Room: Exhibit Hall
Purpose: To design and print a custom patient specific template, ensuring accurate needle insertion and fixation in temporary brachytherapy treatments.
Methods: Using the patientâ€™s CT image set, we defined a PTV and determined the needle configuration needed for the procedure. Initial template structure was created using iPlan (BrainLab Inc., Munich, Germany). This structure was exported to â€œ3D Slicerâ€?, an open source software platform for medical image processing, in which the DICOM-RT file was converted to a 3D model (STL format). We conducted a post-processing of the model using AutodeskÂ® Meshmixer version 3.4.35 (Autodesk Inc.) software. First, all elements of the model were joined to a single element to enable the increment of the number of vertices and model resolution. Then, holes for the applicators and fixation stitches were created using â€?Boolean differenceâ€? operator on standard cylinders. Finally, we optimize the surface quality and appearance of the template in order to smooth the template for patient comfort. Immediately after needle insertion, a verification CT of the implant was acquired, and the template was sealed to ensure a fixed geometry is maintained for the duration of treatment.
Results: We printed the template using Uprint se plus 3D printer. A 40 needles insertion procedure was held using the template, to allow adequate coverage of the planned target volume. Good treatment geometry was achieved and maintained for the duration of the treatment.
Conclusion: As the clinical outcome is to be determined in the following weeks, the procedure pre planning using 3D printing techniques is found to be convenient, more precise and supportive to the fluency of the operation. Further, this technique setup proved a reliable platform for prolonged treatments enhancing the biological advantages of LDR brachytherapy.