ESTRO 2024 - Abstract Book

S72 ESTRO 2024 Looking to the future, the integration of artificial intelligence and machine learning into imaging, patient monitoring, treatment planning, optimization tools and follow-up offers the prospect of more accurate, efficient, and adaptable treatment protocols. These prospects may offer significant quality improvements of treatment for the patient. In conclusion, current SRT and SRS technology represent remarkable opportunities for the radiotherapy community. Through continued innovation, research, and collaboration across disciplines, the future of SRT and SRS appears bright, with the potential to significantly enhance the quality and effectiveness of care provided to patients worldwide. Invited Speaker

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New directions for 3D printing in brachytherapy

James Robar

Nova Scotia Health, Medical Physics, Halifax, Canada

Abstract:

Although 3D printing (3Dp) in brachytherapy (BT) has seen significant development over the past decade, accessible technologies and viable workflows been introduced into the clinic recently. This presentation will describe the state of-the-art in customizing patient high dose rate (HDR) BT with review of the recent literature on patient-personalized applicators that can be designed, printed and used for treatment, in timelines that are clinically practical. Two exemplary use-cases will be described: the Halifax Vault applicator and the Montreal Split Ring applicator. Relative to standard vaginal cylinder applicators, the Halifax applicator tailors the geometry and fit to the patient for endometrial, vaginal, vulva and recurrent cervical cancer treatment. This device introduces new flexibility in positioning of interstitial (IS) needles, whereby needle guides are in-printed in the applicator. This has been demonstrated to offer improved dose coverage of target volumes and sparing of organs-at-risk. The approach also reduces or eliminates the need for freehand insertion, provides plan-specific insertion guides, and eliminates hand fabrication, e.g., of wax moulds. The Montreal Split Ring applicator provides patient-specific 3D printed caps for standard commercial ring applicators to accommodate customized IS needle guides. This significantly extends the functionality of traditional split rings. The spatial fidelity of caps printed from sterilizable stereolithography (SLA) resins has been validated to within 0.3 mm. Leading institutions incorporating this applicator have devised efficient clinical workflows that do not require additional imaging sessions by capturing MRI pre-plan imaging and delivering the first fraction with the standard applicator, then personalizing patient treatment with 3Dp caps for remaining fractions. Both applicators discussed in this presentation involve new workflow steps of 3Dp applicator design during HDR BT treatment planning, 3D printing, and sterilization.