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A Simulation-Free Replacement Solution for Radiation Therapy Immobilization Devices Using Computer Numerical Control
Samuel Hellman1, Laszlo Voros1, Victoria Y Yu1
1Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York.
Advances in Radiation Oncology
|July 25, 2024
Summary
A new simulation-free method uses CNC milling of extruded polystyrene (XPS) foam to quickly and affordably replace lost or damaged radiation therapy (RT) immobilization devices, improving patient convenience and reducing costs.
Area of Science:
- Medical Physics
- Biomedical Engineering
- Radiation Oncology
Background:
- Radiation therapy (RT) immobilization devices are crucial for accurate treatment delivery.
- Loss or damage necessitates resimulation, leading to delays, increased radiation exposure, and costs.
Purpose of the Study:
- To describe and evaluate a simulation-free method for fabricating replacement RT immobilization devices.
- To assess the feasibility, cost-effectiveness, and accuracy of this novel approach.
Main Methods:
- Utilized existing simulation scans as templates for computer numerical control (CNC) milling of extruded polystyrene (XPS) foam molds.
- Evaluated XPS material properties (attenuation, bolusing) and established a clinical workflow.
- Treated 12 patients and analyzed setup reproducibility using Dice Similarity Coefficient (DSC) and Mean Distance to Agreement (MDA).
Main Results:
- XPS foam demonstrated favorable dosimetric properties compared to standard materials.
- Replacement molds cost $242.17 and took 86.3 minutes of hands-on time, significantly faster and cheaper than resimulation.
- Setup reproducibility showed high agreement (DSC avg. 0.966, MDA avg. 2.694 mm).
Conclusions:
- CNC-milled XPS foam offers a rapid, cost-effective, and accurate alternative for replacing RT immobilization devices.
- The method ensures satisfactory patient immobilization with minimal dosimetric impact.
- This approach provides a viable solution for clinicians facing device replacement challenges.
