A modern mold room: Meshing 3D surface scanning, digital design, and 3D printing with bolus fabrication

• Published in: Journal of applied clinical medical physics 2019-09, Vol.20 (9), p.78-85
• Main Authors: Sasaki, David Kiyoshi, McGeachy, Philip, Alpuche Aviles, Jorge E., McCurdy, Boyd, Koul, Rashmi, Dubey, Arbind
• Format: Article
• Language: English
• Subjects: 3-D printers; 3D printing; 3D scanning; Accuracy; Aged; Aged, 80 and over; bolus; Carcinoma, Basal Cell - diagnostic imaging; Carcinoma, Basal Cell - radiotherapy; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - radiotherapy; Design; digital design; Equipment Design; Female; Humans; Image Processing, Computer-Assisted - methods; Male; Middle Aged; mold room; Organs at Risk - radiation effects; Patients; Printing, Three-Dimensional - instrumentation; Prognosis; Quality Assurance, Health Care - standards; Quality control; Radiation Oncology Physics; Radiation therapy; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted - methods; Radiotherapy, Intensity-Modulated - instrumentation; Radiotherapy, Intensity-Modulated - methods; Scanners; Skin Neoplasms - diagnostic imaging; Skin Neoplasms - radiotherapy; Software; Tomography, X-Ray Computed - methods; Tumors
• ISSN: 1526-9914; 1526-9914
• DOI: 10.1002/acm2.12703

Purpose This case series represents an initial experience with implementing 3‐dimensional (3D) surface scanning, digital design, and 3D printing for bolus fabrication for patients with complex surface anatomy where traditional approaches are challenging. Methods and Materials For 10 patients requiring bolus in regions with complex contours, bolus was designed digitally from 3D surface scanning data or computed tomography (CT) images using either a treatment planning system or mesh editing software. Boluses were printed using a fused deposition modeling printer with polylactic acid. Quality assurance tests were performed for each printed bolus to verify density and shape. Results For 9 of 10 patients, digitally designed boluses were used for treatment with no issues. In 1 case, the bolus was not used because dosimetric requirements were met without the bolus. QA tests revealed that the bulk density was within 3% of the reference value for 9 of 12 prints, and with more judicious selection of print settings this could be increased. For these 9 prints, density uniformity was as good as or better than our traditional sheet bolus material. The average shape error of the pieces was less than 0.5 mm, and no issues with fit or comfort were encountered during use. Conclusions This study demonstrates that new technologies such as 3D surface scanning, digital design and 3D printing can be safely and effectively used to modernize bolus fabrication.