3D printing in brachytherapy: A systematic review of gynecological applications

Fahimian, B; Liu, Wu; Skinner, Lawrie; Yu, Amy S.; Phillips, Tiffany R; Steers, Jennifer M.; DeMarco, John J.; Fraass, Benedick A.; Kamrava, Mitchell

doi:10.1016/j.brachy.2023.02.002

Cited by 12 publications

(10 citation statements)

References 85 publications

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“…Non-invasive devices are external applications, like 3DP models. The medical fields included are anesthesia [1], cardiology [2][3][4][5][6][7][8][9][10][11][12][13], coloproctology [14], dentistry [15][16][17][18], general surgery [19][20][21][22][23][24][25], health care engineering [26,27], hepatology [28], interventional radiology [29], medical education [30][31][32][33][34], neurosurgery [35][36][37][38][39], oncology [40][41][42][43] and radiation oncology [44][45][46]. Further medical fields included are oral and maxillofacial surgery [47][48][49]<...…”

Section: Non-invasive Applicationsmentioning

confidence: 99%

“…Further medical fields include plastic surgery [93,94], traumatology [95][96][97], urology [98][99][100][101][102] and vascular surgery [103][104][105][106]. The affected organs or organ systems include the aorta [13,103,106], bladder [29], brain [35,37,39], cranium [30, 31, 34, 36, 44, 48-50, 53-55, 82, 84, 86, 91], ear [48, 78-81, 83, 93], female internal genitals [46], heart [2-12, 87, 88, 104], jaw [17, 20, 21, 23, 25, 47-52, 55, 56], kidney [29,41,98,[100][101][102], lip [94], liver [19,22,28], musculoskeletal system [20, 21, 24, 31-33, 38, 43, 57-77, 89, 90, 92, 93, 95-97], prostate [98,99], rectum and colon [14,40,42,45], spine [38,59,68,77,…”

Section: Non-invasive Applicationsmentioning

confidence: 99%

“…Further pathologies are musculoskeletal diseases [25, 36, 43, 47, 48, 50, 53-55, 57-65, 67-77, 90-92, 95-97] which include different fracture types, such as pelvic fractures and tibial plateau fractures but also complex spinal deformities. Finally, diseases of the urogenital tract were found [29,41,46,[98][99][100]102] such as renal disease. Procedures include orthopedic surgery [25,[95][96][97].…”

Section: Non-invasive Applicationsmentioning

confidence: 99%

“…Procedures found in plastic surgery include breast, bone, nose, ear and skin reconstruction [93]. Radiation oncology procedures include brachytherapy, photon radiotherapy, electron radiotherapy and proton radiotherapy [44][45][46]. Materials can be categorised into 5 classes: polymers, metals, ceramics, organic materials and composite materials.…”

Section: Non-invasive Applicationsmentioning

confidence: 99%

“…Table 3 is sorted according to the medical field (n = 42). The medical fields are dentistry [126,127], general surgery [20,21,24,25] health care engineering [26], neurosurgery [38,[128][129][130][131], oncology [42,43], oral and maxillofacial surgery [47-50, 52, 53, 55, 56], orthopedics [57-59, 63, 67, 68, 73, 77, 132-134], otorhinolaryngology [78,79,83], pediatrics [85,89,90,92] and radiation oncology [44,46]. The affected organs or body parts are the brain [38], cardiothoracic system [89], central nervous system [89], cranium [25, 48-50, 52, 53, 55, 56, 78, 83, 132], ear [78,79,132], eye [132], female internal genitals [44,46], gastrointestinal system [89], genitourinary tract [89], jaw [25, 47-50, 56, 126], liver [25,44], musculoskeletal system [20,21,24,25,…”

Section: Invasive and Non-permanent Applicationsmentioning

confidence: 99%

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A Meta-Review about Medical 3D Printing

Meister,

Luijten,

Gsaxner

et al. 2024

Preprint

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In recent years, 3D printing (3DP) has gained importance in various fields. This technology has numerous applications, particularly in medicine. This contribution provides an overview on the state of the art of 3DP in medicine and showcases its current use in different medical disciplines and for medical education. In this meta-review, we provide a detailed listing of systematic reviews on this topic as this technology has become increasingly applied in modern medicine. We identified 134 relevant systematic reviews on medical 3DP in the medical search engine PubMed until 2023. 3DP has applications in various medical specialties, but is mainly used in orthopedics, oral and maxillofacial surgery, dentistry, cardiology and neurosurgery. In surgical contexts, the adoption of 3DP contributes to a reduction in operation time, reduced blood loss, minimized fluoroscopy time and an overall improved surgical outcome. Nevertheless, the primary use of 3DP is observed in non-invasive applications, particularly in the creation of patient-specific models (PSM). These PSMs enhance the visualization of patients’ anatomy and pathology, thereby facilitating surgical planning and execution, medical education and patient counseling. The current significance of 3DP in medicine offers a compelling perspective on the potential for more individualized and personalized medical treatments in the future.

