This paper presents the design evolution, fabrication, and testing of a novel patient and organ-specific, three-dimensional (3D)-printed phantom for external beam radiation therapy (EBRT) of prostate cancer. In contrast to those found in current practice, this phantom can be used to plan and validate treatment tailored to an individual patient. It contains a model of the prostate gland with a dominant intraprostatic lesion (DIL), seminal vesicles, urethra, ejaculatory duct, neurovascular bundles, rectal wall, and penile bulb generated from a series of combined T2-weighted/dynamic contrast-enhanced magnetic resonance (MR) images. The iterative process for designing the phantom based on user interaction and evaluation is described. Using the CyberKnife System at Boston Medical Center, a treatment plan was successfully created and delivered. Dosage delivery results were validated through gamma index calculations based on radiochromic film measurements which yielded a 99.8% passing rate. This phantom is a demonstration of a methodology for incorporating high-contrast MR imaging into computed-tomography-based radiotherapy treatment planning; moreover, it can be used to perform quality assurance (QA).
Issue Section:
Research Papers
References
1.
Hoskin
, P.
, ed., 2012
, External Beam Therapy
, 2nd ed., Oxford University Press
, Oxford, UK
.2.
Podgorsak
, E. B.
, ed., 2005
, Radiation Oncology Physics: A Handbook for Teachers and Students
, IAEA
, Vienna, Austria
.3.
Schmidt
, M. A.
, and Payne
, G. S.
, 2015
, “Radiotherapy Planning Using MRI
,” Phys. Med. Biol.
, 60
(22
), pp. R323
–R361
.4.
Dowling
, J. A.
, Lambert
, J.
, Parker
, J.
, Salvado
, O.
, Fripp
, J.
, Capp
, A.
, Wratten
, C.
, Denham
, J. W.
, and Greer
, P. B.
, 2012
, “An Atlas-Based Electron Density Mapping Method for Magnetic Resonance Imaging (MRI)-Alone Treatment Planning and Adaptive MRI-Based Prostate Radiation Therapy
,” Int. J. Radiat. Oncol. Biol. Phys.
, 83
(1
), pp. e5
–e11
.5.
Paliwal
, B. R.
, Ritter
, M. A.
, McNutt
, T. R.
, Mackie
, T. R.
, Thomadsen
, B. R.
, Purdy
, J. A.
, and Kinsella
, T. J.
, 1998
, “A Solid Water Pelvic and Prostate Phantom for Imaging, Volume Rendering, Treatment Planning, and Dosimetry for an RTOG Multi-Institutional, 3-D Does Escalation Study
,” Int. J. Radiat. Oncol. Biol. Phys.
, 42
(1
), pp. 205
–211
.6.
Followill
, D. S.
, Evans
, D. R.
, Cherry
, C.
, Molineu
, A.
, Fisher
, G.
, Hanson
, W. F.
, and Ibbott
, G. S.
, 2007
, “Design, Development, and Implementation of the Radiological Physics Center's Pelvis and Thorax Anthropomorphic Quality Assurance Phantoms
,” Med. Phys.
, 34
(6
), pp. 2070
–2076
.7.
Harrison
, K. M.
, Ebert
, M. A.
, Kron
, T.
, Howlett
, S. J.
, Cornes
, D.
, Hamilton
, C. S.
, and Denham
, D. W.
, 2011
, “Design, Manufacture, and Evaluation of an Anthropomorphic Pelvic Phantom Purpose-Built for Radiotherapy Dosimetric Intercomparison
,” Med. Phys.
, 38
(10
), pp. 5330
–5337
.8.
Meakin
, J. R.
, Shepherd
, D. E. T.
, and Hukins
, D. W. L.
, 2009
, “Fused Deposition Models From CT Scans
,” Br. J. Radiol.
, 77
(918
), pp. 504
–507
.9.
Reniger
, F.
, Mehndiratta
, A.
, von Tengg-Kobligk
, H.
, Zechmann
, C. M.
, Unterhinninghofen
, R.
, Kauczor
, H.-U.
, and Giesel
, F. L.
, 2010
, “3D Printing Based on Imaging Data: Review of Medical Applications
,” Int. J. Comput. Assist. Radiol. Surg.
, 5
(4
), pp. 335
–341
.10.
Breseman
, K.
, Lee
, C. L.
, Bloch
, B. N.
, and Jaffe
, C. C.
, 2013
, “Constructing 3D-Printable CAD Models of Prostates From MR Images
,” 39th Annual Northeast Bioengineering Conference
, Syracuse, NY, pp. 27
–28
.11.
Kumar
, R.
, Sharma
, S. D.
, Despande
, S.
, Ghadi
, Y.
, Shaiju
, V. S.
, Amols
, H. I.
, and Mayya
, Y. S.
, 2010
, “Acrylonitrile Butadiene Styrene (ABS) Plastic-Based Low Cost Tissue Equivalent Phantom for Verification Dosimetry in IMRT
,” J. Appl. Clin. Med. Phys.
, 11
(1
), pp. 24
–32
.12.
Trivedi
, H.
, Turkbey
, B.
, Rastinehad
, A. R.
, Benjamin
, C. J.
, Bernardo
, M.
