Rapid Prototyping, Design and Early Testing of a Novel Device for Supine Positioning of Large Volume or Pendulous Breasts in Radiotherapy

Burns, Levi; Young, Scott W.; Beaudry, Joel; Gill, Beant S.; Coope, Robin; Duzenli, Cheryl

doi:10.1007/978-981-10-9023-3_77

Cited by 6 publications

(8 citation statements)

References 14 publications

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“…They used an intensity‐modulated radiation therapy (IMRT) thorax anthropomorphic phantom as a surrogate for a real patient to imitate a CT scan. [ 52 ] ABS and PLA are used to create a tissue‐like imitation. They used PLA 100% infill and 20% infill to build soft tissue and lungs and found that the 3D printed phantom was an excellent match for commercially supplied CIRS‐IMRT phantoms.…”

Section: Introductionmentioning

confidence: 99%

Property enhancement approaches of fused filament fabrication technology: A review

Pazhamannil

Govindan

et al. 2022

Polymer Engineering & Sci

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The shift from rapid prototyping to rapid manufacturing using 3D printing is prominent after the development of volumetric 3D printing, multi-material printing, and functional materials development. Fused filament fabrication (FFF) is a fast-growing additive manufacturing technology with widespread end-user applications. The key constraints to its growth are the lower surface and mechanical properties compared to conventional manufacturing paradigms. The goal of this review is to look at the numerous pre-processing and post-processing parameters for the property enhancement of FFF. Preprocessing methods included optimization of process parameters (infill percentage, pattern, layer height, nozzle and platform temperature, raster angle and width, build orientation, and air gap) and adaptive slicing techniques.Mechanical (hot air jetting, barrel finishing, sand blasting, laser polishing, etc.), chemical (vapor smoothing, dipping, plating, and painting), and thermal (thermal annealing and normalizing) post-processing techniques were successful in improving the mechanical strength and surface finish of fused filament fabricated parts. This paper outlines the various methodologies a FFF user could incorporate for enhancing the final finished product's properties. The potential future prospects for the development of the 3D printing sector are also examined.

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Section: Introductionmentioning

confidence: 99%

Property enhancement approaches of fused filament fabrication technology: A review

Pazhamannil

Govindan

et al. 2022

Polymer Engineering & Sci

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“…Detailed technical descriptions and figures of CARA are published elsewhere and similar to the completed pilot studies [ 24 – 26 ]. In the experimental arm, CARA settings will be adjusted on a patient-by-patient basis to eliminate the IMF and lateral tissue droop such that that all palpable breast tissue sits anterior to the mid-axilla line.…”

Section: Methodsmentioning

confidence: 99%

“…To reduce MD incidence in this patient population, a novel Carbon-fibre Adjustable Reusable Accessory (CARA) for breast support was designed, fabricated, and tested beginning in 2016 [ 24 , 25 ]. The current CARA clinical prototype is shown in use on a patient in Fig.…”

Section: Introductionmentioning

confidence: 99%

A novel carbon-fibre adjustable reusable accessory (CARA) for supine breast positioning to reduce toxicity in breast adjuvant radiotherapy: a study protocol for a multicentre phase III randomized controlled trial

et al. 2022

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Background A novel device for supine positioning in breast radiotherapy for patients with large or pendulous breasts has been developed and tested in phase II studies. This trial is designed to assess the efficacy of the device to reduce skin toxicity and unwanted normal tissue dose in comparison to the current clinical standard for supine breast support during breast radiotherapy. Methods Patients at high risk for moist desquamation, having infra-mammary fold or lateral ptosis, will be randomized into two arms. Patients in the control arm will receive breast radiotherapy with supine positioning using current standard of care. Patients in the experimental arm will be positioned supine with the novel device. The primary endpoint is the incidence of moist desquamation in the infra-mammary fold. We hypothesize a 20% reduction (from 50 to 30%) in the rate of moist desquamation in the study arm versus the control arm. For 80% power, two-tailed α = 0.05 and 10% loss to follow up, 110 patients will be assigned to each arm. The proportion of patients experiencing moist desquamation in the two arms will be compared using logistic regression adjusting for brassiere cup size, skin fold size, body mass index, smoking status, and dose fractionation schedule. An unadjusted comparison will also be made using the chi-square test, or Fisher’s exact test, if appropriate. Secondary endpoints include dose-volume statistics for the lung and heart, skin dose and clinical parameters including setup time, reproducibility, and staff experience with setup procedures. Patient-reported pain, skin condition interference with sleep and daily activities, and comfort during treatment are also secondary endpoints. Discussion Based on results from earlier phase II studies, it is expected that the device-enabled elimination of infra-mammary fold should reduce toxicity and improve quality of life for this patient population. Earlier studies showed reduction in dose to organs at risk including lung and heart, indicating potential for other long-term benefits for patients using the device. This study is limited to acute skin toxicity, patient-reported outcomes, and clinical factors to inform integration of the device into standard breast radiotherapy procedures. Trial registration Clinicaltrials.gov identifier: NCT04257396. Registered February 6 2020.

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“…Carbon fibre composites are low-density materials with high tensile strength that can provide the needed support for large and pendulous breasts while minimizing the bolus effect to the skin to avoid severe skin reactions. A Carbon-fibre Adjustable Reusable Accessory (CARA) for breast support was designed using optical surface imaging and 3D printing for rapid prototyping (21). The device consists of a carbon-fibre frame that fits over the patient at hip level with the patient on a conventional angled breast board, as shown in Figures 1 and 2.…”

Section: Introductionmentioning

confidence: 99%

Reduction in Doses to Organs at Risk and Normal Tissue During Breast Radiation Therapy With a Carbon-Fiber Adjustable Reusable Accessory

Duzenli

Koulis²,

Menna³

et al. 2021

Practical Radiation Oncology

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Rapid Prototyping, Design and Early Testing of a Novel Device for Supine Positioning of Large Volume or Pendulous Breasts in Radiotherapy

Cited by 6 publications

References 14 publications

Property enhancement approaches of fused filament fabrication technology: A review

Property enhancement approaches of fused filament fabrication technology: A review

A novel carbon-fibre adjustable reusable accessory (CARA) for supine breast positioning to reduce toxicity in breast adjuvant radiotherapy: a study protocol for a multicentre phase III randomized controlled trial

Reduction in Doses to Organs at Risk and Normal Tissue During Breast Radiation Therapy With a Carbon-Fiber Adjustable Reusable Accessory

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