Influence of backscatter radiation on cranial reconstruction implants

Sakamoto, Yoshiaki; Koike, Naoyoshi; Takei, Hiroyuki; Ohno, Mari; Miwa, Takaki; Yoshida, Kazunari; Shigematsu, Naoyuki; Kishi, Kazuo

doi:10.1259/bjr.20150537

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…In this, it must be mentioned that (1) the time between CT scanning, cranioplasty manufacturing, and performing surgery should be minimized due to interim growth of the tumor; (2) presence of malignant tumors may require further radiation therapy; therefore, the implants material should be chosen to prevent radiation ulcers. Considering this, titanium does not seem to be the best choice due to high backscatter radiation to the scalp among other materials (21).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Simultaneous Resection of Bone Tumor and CAD/CAM Titanium Cranioplasty in Fronto-Orbital Region

et al. 2021

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Background: Simultaneous resection of bone tumors in the fronto-naso-orbital region is a great challenge due to the need for adequate reconstruction of the facial skeleton. Pre-operative virtual planning of resection margins and the simultaneous fabrication of the cranioplasty using computer-aided design/computer-aided manufacturing (CAD/CAM) technology could allow combining the tumor resection and cosmetic restoration steps into a single procedure.Methods: We present five consecutive cases of patients with bone tumors of the fronto-naso-orbital region. The indications for surgery included: (1) the presence of a major cosmetic defect; (2) progressive tumor growth. The histological examination revealed vascular malformation, hemangioma, and fibrous dysplasia in two cases. Tumor resection was performed with the help of a drilling template in form of a tumor. The computer-designed cranioplasty formed based on the non-involved side of the skull of the patient was manufactured. In one patient, the reconstruction was performed using two separate implants.Results: The position of the implant fits in with pre-operative planning in two cases; in those cases, the additional trimming of the implant or bone defect was required. Good cosmetic outcomes were noted in all patients, and no complications occurred. No repeat surgery was necessary. The template has proved to have high application potential.Conclusion: Simultaneous resection and CAD/CAM cranioplasty in the case of bone tumors in the fronto-orbital region is a promising technique with the aim of minimizing operation time and achieving a good esthetic outcome.

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Section: Discussionmentioning

confidence: 99%

Case Report: Simultaneous Resection of Bone Tumor and CAD/CAM Titanium Cranioplasty in Fronto-Orbital Region

et al. 2021

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“…The radiation dose increases most on top of the implant and the effect of metallic reconstruction materials on radiation is inevitable even with careful planning . The scattering caused by titanium plates during radiotherapy is greater with thicker plates than with smaller and thinner ones.…”

Section: Discussionmentioning

confidence: 99%

“…Our results show that different implantable reconstructive materials used in head and neck surgery and neurosurgery affect the radiation dose in the surroundings of the implanted material. Sakamoto et al studied the effect of different implants used in cranial surgery. The radiation dose increased most due to scattering with titanium and with growing radiation energy which is in accordance with our results.…”

Section: Discussionmentioning

confidence: 99%

Scattering of therapeutic radiation in the presence of craniofacial bone reconstruction materials

