MO‐B‐BRD‐03: Principles, Pitfalls and Techniques of 3D Printing for Bolus and Compensators
Authors: Baker J. 
Published: June 2015

This session is designed so that the learning objectives are practical. The intent is that the attendee may take home an understanding of not just the technology, but also the logistical steps necessary to execute these 3D printing techniques in the clinic. Four practical 3D printing topics will be discussed: (i) Creating bolus and compensators for photon machines; (ii) tools for proton therapy; (iii) clinical applications in imaging; (iv) custom phantom design for clinic and research use.

The use of 3D printers within the radiation oncology setting is proving to be a useful tool for creating patient specific bolus and compensators with the added benefit of cost savings. Creating the proper protocol is essential to ensuring that the desired effect is achieved and modeled in the treatment planning system. The critical choice of printer material (since it determines the interaction with the radiation) will be discussed. Selection of 3D printer type, design methods, verification of dose calculation, and the printing process will be detailed to give the basis for establishing your own protocol for electron and photon fields. A practical discussion of likely obstacles that may be encountered will be included.
The diversity of systems and techniques in proton facilities leads to different facilities having very different requirements for beam modifying hardware and quality assurance devices. Many departments find the need to design and fabricate facility‐specific equipment, making 3D printing an attractive technology. 3D printer applications in proton therapy will be discussed, including beam filters and compensators, and the design of proton therapy specific quality assurance tools. Quality control specific to 3D printing in proton therapy will be addressed. Advantages and disadvantages of different printing technology for these applications will also be discussed.
3D printing applications using high‐resolution radiology‐based imaging data will be presented. This data is used to 3D print individualized physical models of patient's unique anatomy for aid in planning complex and challenging surgical procedures. Methods, techniques and imaging requirements for 3D printing anatomic models from imaging data will be discussed. Specific applications currently being used in the radiology clinic will be detailed.
Standardized phantoms for radiation therapy are abundant. However, custom phantom designs can be advantageous for both clinical tasks and research. 3D printing is a useful method of custom fabrication that allows one to construct custom objects relatively quickly. Possibilities for custom radiotherapy phantoms range from 3D printing a hollow shell and filling the shell with tissue equivalent materials to fully printing the entire phantom with materials that are tissue equivalent as well as suitable for 3D printing. A range of materials available for use in radiotherapy phantoms and in the case of phantoms for dosimetric measurements, this choice is critical. The necessary steps required will be discussed including: modalities of 3D model generation, 3D model requirements for 3D printing, generation of machine instructions from the 3D model, and 3D printing techniques, choice of phantoms material, and troubleshooting techniques for each step in the process. Case examples of 3D printed phantoms will be shown.
Learning Objectives:

Understand the types of 3D modeling software required to design your device, the file formats required for data transfer from design software to 3D printer, and general troubleshooting techniques for each step of the process.
Learn the differences between materials and design for photons vs. electrons vs. protons.
Understand the importance of material choice and design geometries for your custom phantoms.
Learn specific steps of quality assurance and quality control for 3D printed beam filters and compensators for proton therapy.
Learn of special 3D printing applications for imaging.
Cunha: Research support from Phillips Healthcare.