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Intrapatient study comparing 3D printed bolus versus standard vinyl gel sheet bolus for postmastectomy chest wall radiation therapy James L. Robar, PhD, FCCPM, Kathryn Moran, BSc, RTT, James Allan, BSc, RTT, James Clancey, BSc, RTT, CMD, Tami Joseph, BSc, RTT, Krista Chytyk-Praznik, BSc, PhD, MCCPM, R. Lee MacDonald, BSc, MSc, John Lincoln, BSc, Parisa Sadeghi, BSc, MSc, Robert Rutledge, MD, FRCPC Practical Radiation Oncology Volume 8, Issue 4, Pages (July 2018) DOI: /j.prro Copyright © 2017 The Authors Terms and Conditions
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Figure 1 (A) Example of a 3-dimensional printed bolus, (B) locations of 7 OSLDs (labeled A to G) relative to patient and tangential fields, and (C) embedded OSLD contained by in-printed pocket, where OSLD is flush with the skin side of the bolus surface. Practical Radiation Oncology 2018 8, DOI: ( /j.prro ) Copyright © 2017 The Authors Terms and Conditions
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Figure 2 Frequency histogram of maximum dimension of airgap between bolus and patient surface as measured on cone beam computed tomography comparing sheet bolus with 3D printed bolus. Practical Radiation Oncology 2018 8, DOI: ( /j.prro ) Copyright © 2017 The Authors Terms and Conditions
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Figure 3 Examples of differences in accuracy of fit between SuperFlab sheet bolus (left) and 3D printed bolus (right) for patients with convexity (patient 4, top row) or concavity (patient 13, bottom row). See Fig 2 for abbreviations. Practical Radiation Oncology 2018 8, DOI: ( /j.prro ) Copyright © 2017 The Authors Terms and Conditions
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Figure 4 Frequency histogram of OSLD measured dose values for sheet bolus and 3D printed bolus, including all measurements, for all OSLDs and patients. See Figs 1 and 2 for abbreviations. Practical Radiation Oncology 2018 8, DOI: ( /j.prro ) Copyright © 2017 The Authors Terms and Conditions
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Figure 5 Ratio of measured over planned dose at each of the 7 OSLD locations, averaged over all fractions and patients, comparing sheet bolus (top) with 3D printed bolus (bottom). The locations of the OSLDs (indicated by A-F) are depicted in Fig 1. See Figs 1 and 2 for abbreviations. Practical Radiation Oncology 2018 8, DOI: ( /j.prro ) Copyright © 2017 The Authors Terms and Conditions
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Figure 6 Images explaining the outlying result in Fig 2 for 3D printed bolus. The patient exhibited significant anatomical change such that the final fraction (A) differed significantly from that in the first fraction (B), causing a loss of accuracy of fit. See Fig 2 for abbreviation. Practical Radiation Oncology 2018 8, DOI: ( /j.prro ) Copyright © 2017 The Authors Terms and Conditions
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