The Montreal split ring applicator: Towards highly adaptive gynecological brachytherapy using 3D-printed biocompatible patient-specific interstitial caps.

Autor:	Kamio Y; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.; Centre de Recherche du CHUM (CRCHUM), Montréal, QC, Canada.; Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, QC, Canada., Roy MÈ; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada., Morgan LA; Adaptiiv Medical Technologies Inc., Halifax, NS, Canada., Barkati M; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada., Beauchemin MC; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada., DeBlois F; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.; Centre de Recherche du CHUM (CRCHUM), Montréal, QC, Canada.; Département de Physique, Université de Montréal, Montréal, QC, Canada., Basaric B; Adaptiiv Medical Technologies Inc., Halifax, NS, Canada., Carrier JF; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.; Centre de Recherche du CHUM (CRCHUM), Montréal, QC, Canada.; Département de Physique, Université de Montréal, Montréal, QC, Canada., Bedwani S; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.; Centre de Recherche du CHUM (CRCHUM), Montréal, QC, Canada.; Département de Physique, Université de Montréal, Montréal, QC, Canada.
Jazyk:	angličtina
Zdroj:	Journal of contemporary brachytherapy [J Contemp Brachytherapy] 2023 Dec; Vol. 15 (6), pp. 453-464. Date of Electronic Publication: 2023 Dec 12.
DOI:	10.5114/jcb.2023.133676
Abstrakt:	Purpose: The addition of interstitial (IS) needles to intra-cavitary (IC) brachytherapy applicators is associated with improved outcomes in locally advanced cervical cancers involving parametrial tumor extensions. The purpose of this work was to validate a clinical workflow involving 3D-printed caps for a commercial IC split ring applicator that enable using IS needle trajectories tailored to each treatment. Material and Methods: A dedicated software module was developed in this work allowing users to design patient-specific IS caps without knowledge of computer-aided design (CAD) software. This software module was integrated to 3D Brachy, a commercial software developed by Adaptiiv Medical Technologies Inc. For validation of the workflow, CAD models of ground truth caps with five IS needle trajectories were designed with Fusion 360™, 3D-printed, assembled with a split ring applicator, and CT-scanned with radio-opaque markers. 3D Brachy was then applied to generate a replica based on trajectories reconstructed from the radio-opaque markers. A comparison between ground truth and replicated IS needle trajectories was done using intersection points with planes at the level of the cervix (z = 0 cm) and a representative needle depth (z = 3 cm). Results: Prototypes of interstitial caps 3D-printed in both BioMed Amber and BioMed Clear SLA resins were tested to be functional both pre- and post-sterilization for IS needles with obliquity angles ≤ 45°. Distance-to-agreement at z = 0 cm and 3 cm as well as deviations in pitch and yaw angles of the five IS needle trajectories were found to have mean values of 3.3 ±2.1 mm, 7.3 ±2.0 mm, 2.9° ±2.3°, and 7.0° ±7.0°, respectively. Conclusions: The clinical workflow for image-guided adaptive cervical cancer brachytherapy using the Montreal split ring applicator was validated. (Copyright © 2023 Termedia.)
Databáze:	MEDLINE
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