Toivonen

Björkqvist

Minn

et al. 2019

J Applied Clin Med Phys

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PurposeRadiation scattering from bone reconstruction materials can cause problems from prolonged healing to osteoradionecrosis. Glass fiber reinforced composite (FRC) has been introduced for bone reconstruction in craniofacial surgery but the effects during radiotherapy have not been previously studied. The purpose of this study was to compare the attenuation and back scatter caused by different reconstruction materials during radiotherapy, especially FRC with bioactive glass (BG) and titanium.MethodsThe effect of five different bone reconstruction materials on the surrounding tissue during radiotherapy was measured. The materials tested were titanium, glass FRC with and without BG, polyether ether ketone (PEEK) and bone. The samples were irradiated with 6 MV and 10 MV photon beams. Measurements of backscattering and dose changes behind the sample were made with radiochromic film and diamond detector dosimetry.ResultsAn 18% dose enhancement was measured with a radiochromic film on the entrance side of irradiation for titanium with 6 MV energy while PEEK and FRC caused an enhancement of 10% and 4%, respectively. FRC‐BG did not cause any measurable enhancement. The change in dose immediately behind the sample was also greatest with titanium (15% reduction) compared with the other materials (0–1% enhancement). The trend is similar with diamond detector measurements, titanium caused a dose enhancement of up to 4% with a 1 mm sample and a reduction of 8.5% with 6 MV energy whereas FRC, FRC‐BG, PEEK or bone only caused a maximum dose reduction of 2.2%.ConclusionsGlass fiber reinforced composite causes less interaction with radiation than titanium during radiotherapy and could provide a better healing environment after bone reconstruction.

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“…Титан является оптимальным материалом в случае одноэтапного удаления опухоли с проведением пластики дефекта при доброкачественных опухолях. Данную технологию возможно использовать и при хирургической резекции злокачественных опухолей [27], однако из-за его высокой способности отражать излучение возрастает риск образования лучевых язв мягких тканей головы [28]. В случае злокачественных опухолей следует также отметить необходимость минимизации временных сро-ков между проведением компьютерной томографии и созданием шаблона, учитывая их быстрый инвазивный рост.…”

Section: Russian Journal Of Neurosurgeryunclassified

Resection of tumors of the cranial bones with single-step defect reconstruction using a personalized implant

Yashin,

Zinatullin,

Bratsev

et al. 2024

Nejrohirurgiâ (Mosk.)

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Background. In patients with skull bone tumors, it was demonstrated that not only the oncological but also the cosmetic result has a significant influence on the long-term outcome. The traditional approach to the surgical treatment of tumor lesions of the skull bones is removal of the tumor and intraoperative modeling an artificial bone flap without a template. Recently, the technology of simultaneous resection and computer-aided design/computer-aided manufacturing (CAD/CAM) cranioplasty has received more and more attention.Aim. To compare the results of surgical treatment of patients with tumors of the cranial bones using the traditional approach (intraoperative formation of a plate to close the defect) and simultaneous resection followed by plastic surgery of the defect with a personalized implant made using preoperative virtual modeling.Materials and methods. The study included 24 patients with tumors of the skull or meningiomas with extracranial growth. Depending on the surgical procedure, patients were divided into 2 groups: group 1 (n = 13) – the technology of simultaneous resection and CAD/CAM cranioplasty; group 2 (n = 11) – where surgery was performed using a traditional approach based on intraoperative modeling an artificial bone flap without a template.Results. There were no statistically significant differences between groups in gender, age, time of surgery, blood loss, or time in hospital. The use of simultaneous resection and CAD/CAM cranioplasty did not demonstrate a statistically significant better result in terms of maintaining skull symmetry compared to the traditional approach. All patients had a good cosmetic result and there were no complications.Conclusion. The technology of simultaneous resection and CAD/CAM cranioplasty is an effective method of treating patients with neoplasmas of the skull bones. Despite the absence of statistically significant differences in the results of treatment of cranial bone tumors between this method and the traditional approach based on intraoperative modeling an artificial bone flap without a template this method seems to be a more precise providing the best cosmetic effect in patients with lesion in fronto-orbital region.

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Influence of backscatter radiation on cranial reconstruction implants

Cited by 6 publications

References 16 publications

Case Report: Simultaneous Resection of Bone Tumor and CAD/CAM Titanium Cranioplasty in Fronto-Orbital Region

Case Report: Simultaneous Resection of Bone Tumor and CAD/CAM Titanium Cranioplasty in Fronto-Orbital Region

Scattering of therapeutic radiation in the presence of craniofacial bone reconstruction materials

Resection of tumors of the cranial bones with single-step defect reconstruction using a personalized implant

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