Towards using a multi-material, pellet-fed additive manufacturing platform to fabricate novel imaging phantoms.

The design freedom afforded by additive manufacturing (AM) is now being leveraged across multiple applications, including many in the fields of imaging for personalised medicine. This study utilises a pellet-fed, multi-material AM machine as a route to fabricating new imaging phantoms, used for developing and refining algorithms for the detection of subtle soft tissue anomalies. Traditionally comprising homogeneous materials, higher-resolution scanning now allows for heterogeneous, multi-material phantoms. Polylactic acid (PLA), a thermoplastic urethane (TPU) and a thermoplastic elastomer (TPE) were investigated as potential materials. Manufacturing accuracy and precision were assessed relative to the digital design file, whilst the potential to achieve structural heterogeneity was evaluated by quantifying infill density via micro-computed tomography. Hounsfield units (HU) were also captured via a clinical scanner. The PLA builds were consistently too small, by 0.2 - 0.3%. Conversely, TPE parts were consistently larger than the digital file, though by only 0.1%. The TPU components had negligible differences relative to the specified sizes. The accuracy and precision of material infill were inferior, with PLA exhibiting greater and lower densities relative to the digital file, across the 3 builds. Both TPU and TPE produced infills that were too dense. The PLA material produced repeatable HU values, with poorer precision across TPU and TPE. All HU values tended towards, and some exceeded, the reference value for water (0 HU) with increasing infill density. These data have demonstrated that pellet-fed AM can produce accurate and precise structures, with the potential to include multiple materials providing an opportunity for more realistic and advanced phantom designs. In doing so, this will enable clinical scientists to develop more sensitive applications aimed at detecting ever more subtle variations in tissue, confident that their calibration models reflect their intended designs.

Evaluating the influence of the Siemens IGRT carbon fibre tabletop in head and neck IMRT.

BACKGROUND AND PURPOSE: To investigate the impact of a commercial IMRT/IGRT carbon-fibre tabletop in radiotherapy planning optimization and clinical dose distribution. MATERIALS AND METHODS: In this investigation the Siemens IGRT carbon fibre tabletop, routinely used for IMRT treatments in our Centre, has been incorporated into the CT volume of 6 IMRT patients. This was done by CT scanning the tabletop and by adding the obtained volume to the clinical dataset, acquired using the standard couch available in our CT scanner. This procedure was tested and validated for the purpose of this study. The radiotherapy plans have been optimized using both the original CT volume and the modified CT volume. RESULTS: IMRT optimization with the tabletop included in the clinical volume produced significantly different deliverable plans compared to standard optimized plans which did not include the treatment couch. Differences up to 6%/7% in terms of total number of MU were found in half of the clinical cases. Differences up to 37% in the number of MU per beam were also found. The number of iterations needed to reach an optimal solution also varied between -18% and +25%. Although the DVH analysis produced similar results, due to the fulfilment of the optimization objectives, differences higher than 10% were found in the dose calculated to superficial regions of the body. CONCLUSIONS: The results of this investigation show that the presence of the carbon fibre tabletop significantly affects the outcome of the beam parameters optimization. We suggest including carbon fibre tabletops into patient treatment planning dose calculation and optimization.

Design and characterization of tissue-mimicking gel phantoms for diffusion kurtosis imaging.

PURPOSE: The aim of this work was to create tissue-mimicking gel phantoms appropriate for diffusion kurtosis imaging (DKI) for quality assurance, protocol optimization, and sequence development. METHODS: A range of agar, agarose, and polyvinyl alcohol phantoms with concentrations ranging from 1.0% to 3.5%, 0.5% to 3.0%, and 10% to 20%, respectively, and up to 3 g of glass microspheres per 100 ml were created. Diffusion coefficients, excess kurtosis values, and relaxation rates were experimentally determined. RESULTS: The kurtosis values for the plain gels ranged from 0.05 with 95% confidence interval (CI) of (0.029,0.071) to 0.216(0.185,0.246), well below the kurtosis values reported in the literature for various tissues. The addition of glass microspheres increased the kurtosis of the gels with values up to 0.523(0.465,0.581) observed for gels with the highest concentration of microspheres. Repeat scans of some of the gels after more than 6 months of storage at room temperature indicate changes in the diffusion parameters of less than 10%. The addition of the glass microspheres reduces the apparent diffusion coefficients (ADCs) and increases the longitudinal and transverse relaxation rates, but the values remain comparable to those for plain gels and tissue, with ADCs observed ranging from 818(585,1053) × 10-6  mm2 /s to 2257(2118,2296) × 10-6  mm2 /s, R1 values ranging from 0.34(0.32,0.35) 1/s to 0.51(0.50,0.52) 1/s, and R2 values ranging from 9.69(9.34,10.04) 1/s to 33.07(27.10, 39.04) 1/s. CONCLUSIONS: Glass microspheres can be used to effectively modify diffusion properties of gel phantoms and achieve a range of kurtosis values comparable to those reported for a variety of tissues.

Dosimetric characteristics of the Siemens IGRT carbon fiber tabletop.

In this work, the dosimetric characteristics of a new commercial carbon fiber treatment table are investigated. The photon beam attenuation properties of the Siemens image-guided radiation therapy (IGRT) tabletop were studied in detail. Two sets of dosimetric measurements were performed. In the first experiment a polystyrene slab phantom was used: the central axis attenuation and the skin-sparing detriment were investigated. In the second experiment, the off-axis treatment table transmission was investigated using a polystyrene cylindrical phantom. Measurements were taken at the isocenter for a 360 degrees rotation of the radiation beam. Our results show that the photon beam attenuation of the Siemens IGRT carbon fiber tabletop varies from a minimum of 2.1% (central axis) to a maximum of 4.6% (120 degrees and 240 degrees beam incidence). The beam entrance dose increases from 82% to 97% of the dose at the depth of maximum for a clinical 6-MV radiation field. The depth of maximum also decreases by 0.4 cm. Despite the wedge cross section of the table the beam attenuation properties of the IGRT tabletop remain constant along the longitudinal direction. American Association of Medical Dosimetrists.