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Technical note: Evaluation of a silicone‐based custom bolus for radiation therapy of a superficial pelvic tumor

PURPOSE: Use of standard‐of‐care radiation therapy boluses may result in air‐gaps between the target surface and bolus, as they may not adequately conform to each patient's unique topography. Such air‐gaps can be particularly problematic in cases of superficial pelvic tumor radiation, as the de...

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Autores principales: Wang, Karissa M., Rickards, Amanda J., Bingham, Trevor, Tward, Jonathan D., Price, Ryan G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8992939/
https://www.ncbi.nlm.nih.gov/pubmed/35084098
http://dx.doi.org/10.1002/acm2.13538
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author Wang, Karissa M.
Rickards, Amanda J.
Bingham, Trevor
Tward, Jonathan D.
Price, Ryan G.
author_facet Wang, Karissa M.
Rickards, Amanda J.
Bingham, Trevor
Tward, Jonathan D.
Price, Ryan G.
author_sort Wang, Karissa M.
collection PubMed
description PURPOSE: Use of standard‐of‐care radiation therapy boluses may result in air‐gaps between the target surface and bolus, as they may not adequately conform to each patient's unique topography. Such air‐gaps can be particularly problematic in cases of superficial pelvic tumor radiation, as the density variation may result in the radiation delivered to the target site being inconsistent with the prescribed dose. To increase bolus fit and thereby dose predictability and homogeneity, we designed and produced a custom silicone bolus for evaluation against the clinical standard. METHODS: A custom bolus was created for the pelvic regions of both an anthropomorphic phantom and a pelvic patient with squamous cell carcinoma of the penile shaft. Molds were designed using computed tomography (CT) scans, then 3D‐printed and cast with silicone rubber to yield the boluses. Air‐gap measurements were performed on custom and standard‐of‐care Superflab gel sheet boluses by analyzing total volume between the bolus and target surface, as measured from CT scans. Therapeutic doses of radiation were delivered to both boluses. Radiation dose was measured and compared to the expected dose using nine optically stimulated luminescent dosimeters (OSLDs) placed on the phantom. RESULTS: Mean air‐gap volume between the bolus and phantom was decreased from 314 ± 141 cm(3) with the standard bolus to 4.56 ± 1.59 cm(3) using the custom device. In the case of the on‐treatment patient, air‐gap volume was reduced from 169 cm(3) with the standard bolus to 46.1 cm(3) with the custom. Dosimetry testing revealed that the mean absolute difference between expected and received doses was 5.69%±4.56% (15.1% maximum) for the standard bolus and 1.91%±1.31% (3.51% maximum) for the custom device. Areas of greater dose difference corresponded to areas of larger air‐gap. CONCLUSIONS: The custom bolus reduced air‐gap and increased predictability of radiation dose delivered compared to the standard bolus. The custom bolus could increase the certainty of prescribed dose‐delivery of radiation therapy for superficial tumors.
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spelling pubmed-89929392022-04-13 Technical note: Evaluation of a silicone‐based custom bolus for radiation therapy of a superficial pelvic tumor Wang, Karissa M. Rickards, Amanda J. Bingham, Trevor Tward, Jonathan D. Price, Ryan G. J Appl Clin Med Phys Technical Notes PURPOSE: Use of standard‐of‐care radiation therapy boluses may result in air‐gaps between the target surface and bolus, as they may not adequately conform to each patient's unique topography. Such air‐gaps can be particularly problematic in cases of superficial pelvic tumor radiation, as the density variation may result in the radiation delivered to the target site being inconsistent with the prescribed dose. To increase bolus fit and thereby dose predictability and homogeneity, we designed and produced a custom silicone bolus for evaluation against the clinical standard. METHODS: A custom bolus was created for the pelvic regions of both an anthropomorphic phantom and a pelvic patient with squamous cell carcinoma of the penile shaft. Molds were designed using computed tomography (CT) scans, then 3D‐printed and cast with silicone rubber to yield the boluses. Air‐gap measurements were performed on custom and standard‐of‐care Superflab gel sheet boluses by analyzing total volume between the bolus and target surface, as measured from CT scans. Therapeutic doses of radiation were delivered to both boluses. Radiation dose was measured and compared to the expected dose using nine optically stimulated luminescent dosimeters (OSLDs) placed on the phantom. RESULTS: Mean air‐gap volume between the bolus and phantom was decreased from 314 ± 141 cm(3) with the standard bolus to 4.56 ± 1.59 cm(3) using the custom device. In the case of the on‐treatment patient, air‐gap volume was reduced from 169 cm(3) with the standard bolus to 46.1 cm(3) with the custom. Dosimetry testing revealed that the mean absolute difference between expected and received doses was 5.69%±4.56% (15.1% maximum) for the standard bolus and 1.91%±1.31% (3.51% maximum) for the custom device. Areas of greater dose difference corresponded to areas of larger air‐gap. CONCLUSIONS: The custom bolus reduced air‐gap and increased predictability of radiation dose delivered compared to the standard bolus. The custom bolus could increase the certainty of prescribed dose‐delivery of radiation therapy for superficial tumors. John Wiley and Sons Inc. 2022-01-27 /pmc/articles/PMC8992939/ /pubmed/35084098 http://dx.doi.org/10.1002/acm2.13538 Text en © 2022 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Technical Notes
Wang, Karissa M.
Rickards, Amanda J.
Bingham, Trevor
Tward, Jonathan D.
Price, Ryan G.
Technical note: Evaluation of a silicone‐based custom bolus for radiation therapy of a superficial pelvic tumor
title Technical note: Evaluation of a silicone‐based custom bolus for radiation therapy of a superficial pelvic tumor
title_full Technical note: Evaluation of a silicone‐based custom bolus for radiation therapy of a superficial pelvic tumor
title_fullStr Technical note: Evaluation of a silicone‐based custom bolus for radiation therapy of a superficial pelvic tumor
title_full_unstemmed Technical note: Evaluation of a silicone‐based custom bolus for radiation therapy of a superficial pelvic tumor
title_short Technical note: Evaluation of a silicone‐based custom bolus for radiation therapy of a superficial pelvic tumor
title_sort technical note: evaluation of a silicone‐based custom bolus for radiation therapy of a superficial pelvic tumor
topic Technical Notes
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8992939/
https://www.ncbi.nlm.nih.gov/pubmed/35084098
http://dx.doi.org/10.1002/acm2.13538
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