and is appropriate for high temperature steam sterilization [35]. Kudla et al had their patient-specific cylindrical template (PSCT) made of PEEK material validated by an independent contract testing laboratory for a sterility assurance level (SAL) of 10 -6 using a biological indicator overkill method [35]. Finally, the design of 3D-printed BT applicators should be free of sharp edges and easy to clean.…”

Section: Materials Selection and Cost Evaluationmentioning

confidence: 99%

“…Other groups developed similar workflows to select IS needle trajectories for vaginal vault templates based on vaginal packing with MRI contrast-soaked gauzes [47,48]. Kudla et al automated the design of their PSCT applicator with Eclipse Scripting API using a TPS pre-plan based on a library of virtual straight and curved needle trajectories [35]. Eventually, optimal IS needle trajectories for Adaptiiv caps could be determined automatically without requiring a TPS pre-plan with an inverse optimization technique applied on the target structures.…”

Section: Proposed Clinical Workflowmentioning

confidence: 99%

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The Montreal split ring applicator: Towards highly adaptive gynecological brachytherapy using 3D-printed biocompatible patient-specific interstitial caps

Kamio,

Roy,

Morgan

et al. 2023

jcb

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Purpose The addition of interstitial (IS) needles to intra-cavitary (IC) brachytherapy applicators is associated with improved outcomes in locally advanced cervical cancers involving parametrial tumor extensions. The purpose of this work was to validate a clinical workflow involving 3D-printed caps for a commercial IC split ring applicator that enable using IS needle trajectories tailored to each treatment. Material and methods A dedicated software module was developed in this work allowing users to design patient-specific IS caps without knowledge of computer-aided design (CAD) software. This software module was integrated to 3D Brachy, a commercial software developed by Adaptiiv Medical Technologies Inc. For validation of the workflow, CAD models of ground truth caps with five IS needle trajectories were designed with Fusion 360™, 3D-printed, assembled with a split ring applicator, and CT-scanned with radio-opaque markers. 3D Brachy was then applied to generate a replica based on trajectories reconstructed from the radio-opaque markers. A comparison between ground truth and replicated IS needle trajectories was done using intersection points with planes at the level of the cervix (z = 0 cm) and a representative needle depth (z = 3 cm). Results Prototypes of interstitial caps 3D-printed in both BioMed Amber and BioMed Clear SLA resins were tested to be functional both pre- and post-sterilization for IS needles with obliquity angles ≤ 45°. Distance-to-agreement at z = 0 cm and 3 cm as well as deviations in pitch and yaw angles of the five IS needle trajectories were found to have mean values of 3.3 ±2.1 mm, 7.3 ±2.0 mm, 2.9° ±2.3°, and 7.0° ±7.0°, respectively. Conclusions The clinical workflow for image-guided adaptive cervical cancer brachytherapy using the Montreal split ring applicator was validated.

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Section: Purposementioning

confidence: 99%

Section: Materials Selection and Cost Evaluationmentioning

confidence: 99%

Section: Materials Selection and Cost Evaluationmentioning

confidence: 99%

Section: Proposed Clinical Workflowmentioning

confidence: 99%

See 2 more Smart Citations

The Montreal split ring applicator: Towards highly adaptive gynecological brachytherapy using 3D-printed biocompatible patient-specific interstitial caps

Kamio,

Roy,

Morgan

et al. 2023

jcb

View full text Add to dashboard Cite

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Individualized medicine using 3D printing technology in gynecology: a scoping review

