The design of an individualized cylindrical vaginal applicator with oblique guide holes using 3D modeling and printing technologies

Zhao, Zhigang; Tang, Xiaodi; Mao, Zhuang; Zhao, Hongfu

doi:10.5114/jcb.2019.88441

Cited by 17 publications

(15 citation statements)

References 14 publications

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“…As shown in Table 3 , the range of false negative cases was 1-25 (0.8-21.0%), which indicates that in some patients in previous fractions of predictive dose, the planning aim dose was not achieved, but ACEQD 2 reached the planning aim dose. This result is due to our positive adjustment, when TEPB n did not achieve the planning aim dose, including changed applicator [ 27 ], interstitial needles’ optimization [ 15 , 28 , 29 , 30 ], or/and optimized bladder volume [ 31 , 32 ]. We also found that the false negative values gradually decreased with BT, from 10-25 (8.4-21.0%) of TEPB 1 to 1-7 (0.8-5.9%) of TEPB 2 and to 1-5 (0.8-4.2%) of TEPB 3 .…”

Section: Discussionmentioning

confidence: 99%

Predictive value of Excel forms based on an automatic calculation of dose equivalent in 2 Gy per fraction in adaptive brachytherapy for cervical cancer

Cheng

Liu

et al. 2020

jcb

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Purpose External beam radiotherapy (EBRT) combined with brachytherapy (BT) is the standard mode of radical radiotherapy for locally advanced cervical cancer. The cumulative equivalent doses in 2 Gy per fraction (EQD 2 ) is an important basis for estimating the probability of local control of tumors and monitoring the occurrence of side effects in normal tissues. The purpose of this study was to explore the predictive value of Excel forms based on an automatic calculation in radical adaptive BT for cervical cancer. Material and methods A retrospective analysis of 119 patients suffering from cervical cancer, treated with radical radiotherapy. All patients were treated with EBRT and adaptive BT. EBRT prescribed dose was 42.0-50.4 Gy in 21-28 fractions. BT nominal prescribed dose was 28 Gy in 4 fractions, separated by one week. Total EQD 2 prediction at nth ( n = 1-3) BT (TEPB n ) or actual cumulative EQD 2 (ACEQD 2 ) can be calculated automatically by inputting the physical dose based on an in-house designed application. The relationship between TEPB n and ACEQD 2 was evaluated, and the predictive value of Excel forms based on the automatic calculation was analyzed. Results For the volume of high-risk clinical target, there was a significant decrease between BT1 and BT2. Similarly, for the volume of intermediate-risk clinical target, there was a significant decrease between BT2 and BT3. The sensitivity ranges of TEPB 1 , TEPB 2 , and TEPB 3 prediction were 74.5-91.3%, 83.7-95.7%, and 92.9-99.1%, respectively, and the specificity ranges were 46.7-80.0%, 53.3-90.5%, and 66.7-90.5%, respectively. Conclusions The in-house designed application has the function of quickly reading dose-volume histogram (DVH) parameters from the treatment planning system, which allows for balance between the total dose to target volumes and organs at risk (OARs). Excel forms based on EQD 2 automatic calculation presents high predictive accuracy.

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Section: Discussionmentioning

confidence: 99%

Predictive value of Excel forms based on an automatic calculation of dose equivalent in 2 Gy per fraction in adaptive brachytherapy for cervical cancer

Cheng

Liu

et al. 2020

jcb

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“…Personalized vaginal applicators are one of the choices to overcome these limitations of commercially used vaginal applicators [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Traditional technique, such as mold technique, is costly and time-consuming to create personalized vaginal applicator for each patient [ 23 ].…”

Section: Purposementioning

confidence: 99%

Manufacturing and evaluation of multi-channel cylinder applicator with 3D printing technology

