The Montreal split ring applicator: Towards highly adaptive gynecological brachytherapy using 3D-printed biocompatible patient-specific interstitial caps

IF 1.1 4区医学 Q4 ONCOLOGY

Journal of Contemporary Brachytherapy Pub Date : 2023-12-12 DOI:10.5114/jcb.2023.133676

Yuji Kamio, Marie-Ève Roy, Lori-Anne Morgan, Maroie Barkati, Marie-Claude Beauchemin, François DeBlois, Borko Basaric, Jean-François Carrier, Stéphane Bedwani

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引用次数: 0

Abstract

Purpose:
The addition of interstitial (IS) needles to intra-cavitary (IC) brachytherapy applicators is associated with improved outcomes in locally advanced cervical cancers involving parametrial tumor extensions. The purpose of this work was to validate a clinical workflow involving 3D-printed caps for a commercial IC split ring applicator that enable using IS needle trajectories tailored to each treatment.

Material and methods:
A dedicated software module was developed in this work allowing users to design patient-specific IS caps without knowledge of computer-aided design (CAD) software. This software module was integrated to 3D Brachy, a commercial software developed by Adaptiiv Medical Technologies Inc. For validation of the workflow, CAD models of ground truth caps with five IS needle trajectories were designed with Fusion 360™, 3D-printed, assembled with a split ring applicator, and CT-scanned with radio-opaque markers. 3D Brachy was then applied to generate a replica based on trajectories reconstructed from the radio-opaque markers. A comparison between ground truth and replicated IS needle trajectories was done using intersection points with planes at the level of the cervix (z = 0 cm) and a representative needle depth (z = 3 cm).

Results:
Prototypes of interstitial caps 3D-printed in both BioMed Amber and BioMed Clear SLA resins were tested to be functional both pre- and post-sterilization for IS needles with obliquity angles ≤ 45°. Distance-to-agreement at z = 0 cm and 3 cm as well as deviations in pitch and yaw angles of the five IS needle trajectories were found to have mean values of 3.3 ±2.1 mm, 7.3 ±2.0 mm, 2.9° ±2.3°, and 7.0° ±7.0°, respectively.

Conclusions:
The clinical workflow for image-guided adaptive cervical cancer brachytherapy using the Montreal split ring applicator was validated.

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蒙特利尔分瓣环涂抹器：利用三维打印的生物相容性患者特异性间隙帽实现高度适应性妇科近距离放射治疗

目的：在腔内近距离放射治疗器中添加间质（IS）针可改善涉及宫旁肿瘤延伸的局部晚期宫颈癌的治疗效果。材料与方法：这项工作开发了一个专用软件模块，允许用户在不了解计算机辅助设计（CAD）软件的情况下设计患者专用的IS帽。该软件模块与Adaptiiv医疗技术公司开发的商业软件3D Brachy集成。为了验证该工作流程，使用 Fusion 360™ 设计了带有五种 IS 针轨迹的真实帽的 CAD 模型，进行了三维打印，与分瓣环涂抹器组装在一起，并使用不透射线标记进行了 CT 扫描。然后应用 3D Brachy 根据不透射线标记重建的轨迹生成复制品。结果：使用 BioMed Amber 和 BioMed Clear SLA 树脂 3D 打印的间隙帽原型经过测试，在消毒前和消毒后对斜角≤45°的 IS 针均可正常使用。五种IS针轨迹在z = 0 cm和3 cm处的一致性距离以及俯仰角和偏航角偏差的平均值分别为3.3 ±2.1 mm、7.3 ±2.0 mm、2.9° ±2.3°和7.0° ±7.0°。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

2.40

自引率

14.30%

发文量

审稿时长

16 weeks

期刊介绍： The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.