et al. 2023

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Objective Developments in 3-dimensional (3D) printing technology has made it possible to produce high quality, affordable 3D printed models for use in medicine. As a result, there is a growing assessment of this approach being published in the medical literature. The objective of this study was to outline the clinical applications of individualized 3D printing in gynecology through a scoping review. Data sources Four medical databases (Medline, Embase, Cochrane CENTRAL, Scopus) and grey literature were searched for publications meeting eligibility criteria up to 31 May 2021. Study eligibility criteria Publications were included if they were published in English, had a gynecologic context, and involved production of patient specific 3D printed product(s). Study appraisal and synthesis methods Studies were manually screened and assessed for eligibility by two independent reviewers and data were extracted using pre-established criteria using Covidence software. Results Overall, 32 studies (15 abstracts,17 full text articles) were included in the scoping review. Most studies were either case reports (12/32,38%) or case series (15/32,47%). Gynecologic sub-specialties in which the 3D printed models were intended for use included: gynecologic oncology (21/32,66%), benign gynecology (6/32,19%), pediatrics (2/32,6%), urogynecology (2/32,6%) and reproductive endocrinology and infertility (1/32,3%). Twenty studies (63%) printed 5 or less models, 6/32 studies (19%) printed greater than 5 (up to 50 models). Types of 3D models printed included: anatomical models (11/32,34%), medical devices, (2/32,6%) and template/guide/cylindrical applicators for brachytherapy (19/32,59%). Conclusions Our scoping review has outlined novel clinical applications for individualized 3D printed models in gynecology. To date, they have mainly been used for production of patient specific 3D printed brachytherapy guides/applicators in patients with gynecologic cancer. However, individualized 3D printing shows great promise for utility in surgical planning, surgical education, and production of patient specific devices, across gynecologic subspecialties. Evidence supporting the clinical value of individualized 3D printing in gynecology is limited by studies with small sample size and non-standardized reporting, which should be the focus of future studies.

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Individualized medicine using 3D printing technology in gynecology: a scoping review

Cooke

Flaxman

Sikora

et al. 2023

Preprint

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Objective: Developments in 3-dimensional (3D) printing technology has made it possible to produce high quality, affordable 3D printed models for use in medicine. As a result, there is a growing assessment of this approach being published in the medical literature. The objective of this study was to outline the clinical applications of individualized 3D printing in gynecology through a scoping review. Data Sources: Four medical databases (Medline, Embase, Cochrane CENTRAL, Scopus) and grey literature were searched for publications meeting eligibility criteria up to 31 May 2021. Study Eligibility Criteria: Publications were included if they were published in English, had a gynecologic context, and involved production of patient specific 3D printed product(s). Study Appraisal and Synthesis Methods: Studies were manually screened and assessed for eligibility by two independent reviewers and data were extracted using pre-established criteria using Covidence software. Results: Overall, 32 studies (15 abstracts,17 full text articles) were included in the scoping review. Most studies were either case reports (12/32,38%) or case series (15/32,47%). Gynecologic sub-specialties in which the 3D printed models were intended for use included: gynecologic oncology (21/32,66%), benign gynecology (6/32,19%), pediatrics (2/32,6%), urogynecology (2/32,6%) and reproductive endocrinology and infertility (1/32,3%). Twenty studies (63%) printed 5 or less models, 6/32 (19%) printed greater than 5 (up to 50 models). Types of 3D models printed included: anatomical models (11/32,34%), medical devices, (2/32,6%) and template/guide/cylindrical applicators for brachytherapy (19/32,59%). Conclusions: Our scoping review has outlined novel clinical applications for individualized 3D printed models in gynecology. To date, they have mainly been used for production of patient specific 3D printed brachytherapy guides/applicators in patients with gynecologic cancer. However, individualized 3D printing shows great promise for utility in surgical planning, surgical education, and production of patient specific devices, across gynecologic subspecialties. Evidence supporting the clinical value of individualized 3D printing in gynecology is limited by studies with small sample size and non-standardized reporting, which should be the focus of future studies.

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Custom Applicator Design and Manufacture Automation for Interstitial Gynecological Brachytherapy

Cited by 3 publications

References 13 publications

The Montreal split ring applicator: Towards highly adaptive gynecological brachytherapy using 3D-printed biocompatible patient-specific interstitial caps

The Montreal split ring applicator: Towards highly adaptive gynecological brachytherapy using 3D-printed biocompatible patient-specific interstitial caps

Individualized medicine using 3D printing technology in gynecology: a scoping review

Individualized medicine using 3D printing technology in gynecology: a scoping review

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