Workload implications for clinic workflow with implementation of three-dimensional printed customized bolus for...

Area of Science:

• Veterinary Radiation Oncology
• Medical Physics
• Biomedical Engineering

Background:

• Commercially available radiation therapy bolus often exhibits poor conformity to patient surfaces, potentially compromising tumor control, especially for superficial tumors, due to air gaps.
• Three-dimensional (3D) printing offers a promising solution for creating patient-specific, customized bolus with high precision and affordability.

Purpose of the Study:

• To evaluate the time efficiency and clinical fit of a 3D printing workflow for customized bolus in companion animals undergoing radiation therapy.
• To assess the impact of 3D printed bolus on radiation dose distribution at the skin surface.

Main Methods:

• A workflow for 3D printing patient-specific bolus was developed and implemented for companion animals with spontaneous tumors.
• Time from image segmentation to bolus generation was recorded.
• Clinical fit was assessed by comparing 3D printed bolus deviation to planned bolus and conventional bolus.
• Skin surface dose was verified for accuracy.

Main Results:

• The mean and median times from segmentation to 3D printed bolus generation were 6.15 and 5.25 hours, respectively.
• 3D printed bolus demonstrated significantly less deviation from the planned bolus compared to conventional bolus (p = 0.0078).
• 88% of measurements showed skin surface dose within 5% agreement of the expected dose.
• Clinically acceptable customized bolus was produced within one working day.

Conclusions:

• A 3D printing workflow can successfully produce customized, clinically acceptable bolus for companion animal radiation therapy within one working day.
• This technology significantly improves bolus fit and dose accuracy compared to conventional methods.
• Quality assurance is recommended for clinical implementation of 3D printing in radiotherapy.