Examination of Jeltrate®Plus as a tissue equivalent bolus material

Babic, Steven; Kerr, A; Westerland, Mary; Gooding, J.; Schreiner, L J

doi:10.1120/jacmp.v3i3.2560

Cited by 13 publications

(5 citation statements)

References 2 publications

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“… 5 , 6 Similarly, a three-dimensional (3D) printed bolus commonly used in breast cancer radiotherapy may reduce the air gap and dose deviation but requires a second computed tomography (CT) scan and Prolong the waiting time for treatment. 7 – 9 Early studies by Babic et al 10 have shown that dental impressions materials with excellent plasticity can be utilized in radiotherapy, but proper storage methods must be employed, such as keeping them in a water-filled container. Therefore, it is crucial to develop a bolus with high individualized conformal for clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey

Chen,

Xu,

Zeng

et al. 2024

Technol Cancer Res Treat

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Objective: To investigate the dosimetric effects of using individualized silicone rubber (SR) bolus on the target area and organs at risk (OARs) during postmastectomy radiotherapy (PMRT), as well as evaluate skin acute radiation dermatitis (ARD). Methods: A retrospective study was performed on 30 patients with breast cancer. Each patient was prepared with an individualized SR bolus of 3 mm thickness. Fan-beam computed tomography (FBCT) was performed at the first and second fractions, and then once a week for a total of 5 times. Dosimetric metrics such as homogeneity index (HI), conformity index (CI), skin dose (SD), and OARs including the heart, lungs, and spinal cord were compared between the original plan and the FBCTs. The acute side effects were recorded. Results: In targets' dosimetric metrics, there were no significant differences in Dmean and V105% between planning computed tomography (CT) and actual treatments ( P > .05), while the differences in D95%, V95%, HI, and CI were statistically significant ( P < .05). In OARs, there were no significant differences between the Dmean, V5, and V20 of the affected lung, V5 of the heart and Dmax of the spinal cord ( P > .05) except the V30 of affected lung, which was slightly lower than the planning CT ( P < .05). In SD, both Dmax and Dmean in actual treatments were increased than plan A, and the difference was statistically significant ( P < .05), while the skin-V20 and skin-V30 has no difference. Among the 30 patients, only one patient had no skin ARD, and 5 patients developed ARD of grade 2, while the remaining 24 patients were grade 1. Conclusion: The OR bolus showed good anastomoses and high interfraction reproducibility with the chest wall, and did not cause deformation during irradiation. It ensured accurate dose delivery of the target and OARs during the treatment, which may increase SD by over 101%. In this study, no cases of grade 3 skin ARD were observed. However, the potential of using OR bolus to reduce grade 1 and 2 skin ARD warrants further investigation with a larger sample size.

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Section: Introductionmentioning

confidence: 99%

Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey

Chen,

Xu,

Zeng

et al. 2024

Technol Cancer Res Treat

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“…Superflab bolus material (Mick Radio-Nuclear Instruments, Inc.) is widely used in radiotherapy clinics worldwide to provide a buildup of dose to superficial treatment volumes. [1][2][3] The homogenous material is made of a proprietary synthetic gel and designed to be tissue-equivalent at megavoltage photon energies, however its tissue-equivalence at kilovoltage x-ray energies has not been characterized. 4 Because it is readily accessible at many medical institutions with radiation oncology departments, it is worth considering the value Superflab may provide to radiology departments, as well.…”

Section: Introductionmentioning

confidence: 99%

Technical note: Water‐equivalent thickness of Superflab bolus material at diagnostic x‐ray energies

et al. 2023

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The purpose of this work was to determine the water-equivalent thickness of Superflab bolus material for narrow and broad field-of -view (FOV) x-ray geometries at diagnostic x-ray energies. Methods: Transmission measurements were performed for incremental thicknesses of Superflab bolus material and water in narrow and broad FOV x-ray geometries. The transmission data was fit to a non-linear model for x-ray transmission -the Archer model. Water-equivalent thickness of Superflab was calculated based upon fitting parameters to transmission curves for 75, 95, and 115 kV x-ray tube voltages. Measured x-ray transmission factors for water and Superflab were used to determine the water equivalence of Superflab. Results: For all x-ray tube voltages and geometries, the water equivalence of Superflab was greater than one, indicating that Superflab is more attenuating than water.This effect was stronger for broad FOV geometries.At 95 kV,30 cm of Superflab corresponded to 32.0 cm of water in the narrow FOV geometry, and 34.3 cm of water in the broad FOV geometry. The Archer model fitting parameters and Superflab water equivalence are reported for all x-ray beam conditions explored in this work. Conclusions: Superflab bolus material is more attenuating than water at diagnostic x-ray energies. The Archer model and its respective fitting parameters reported in this work may be used to estimate the water-equivalent thickness of Superflab for diagnostic x-ray spectra.

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“…However, because of the skin sparing effect of high-energy photon beams, the superficial lesions cannot receive a sufficient dose. To solve this problem, a build-up material called bolus, is often placed on the surface of the skin to maximize the radiation dose of subcutaneous tissues so as to achieve the desired dose at target position while reducing the dose in deep tissues[ 3 ]. Bolus acts as a layer of skin tissues to provide a more effective treatment to the superficial lesions[ 4 ] ( Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

3D Printing Polymer-based Bolus Used for Radiotherapy

Lü

Song

Yao

et al. 2021

ijb

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Bolus is a kind of auxiliary device used in radiotherapy for the treatment of superficial lesions such as skin cancer. It is commonly used to increase skin dose and overcome the skin-sparing effect. Despite the availability of various commercial boluses, there is currently no bolus that can form full contact with irregular surface of patients’ skin, and incomplete contact would result in air gaps. The resulting air gaps can reduce the surface radiation dose, leading to a discrepancy between the delivered dose and planned dose. To avoid this limitation, the customized bolus processed by three-dimensional (3D) printing holds tremendous potential for making radiotherapy more efficient than ever before. This review mainly summarized the recent development of polymers used for processing bolus, 3D printing technologies suitable for polymers, and customization of 3D printing bolus. An ideal material for customizing bolus should not only have the feature of 3D printability for customization, but also possess radiotherapy adjuvant performance as well as other multiple compound properties, including tissue equivalence, biocompatibility, antibacterial activity, and antiphlogosis.

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Examination of Jeltrate®Plus as a tissue equivalent bolus material

Cited by 13 publications

References 2 publications

Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey

Analysis of Individualized Silicone Rubber Bolus Using Fan Beam Computed Tomography in Postmastectomy Radiotherapy: A Dosimetric Evaluation and Skin Acute Radiation Dermatitis Survey

Technical note: Water‐equivalent thickness of Superflab bolus material at diagnostic x‐ray energies

3D Printing Polymer-based Bolus Used for Radiotherapy

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