Mohammadi¹,

Siavashpour²,

Aghdam³

et al. 2021

jcb

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Purpose: This study was designed to assess dosimetric characteristics of 3D-printed personalized multi-channel cylinder applicator (MCCA). Material and methods: UnionTech RS Pro 600 (UnionTech, Inc., Shanghai, China) 3D printer was used for manufacturing MCCA. The geometry of MCCA was designed with Fusion 360 v.2.0.5827 (Autodesk, Inc.) software. The designed file was exported to Meshmixer v.3.5 (Autodesk, Inc.) to create three-dimensional model in stereolithography (STL) file format, which is the common file format for inputting data to 3D printers. We used high-temp resin, FLHTAM02 model (Formlabs Inc., MA, USA), as material in 3D printing process. This resin model has good resistance to high temperature and compatibility with various solvents. We created a simple cubic shape phantom for dosimetric evaluation of the applicator with Gafchromic EBT3 films. Also, Monte Carlo method was applied to simulate MCCA in the same configuration as in experimental test. Results: The mean ± standard deviation (SD) difference between measured and calculated doses in treatment planning system (TPS) for all control points was 0.0860 ±0.0393 Gy, corresponding to 4.01 ±1.21%. The mean ±SD difference between doses calculated by Monte Carlo simulation and TPS for all control points was 0.0996 ±0.0471 Gy, corresponding to 4.58 ±1.05%. The mean ±SD of dose difference between film measurement and Monte Carlo simulation for all control points was 0.0136 ±0.0200 Gy, corresponding to 0.60 ±0.69%. P-value for dose difference between film measurement and TPS, Monte Carlo and TPS, and film measurement and Monte Carlo were 0.7, 0.66, and 0.95, respectively. Conclusions: Dosimetric results and mechanical accuracy of MCCA show that high-temp resin with SLA 3D printing technique can be used for producing patient-specific MCCA in brachytherapy.

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“…Preplanning is always essential and crucial to obtain a personalized 3D guidance template that can achieve the geometric description of inserted needles as well as the anticipated dose distribution in the target volume and OARs. 16,17 Huang et al 18 designed individual printed templates based on preplanning data that included 125 I seed locations and needle pathways for low-dose-rate radiation in patients with head and neck cancers. Sethi et al 19 inversely designed and printed 3D cylindrical templates through a preplanning process used for the pure interstitial therapy of two patients with vaginal tumors.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of preplan‐based three‐dimensional individual template‐guided brachytherapy compared to freehand implantation

Zhang

Sun

et al. 2022

J Applied Clin Med Phys

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Image‐guided adaptive intracavitary/interstitial brachytherapy (IC/IS IGABT) has exhibited superior dosimetry advantage and local control for locally advanced cervical cancer (LACC). Our group designed a type of cylindrical three‐dimensional (3D) printed vaginal template combining an intracavitary applicator with straight and oblique interstitial needles according to the preplan on computed tomography images. This work aimed to research the consistency of the preplan with the treatment plan at every fraction to verify the practical guiding significance of the preplan. We also investigated the difference between 3D‐printed template‐guided implantation compared with freehand implantation for LACC. Twenty‐six patients were treated with 3D‐printed individual templates (3D template group), and 20 patients were treated by using freehand insertion (freehand group). Patients in the 3D template group would take a preplan one week before treatment to design and print the individual template, while the freehand group did not. All patients accepted volumetric rotational intensity‐modulated radiotherapy at a dose of 49.4 Gy in 26 fractions and subsequent brachytherapy at a dose of 26 Gy in four fractions. All analyses were performed by utilizing SPSS 26. The insertion depth was decreased in fractions 1 and 4 compared with the preplan. None of the dose volume histogram parameters of fractions 1–3, nor the D2cc of bladder and bowel at fraction 4 were barely changed compared with the preplan. The D90 and D98 of the high‐risk clinical target volume in the 3D template group were statistically higher than those in the freehand group (p < 0.01). The D2cc of the rectum, bladder, bowel, and sigmoid in the 3D template group were all lower than those in the freehand group (p < 0.01). The preplan in this research is consistent with treatment plans, which is important to ensure the feasibility of applying a 3D‐printed template in brachytherapy. The 3D‐printed individual guidance template was an effective method in brachytherapy for locally advanced cervical cancer.

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The design of an individualized cylindrical vaginal applicator with oblique guide holes using 3D modeling and printing technologies

Cited by 17 publications

References 14 publications

Predictive value of Excel forms based on an automatic calculation of dose equivalent in 2 Gy per fraction in adaptive brachytherapy for cervical cancer

Predictive value of Excel forms based on an automatic calculation of dose equivalent in 2 Gy per fraction in adaptive brachytherapy for cervical cancer

Manufacturing and evaluation of multi-channel cylinder applicator with 3D printing technology

Characteristics of preplan‐based three‐dimensional individual template‐guided brachytherapy compared to freehand implantation

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