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首页> 外文期刊>Physics in medicine and biology. >A 3D-printed patient-specific applicator guide for use in high-dose-rate interstitial brachytherapy for tongue cancer: a phantom study
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A 3D-printed patient-specific applicator guide for use in high-dose-rate interstitial brachytherapy for tongue cancer: a phantom study

机译：用于高剂量率间质近距离放射治疗的3D印刷患者特定的涂抹器指南：幽灵研究

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摘要

A patient-specific applicator guide system (PSAG) for tongue-cancer high-dose-rate (HDR) interstitial brachytherapy (ISBT) was developed by utilizing a 3D printing technique. An effectiveness of the 3D-printed PSAG (3D-PSAG) was evaluated for HDR ISBT. Six patients with tongue cancer were retrospectively selected for this study. For each patient, a total of three virtual clinical target volumes (CTV) requiring the insertion of four catheters (CTV4), six catheters (CTV6), and eight catheters (CTV8) were defined. For each CTV, treatment plans were generated to deliver 45 Gy in nine fractions. The 3D-PSAG was fabricated using a 3D-printer and the patient's CT-images. The resulting 3D-PSAG took the form of a shell conforming to the patient's contours with tubes for catheter insertion. For each CTV, catheters were inserted into the phantom with and without the 3D-PSAG. After that, CT-images of the phantom with the inserted catheters were acquired. Differences between the planned positions and those of the actually inserted catheters were evaluated from the CT-images. Given the actual catheter insertion positions, the dose distributions were reconstructed and analyzed. The maximum positional errors with and without the 3D-PSAG were 0.2 mm and 4.5 mm, respectively. For CTV6, the D-90% values of the original plan, the reconstructed plan with the 3D-PSAG, and the reconstructed plan without the 3D-PSAG, were 48.8 +/- 1.7 Gy, 49.0 +/- 2.9 Gy, and 45.6 +/- 3.3 Gy, respectively. The D-1(cc) values for the mandible were 51.3 +/- 9.2 Gy, 61.6 +/- 8.3 Gy, and 81.1 +/- 16.7 Gy, respectively. The dose homogeneities in the CTVs into which the catheters had been inserted with the 3D-PSAG were always superior to those into which the catheters had been inserted without the 3D-PSAG. The present phantom study demonstrated the feasibility of more accurate interstitial tongue brachytherapy while simplifying the treatment process by utilizing the 3D-PSAG.
机译：通过利用3D打印技术开发了一种用于舌癌高剂量率（HDR）间隙近距离放射治疗（ISBT）的患者特异性涂抹器引导系统（PSAG）。对HDR ISBT评估了3D印刷PSAG（3D-PSAG）的有效性。回顾性为这项研究回顾性选择舌癌的六名患者。对于每位患者，定义了需要插入四个导管（CTV4），六个导管（CTV6）和八个导管（CTV8）的三个虚拟临床目标体积（CTV）。对于每个CTV，产生治疗计划以在九个部分中递送45。使用3D打印机和患者的CT图像制造3D-PSAG。得到的3D-PSAG采用壳体的形式，符合患者的轮廓，其轮廓具有用于导管插入的管。对于每个CTV，导管插入有和没有3D-PSAG的虚线中。之后，获取与插入导管的虚线的CT图像。从CT图像评估计划位置和实际插入导管之间的差异。考虑到实际的导管插入位置，重建和分析剂量分布。具有和不带3D-PSAG的最大位置误差分别为0.2mm和4.5mm。对于CTV6，原始计划的D-90％值，具有3D-PSAG的重建计划以及没有3D-PSAG的重建计划，为48.8 +/- 1.7 GY，49.0 +/- 2.9 GY，45.6 +/- 3.3 gy分别。下颌骨的D-1（CC）值分别为51.3 +/- 9.2 Gy，61.6 +/- 8.3 Gy，分别为81.1 +/- 16.7 Gy。导管已插入3D-PSAG的CTV中的剂量均匀性总是优于在没有3D-PSAG的情况下插入导管的那些。目前的幻影研究表明，通过利用3D-PSAG来简化治疗过程的同时，更准确的间质舌近距离放射治疗的可行性。

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