In-house development of CT-based 3D-printed head & neck phantom for Radiotherapy applications

Anthropomorphic phantoms are widely used in Radiotherapy for quality assurance (QA), treatment verification and dosimetric validation purposes. However, commercially available anthropomorphic phantoms are expensive and offers limited customization, restricting their broader clinical use. The advancement three-dimensional (3D) printing technology has provided a versatile and cost-effective approach for fabrication of such patient-specific anthropomorphic phantoms with accurate anatomical and radiological properties.

This study aims to design, fabricate and evaluate a CT-based Head & Neck anthropomorphic phantom using 3D printing technique for Radiotherapy applications.

The design of the phantom is developed from the computed tomography (CT) images of a male patient. Relevant organs such as brain, eyes, trachea, thyroid, skull, mandible, spine, soft tissue etc were segmented and reconstructed. Suitable tissue-equivalent materials compatible with 3D printing were selected and optimized to replicate the radiological properties of the human tissues. CT scan images of the fabricated phantom were acquired using a CT simulator. Hounsfield Unit (HU) values of each organ was compared with the patient CT data to assess tissue equivalence and uniformity. For dosimetric evaluation of the phantom, the acquired CT images of the fabricated phantom were imported into the treatment planning system (TPS). A treatment plan was generated in TPS to deliver 2 Gy dose to planning target volume (PTV) and executed in a 6MV Linear accelerator. Dose verification was performed by placing thermoluminescent dosimeters (TLDs) at predefined locations within the PTV and organs at risk (OARs). Measured doses were compared with TPS-calculated dose values to evaluate dosimetric accuracy.

The developed phantom demonstrated good agreement between the patient CT data and the phantom CT images. The agreement of HU values across analyzed slices was within 5%, indicating accurate replication of tissue-equivalent attenuation properties. Intra-organ HU uniformity was also within 5%, confirming consistent material composition and printing quality. Dosimetric comparison revealed that deviations between TPS-calculated and TLD-measured doses were less than 5% within the PTV, 1%-5% for OARs, and 7%-9% at distal exit dose measurement points. The PTV received approximately 190cGy, showing good agreement between planned and delivered doses. Larger percentage deviations observed at distal exit points, where doses were below 10 cGy, were attributed primarily to detector uncertainties and increased measurement uncertainty at low dose levels rather than inaccuracies in phantom design or treatment delivery.

The developed 3D-printed CT-based indigenous Head & Neck phantom accurately replicates both the anatomical and tissue equivalence characteristics of the patient CT data. The phantom demonstrated reliable dosimetric parameters supporting its suitability for Radiotherapy applications. The phantom is customizable, simple to use, cost effective and could be a promising alternative to commercial anthropomorphic phantoms.