Prog Med Phys.  2016 Dec;27(4):196-202. 10.14316/pmp.2016.27.4.196.

Customized 3D Printed Bolus for Breast Reconstruction for Modified Radical Mastectomy (MRM)

• Ha JS
• Jung JH
• Kim MJ
• Jeon MJ
• Jang WS
• Cho YJ
• Lee IJ
• Kim JW
• Suh TS

• KMID: 2376552
• DOI: http://doi.org/10.14316/pmp.2016.27.4.196

Abstract

We aim to develop the breast bolus by using a 3D printer to minimize the air-gap, and compare it to commercial bolus used for patients undergoing reconstruction in breast cancer. The bolus-shaped region of interests (ROIs) were contoured at the surface of the intensity-modulated radiation therapy (IMRT) thorax phantom with 5 mm thickness, after which the digital imaging and communications in mdicine (DICOM)-RT structure file was acquired. The intensity-modulated radiation therapy (Tomo-IMRT) and direct mode (Tomo-Direct) using the Tomotherapy were established. The 13 point doses were measured by optically stimulated luminescence (OSLD) dosimetry. The measurement data was analyzed to quantitatively evaluate the applicability of 3D bolus. The percentage change of mean measured dose between the commercial bolus and 3D-bolus was 2.3% and 0.7% for the Tomo-direct and Tomo-IMRT, respectively. For air-gap, range of the commercial bolus was from 0.8 cm to 1.5 cm at the periphery of the right breast. In contrast, the 3D-bolus have occurred the air-gap (i.e., 0 cm). The 3D-bolus for radiation therapy reduces the air-gap on irregular body surface that believed to help in accurate and precise radiation therapy due to better property of adhesion.

Keyword

Modified radical mastectomy; Breast radiation treatment; 3D printing; Bolus

MeSH Terms

Breast Neoplasms
Breast*
Female
Humans
Luminescence
Mammaplasty*
Mastectomy, Modified Radical*
Printing, Three-Dimensional
Thorax

Figure

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  Fig. 1. 3D-bolus file converted output type by using KISSlice program.

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  Fig. 2. Air-gap measurement of distance and volume.

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  Fig. 3. The IMRT thorax phantom with OSLDs (a) and total of 13 points in horizontal, vertical and central location in breast phantom (b) (L: Lateral, M: Medial, C: Center, S: Superior, I: Inferior).

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  Fig. 4. MVCT image after applying (a) commercialized-bolus and the (b) 3D-bolus.

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  Fig. 5. DVH of (a) IMRT and (b) Direct applied for commercialized-bolus and 3D printed bolus.

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