Volume 27, Issue 5 (7-2020)                   RJMS 2020, 27(5): 240-253 | Back to browse issues page

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Zoljalali Moghaddam S H, Ghaffari H, Shams Abadi R, Mahdavi S R, Baghani H R. A review on applications of three-dimensional printing technology in radiotherapy. RJMS 2020; 27 (5) :240-253
URL: http://rjms.iums.ac.ir/article-1-6104-en.html
Iran University of Medical Sciences , zoljalali.h@tak.iums.ac.ir
Abstract:   (1423 Views)
Nowadays, 3D printing technology is used for rapid prototyping of high quality objects, so that this technology plays an important role in the modern fields of medicine, especially in surgery, radiation therapy, radiology and etc.  Generally, the process of creating a physical object from a digital model is considered as a simple definition of 3D printing. Compared to conventional printers, 3D printers create a physical 3D model of the desire target. Creation of a model by 3D printer requires a digital 3D model which can be obtained by scanning a set of 3D images or drawing them using CAD design software, as well as using computed tomography (CT) data or magnetic resonance imaging (MRI) imaging. Then, this digital model is sent to the printer and finally, a 3D layer-by-layer model is created. The whole mentioned process is called as fast prototyping or 3D printing.
Since, personal radiotherapy is introduced as one of the main modality for the treatment and management of various cancers, requires precise details to improve the performance of the employed modality. Todays, 3D printers are able to produce a realistic model of complex geometries, so 3D printing technology can be a complementary and promising method for treating patients and making specific equipment for them, especially in radiotherapy.  The dramatic growth of 3D printing technology in various fields of medicine in recent years, has led to the introduction of new applications of this technology in these fields, so that the importance of this technology in improving the performance of treatment modalities, has been reported in several recent studies.
The use of 3D printing technology will reduce the cost of radiation therapy which as a promising method, can enhance the efficacy of employed modality. Performed studies have shown that 3D printing technology is a fast, practical and inexpensive method for delivering a uniform dose to the target volume while protecting healthy tissues in the radiation field.  Furthermore, this technology reduces patient discomfort which can provide specific radiotherapy devices to each patient.
The employment of 3D printed devices, based on the anatomical features of each patient in radiotherapy, such as bolus and fixed devices can reduce daily uncertainty (in radiotherapy) and also increase the accuracy of treatment. 3D printing technology enables users to employ various materials for better performance of radiotherapy method.  So far, several materials have been used and evaluated to produce the desired 3D object via the 3D printing technology, including polylactic acid (PLA), acrylonitrile butadiene styrene (ABS), polyethylene terephthalate glycol (PETG), thermoplastic elastomers (TPE), Polyamide (PA, also called nylon), thermoplastic polyurethane (TPU), and polyvinyl acetate. The accuracy and efficacy of 3D printing technology highly depends on the performed materials for creation of the 3D objects.
PLA and ABS have been introduced as the most common performed materials in 3D printing technology. PLA is a type of odorless plastic polymer which can be used in many industries, such as biodegradable implants and food packaging. ABS is more resistant than PLA which can tolerate the high temperatures.  PA material is flexible, very cohesive and very resistant as a plastic polymer as well. The most common use of TPE has been introduced in the construction of flexible objects which with the use of this material objects can be created in a short time.  PETG materials are a combination of PET and glycols with different concentrations. All the mentioned materials are available in the form of filaments with diameters of 1.75 mm and 3 mm.
Performed investigations in our present work have shown that patient-specific devices can be generated from volumetric CT images or MRI data by 3D printing. In fact, 3D printing technology has great potential for improving the accuracy and efficiency of personal radiotherapy which this technology offers a relatively inexpensive and effective method to produce devices based on individual anatomy in radiotherapy. The practical usage of the 3D printing technology in radiation therapy can improve treatment outcomes and reduce treatment error which the weaknesses of traditional radiotherapy methods can be eliminated. Due to the advantages of this new method, the main aim of present review is to introduce some applications of 3D printing technology in radiotherapy, as a new approach in this therapeutic method, such as bolus, phantoms, brachytherapy applicators, filters, patient fixation devices, compensatory blocks and grid blocks. In most of the performed studies, the advent of 3D printing technology in the field of radiotherapy has been reported as a cost-effective and accessible method so that more practical parts can be produced. Performed studies also showed that the favorable agreement between the printed model in terms of matching the unique body geometry of each patient will reduce the side effects of radiation to healthy tissues..
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Type of Study: review article | Subject: Biophysics

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