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Section: Non-invasive Applicationsmentioning

confidence: 99%

Section: Non-invasive Applicationsmentioning

confidence: 99%

Section: Non-invasive Applicationsmentioning

confidence: 99%

Section: Non-invasive Applicationsmentioning

confidence: 99%

Section: Invasive and Non-permanent Applicationsmentioning

confidence: 99%

See 3 more Smart Citations

A Meta-Review about Medical 3D Printing

Meister,

Luijten,

Gsaxner

et al. 2024

Preprint

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A novel multi‐channel applicator with a U‐shaped channel for vaginal intracavity brachytherapy

Lu,

Chen,

Wang

et al. 2024

J Applied Clin Med Phys

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BackgroundEndometrial cancer is one of the most common gynecological malignancies in the world. Vaginal brachytherapy is an important postoperative adjuvant treatment for endometrial cancer. However, a common problem with existing applicators is insufficient dose at the vaginal apex.PurposeThis study describes the Hangzhou (HZ) cylinder, a novel 3D printed vaginal intracavity brachytherapy applicator, detailing its characteristics, dose distribution, and clinical applications.Methods and MaterialsThe HZ cylinder is distinguished by its unique structure: a U‐shaped channel with a 2 mm diameter, a straight central axis channel of the same diameter, and 10 parallel straight channels. For comparison, standard plans were employed, designed to ensure that a minimum of 95% of the prescribed dose reached 5 mm beneath the mucosal surface. We conducted comparative analyses of mucosal surface doses and doses at a 5 mm depth below the mucosa between the HZ cylinder and a conventional single‐channel cylinder across various treatment schemes. Additionally, the study examined dose differences in target volume and organs at risk (OARs) between actual HZ cylinder plans and hypothetical single‐channel plans.ResultsIn the standard plans, mucosal surface doses at the apex of the vagina were 209.32% and 200.61% of the prescribed dose with the HZ and single‐channel cylinders, respectively. The doses on the left and right wall mucosal surfaces varied from 149.26% to 178.13% and 142.98% to 180.75% of the prescribed dose, and on the anterior and posterior wall mucosal surfaces varied from 128.87% to 138.50% and 142.98% to 180.75% of the prescribed dose. Analysis of 24 actual treatment plans revealed that when the vaginal tissue volume dose covering 98% (vaginal D98%) was comparable between the HZ cylinder and virtual single‐channel plans (6.74 ± 0.07 Gy vs. 6.69 ± 0.10 Gy, p = 0.24), rectum doses of HZ cylinder plans were significantly lower than those of single‐channel plans (D1cc, 5.96 ± 0.56 Gy vs. 6.26 ± 0.71 Gy, p = 0.02 and D2cc, 5.26 ± 0.52 Gy vs. 5.56 ± 0.62 Gy, p = 0.02).ConclusionsThe HZ cylinder demonstrates a reduction in dose to the rectum and bladder while maintaining adequate target volume coverage. Its mucosal surface dose is comparable to that of the traditional single‐channel cylinder. These findings suggest that the HZ cylinder is a viable and potentially safer alternative for vaginal brachytherapy, warranting further investigation with larger sample sizes.

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Individual curved‐needle interstitial template created using three‐dimensional printing for brachytherapy for distal parauterine tumor recurrence

Zhang,

Luo,

Zhang

et al. 2024

Medical Physics

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BackgroundAchieving a clinically acceptable dose distribution with commercial vaginal applicators for brachytherapy of recurrent parauterine tumors is challenging. However, the application of three‐dimensional (3D) printing technology in brachytherapy has been widely acknowledged and can improve clinical treatment outcomes.PurposeThis study aimed to introduce an individual curved‐needle interstitial template (ICIT) created using 3D printing technology for high‐dose‐rate (HDR) brachytherapy with interstitial treatment to provide a clinically feasible approach to distal parauterine and vaginal cuff tumors. The entire workflow, including the design, optimization, and application, is presented.MethodsTen patients with pelvic cancer recurrence were examined at our center. The vaginal topography was filled with gauze strips soaked in developer solution, and images were obtained using computed tomography (CT) and magnetic resonance imaging (MRI). Curved needle paths were designed, and ICITs were 3D‐printed according to the high‐risk clinical target volume (HRCTV) and vaginal filling model. The dose and volume histogram parameters of the HRCTV (V100, V200, D90, and D98) and organs at risk (OARs) (D2cc) were recorded.ResultsAll patients completed interstitial brachytherapy treatment with the 3D‐printed ICIT. One patient experienced vaginal cuff tumor recurrence, and nine patients experienced parametrial tumor recurrence (four on the left and five on the right). We used two to five interstitial needles, and the maximum angle of the curved needle was 40°. No source obstruction events occurred during treatment of these 10 patients. The doses delivered to the targets and OARs of all patients were within the dose limits and based on clinical experience at our center.ConclusionThe ICIT is a treatment option for patients with distal parauterine tumor recurrence. This method addresses the limitations of vaginal intracavitary and standard interstitial applicators. The ICIT has the advantages of biocompatibility, personalization, and magnetic resonance imaging compatibility.

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3D printing in brachytherapy: A systematic review of gynecological applications

Cited by 12 publications

References 85 publications

A Meta-Review about Medical 3D Printing

A Meta-Review about Medical 3D Printing

A novel multi‐channel applicator with a U‐shaped channel for vaginal intracavity brachytherapy

Individual curved‐needle interstitial template created using three‐dimensional printing for brachytherapy for distal parauterine tumor recurrence

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