3D Printing in Radiation Therapy

3D Printing in Radiation Therapy provides practical and comprehensive guidance for the implementation, quality management, maintenance and safe use of a clinical 3D printing programme in the radiation therapy context. This book is a valuable resource for all radiation therapy staff who are planning, setting up, managing, researching, auditing or working within a 3D printing service.

3D Printing in Radiation Therapy provides practical and comprehensive guidance for the implementation, quality management, maintenance and safe use of a clinical 3D printing programme in the radiation therapy context. Radiation therapy is a safe and effective treatment that can benefit half of all cancer patients, and the introduction of an appropriately planned, managed, and resourced 3D printing programme can increase that benefit in terms of the radiation therapy patient experience, staff engagement, treatment accuracy and improved treatment outcomes, in addition to monetary savings.

Key features:

• Information to aid in selection of suitable 3D printing modalities, materials and software for radiation therapy applications
• Guidance regarding efficiently and accurately designing, printing and post-processing phantoms, jigs and attachments as well as radiation treatment equipment such as bolus, immobilisation devices, radiation shields and brachytherapy applicators
• A detailed introduction to comprehensive quality management of the 3D printing service, including documented risk assessments, commissioning methods, 3D printer maintenance, 3D print quality control, reviews, audits and staff training
• Advice on the potential costs and benefits of the 3D printing service in terms of time, money, space, patient and staff safety, and waste management

Preface

Acknowledgements

Editor biographies

List of contributors

Contributor biographies

1 Introduction

Tomas Kron and Tanya Kairn

References

2 3D printing

Rance Tino and Martin Leary

2.1 Introduction

2.2 Vat photopolymerisation

2.2.1 Stereolithography

2.2.2 Digital light processing

2.2.3 Continuous direct light processing

2.2.4 State-of-the-art vat photopolymerisation-based techniques

2.3 Material extrusion

2.4 Powder bed fusion

2.4.1 Multi jet fusion

2.4.2 Selective laser sintering

2.4.3 Direct metal laser sintering and selective laser melting

2.4.4 Electron beam melting

2.5 Directed energy deposition

2.5.1 Laser engineering net shape

2.5.2 Electron beam additive manufacturing

2.6 Sheet lamination

2.7 Material jetting

2.7.1 Polymer multi-jet printing

2.7.2 Nanoparticle jetting

2.7.3 Drop-on-demand

2.8 Binder jetting

2.9 Key points

References

3 Materials

Amirhossein Asfia, Giorgio Andrew Katsifis, James I Novak and Scott B Crowe

3.1 Introduction

3.2 3D-printed plastics

3.3 3D-printed composites

3.4 3D-printed metals

3.5 Other materials

3.6 Key points

References

4 Design

Rance Tino, Martin Leary, Gorgio Andrew Katsifis, James I Novak and Scott B Crowe

4.1 Introduction

4.2 Medical imaging

4.3 3D optical scanning

4.4 Design software

4.5 Key points

References

5 Processing

Rance Tino, Amirhossein Asfia, Giorgio Andrew Katsifis, James I Novak and Scott B Crowe

5.1 Introduction

5.2 Preparation

5.2.1 Slicing

5.2.2 Nozzle temperature

5.2.3 Build plate temperature

5.2.4 Printing speed

5.2.5 Layer height

5.2.6 Infill density and pattern

5.2.7 Build orientation and support

5.2.8 Variable print parameters

5.3 Printing

5.4 Post-processing

5.5 Key points

References

6 Costs

Tanya Kairn, Rance Tino, Martin Leary and Adam Unjin Yeo

6.1 Introduction

6.2 Money

6.3 Time

6.4 Health

6.5 Space

6.6 Waste

6.7 Key points

References

7 Quality management

Emily Simpson-Page, Deepak Basaula and Scott B Crowe

7.1 Introduction

7.2 Quality management systems

7.3 Risk management

7.4 Documentation requirements

7.5 Resource management

7.5.1 Human resources

7.5.2 Infrastructure

7.6 Product realisation

7.6.1 Request and specification

7.6.2 Modelling and design

7.6.3 Fabrication

7.6.4 Post-processing

7.6.5 Quality assurance

7.7 Ongoing responsibilities

7.8 Key points

References

8 Quality assurance

Adam Unjin Yeo and Tanya Kairn

8.1 Introduction

8.2 Defects and consequences

8.2.1 Irregular surface

8.2.2 Geometric error

8.2.3 Density variation

8.2.4 Unsuitable doping

8.2.5 Bulk deformation and clearance

8.2.6 Print failure

8.2.7 Consistency and reproducibility

8.3 Commissioning

8.3.1 Risk assessment and overview

8.3.2 Familiarisation with existing documentation

8.3.3 Optimisation of the 3D-printing parameters

8.3.4 Evaluation of geometric accuracy

8.3.5 Characterising the physical properties of materials

8.3.6 Characterising the density properties of materials

8.3.7 Testing challenging geometries and long print jobs

8.3.8 Evaluating 3D-print reproducibility and consistency

8.3.9 Completion of end-to-end testing

8.3.10 Development of a 3D-print sanitisation process

8.3.11 Planning of routine maintenance for a 3D printer

8.3.12 Development of quality control processes

8.3.13 Preparation of a commissioning report

8.3.14 Provision of written instructions

8.3.15 Creating logs

8.3.16 Provision of staff training

8.3.17 Repetition of commissioning for new equipment

8.4 3D-printer maintenance

8.5 3D-print quality control

8.6 Key points

References

9 Patient treatments

Tanya Kairn, Rachael Wilks and Samuel C Peet

9.1 Introduction

9.2 Patient safety

9.2.1 Regulatory and quality management context

9.2.2 External use

9.2.3 Internal use

9.2.4 Cleaning and sterilisation

9.3 Bolus, compensators, and range shifters

9.3.1 Clinical context

9.3.2 Photon radiation therapy

9.3.3 Electron radiation therapy

9.3.4 Proton radiation therapy

9.4 Custom shielding

9.4.1 Clinical context

9.4.2 Shields

9.4.3 Apertures

9.4.4 Positives

9.5 Immobilisation

9.5.1 Clinical context

9.5.2 Mechanical safety

9.5.3 Patient supports

9.5.4 Immobilisation masks

9.5.5 Displacement stabilisation

9.6 Brachytherapy

9.6.1 Clinical context

9.6.2 Superficial applicators

9.6.3 Interstitial templates

9.6.4 Intracavitary moulds

9.6.5 Dose calculation considerations

9.7 Key points

References

10 Treatment verification

Deepak Basaula, Emily Simpson-Page, Scott B Crowe and Tanya Kairn

10.1 Introduction

10.2 Dosimeter augmentation

10.2.1 Dosimetry jigs 1

10.2.2 Adaptors, attachments, and inserts

10.3 Geometrically simple phantoms

10.3.1 Hidden targets

10.3.2 Simple imaging phantoms

10.3.3 Simple dosimetry phantoms

10.4 Anthropomorphic phantoms

10.4.1 Summary of requirements

10.4.2 Geometric properties

10.4.3 Material properties

10.4.4 Functional properties

10.5 Key points

References

11 Beyond radiation therapy

Mathilde R Desselle and Natalka Suchowerska

11.1 Introduction

11.2 Patient-matched anatomical models

11.3 Templates for clinical intervention

11.4 Surgical guides

11.5 Customised prostheses and orthoses

11.6 Regenerative medicine

11.7 Bioprinting

11.8 Key points

References

12 Conclusions

Tanya Kairn, Scott B Crowe and Tomas Kron

List of acronyms/initialisms