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Generation and Applications of 3D Printed Patient Specific Devices for Proton Therapy


X Ding

X Ding1*, A Witztum1, M Reiche2,B Teo1, L Yin1, H Lin1, a olszanski1, J Fiene2, A Kassaee1, (1) University of Pennsylvania, Philadelphia, Perelman Center for Advanced Medicine, PA, (2) University of Pennsylvania, Philadelphia, Department of Mechanical Engineering and Applied Mechanics, PA,

MO-B-Salon AB-8 Monday 10:00:00 AM - 12:00:00 PM Room: Salon AB

Purpose:
We introduce a simple method to use 3D printers to manufacture patient specific bolus and supporting devices created in a Treatment Planning System (TPS) for proton therapy.

Methods:
One brain and one left partial breast proton patient were included in this study. During the planning process, boluses were designed in order to optimize the dose distribution. For the brain patient, a 5cm thick bolus was created to shift the proton range in order to treat the superficial nasal area using Pencil Beam Scanning (PBS) technique. For the left partial breast patient, a custom bolus which can be attached to the breast board was generated. DICOM RT structure set files of bolus structures were exported from the TPS and converted to stereolithography format (STL) for 3D printer. The relative stopping power of the 3D printed material, ABSplus-P430 (Stratasys Incorporated, MN, USA) were measured using the Zebra Multi-layer ionization chamber system (IBA Dosimetry GmbH, Schwarzenbruck, Germany).

Results:
The geometric difference between TPS bolus structure and corresponding STL structure was within 0.2 mm based on analysis performed using MATLAB. The relative stopping power of the material, ABSplus-P430 was 1.05 which is almost water equivalent. From planning perspective, for the partial breast patient, with the option of using PBS plan with 3D-bolus, the skin maximum dose and nipple dose were significantly reduced. Homogeneity of the PBS proton plan were also greatly improved compared to the passive scattering plan as well. It not only gives us an option to treat using PBS technique, but also can be used as a supporting and immobilization device.

Conclusion:
3D printers can be used to accurately manufacture patient specific boluses from the TPS. The ability to create and construct complex patient specific bolus structures provides a new dimension in creating optimized quality treatment plans.


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