, Pohida
, T.
, Shah
, V.
, Merino
, M. J.
, Wood
, B. J.
, Linehan
, W. M.
, Venkatesan
, A. M.
, Choyke
, P. L.
, and Pinto
, P. A.
, 2012
, “Use of Patient-Specific MRI-Based Prostate Mold for Validation of Multiparametric MRI in Localization of Prostate Cancer
,” Urology
, 79
(1
), pp. 233
–239
.13.
Leary
, M.
, Kron
, T.
, Keller
, C.
, Franich
, R.
, Lonshi
, P.
, Subic
, A.
, and Brandt
, M.
, 2015
, “Additive Manufacture of Custom Radiation Dosimetry Phantoms: An Automated Method Compatible With Commercial Polymer 3D Printers
,” Mater. Des.
, 86
, pp. 487
–499
.14.
Madamesila
, J.
, McGeachy
, P.
, Eduardo Villarreal Barajas
, J.
, and Khan
, R.
, 2016
, “Characterizing 3D Printing in the Fabrication of Variable Density Phantoms for Quality Assurance of Radiotherapy
,” Phys. Med.
, 32
(1
), pp. 242
–247
.15.
Ehler
, E. D.
, Barney
, B. M.
, Higgins
, P. D.
, and Dusenbery
, K. E.
, 2014
, “Patient Specific 3D Printed Phantom for IMRT Quality Assurance
,” Phys. Med. Biol.
, 59
(19
), pp. 5763
–5773
.16.
Clark
, K.
, Vendt
, B.
, Smith
, K.
, Freymann
, J.
, Kirby
, J.
, Koppel
, P.
, Moore
, S.
, Phillips
, S.
, Maffitt
, D.
, Pringle
, M.
, Tarbox
, L.
, and Prior
, F.
, 2013
, “The Cancer Imaging Archive (TCIA): Maintaining and Operating a Public Information Repository
,” J. Digit. Imaging
, 26
(6
), pp. 1045
–1057
.17.
Fedorov
, A.
, Beichel
, R.
, Kalpathy-Cramer
, J.
, Finet
, J.
, Fillion-Robin
, J.-C.
, Pujol
, S.
, Bauer
, C.
, Jennings
, D.
, Fennessy
, F. M.
, Sonka
, M.
, Buatti
, J.
, Aylward
, S. R.
, Miller
, J. V.
, Pieper
, S.
, and Kikinis
, R.
, 2012
, “3D Slicer as an Image Computing Platform for the Quantitative Imaging Network
,” Magn. Reson. Imaging.
, 30
(9
), pp. 1323
–1341
.18.
Ross
, C.
, Donlon
, E.
, Kessler
, A.
, Lee
, C.
, Xiang
, H.
, Jaffe
, C. C.
, and Bloch
, B. N.
, 2015
, “Patient and Organ Specific Quality Assurance Phantom Insert for Stereotactic Body Radiation Therapy of Prostate Cancer
,” J. Med. Device.
, 9
(2
), p. 020938
.19.
Heyns
, M.
, Breseman
, K.
, Lee
, C. L.
, Bloch
, B. N.
, Jaffe
, C.
, and Xiang
, H.
, 2013
, “Design of a Patient-Specific Radiotherapy Treatment Target
,” 39th Annual Northeast Bioengineering Conference
, Syracuse, NY, Apr. 5–7, pp. 171
–172
.20.
Alshammari
, M.
, 2016
, “Treatment Planning and Dosimetric Verification of Cyberknife Prostate SBRT (Sterotatic Body Radiation Therapy) on an MR-Based 3D Prostate Model Imaging Insert in a Pelvis Phantom
,” M.S. thesis
, Boston University School of Medicine, Boston, MA.https://hdl.handle.net/2144/1680521.
RTOG-0938 Protocol Information, 2018,
“Radiation Therapy in Treating Patients With Prostate Cancer
,” U.S. National Library of Medicine, Bethesda, MD, accessed July 19, 2018, https://clinicaltrials.gov/ct2/show/results/NCT0143429022.
Drzymala
, R. E.
, Mohan
, R.
, Brewster
, L.
, Chu
, J.
, Goitein
, M.
, Harms
, W.
, and Urie
, M.
, 1991
, “Dose-Volume Histograms
,” Int. J. Radiat. Oncol. Biol. Phys.
, 21
(1
), pp. 71
–78
.23.
Micke
, A.
, Lewis
, D. F.
, and Yu
, X.
, 2011
, “Multichannel Film Dosimetry With Nonuniformity Correction
,” Med. Phys.
, 38
(5
), pp. 2523
–2534
.24.
Low
, D. A.
, Harms
, W. B.
, Mutic
, S.
, and Purdy
, J. A.
, 1997
, “A Technique for the Quantitative Evaluation of Dose Distributions
,” Med. Phys.
, 25
(5
), pp. 656
–661
.25.
Ju
, T.
, Simpson
, T.
, Deasy
, J. O.
, and Low
, D. A.
, 2008
, “Geometric Interpretation of the g Dose Distribution Comparison Technique: Interpolation-Free Calculation
,” Med. Phys.
, 35
(3
), pp. 879
–887
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