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Intensity modulated Ir-192 brachytherapy using high-Z 3D printed applicators.
Lawrie B Skinner1, Thomas Niedermayr1, Nicolas Prionas2
1Radiation Oncology, Stanford University, Stanford, CA, United States of America.
Physics in Medicine and Biology
|June 11, 2020
Summary
New shielded applicators for gynecologic brachytherapy allow precise dose modulation. These designs enable significant dose reduction in specific areas while maintaining symmetry, improving treatment precision and sparing organs at risk.
Area of Science:
- Medical Physics
- Oncology
- Biomedical Engineering
Background:
- Current Ir-192 brachytherapy for gynecologic cancers offers limited radial dose control.
- Asymmetric tumor shapes necessitate advanced dose modulation capabilities.
Purpose of the Study:
- To develop and evaluate shielded brachytherapy applicator designs for precise dose modulation.
- To achieve asymmetric and symmetric dose distributions for improved treatment planning.
Main Methods:
- Developed a 2D calculation algorithm to screen applicator designs.
- Utilized Monte Carlo and Boltzmann-solver algorithms for detailed dose calculations.
- Investigated 3D printing with biocompatible and tungsten-loaded plastics.
Main Results:
- Shielded designs allow dose reduction >50% at 5mm from the surface in targeted regions.
- Achieved radially symmetric dose distributions with <0.5mm isodose line deviation.
- Treatment times were <1.4x longer than unshielded applicators for equivalent symmetric dose.
Conclusions:
- Shielded brachytherapy applicators enable significant dose shaping and organ-at-risk sparing.
- 2D algorithms and 3D printing facilitate rapid design evaluation and prototyping.
- These advancements offer improved precision in gynecologic brachytherapy without compromising treatment efficacy.
