Dual-energy CT evaluation of 3D printed materials for radiotherapy applications

Objective. There is a continuous increase in 3D printing applications in several fields including medical imaging and radiotherapy. Although there are numerous advantages of using 3D printing for the development of customized phantoms, bolus, quality assurance devices and other clinical applications, material properties are not well known and printer settings can affect considerably the properties (e.g. density, isotropy and homogeneity) of the printed parts. This study aims to evaluate several materials and printer properties to identify a range of tissue-mimicking materials. Approach. Dual-energy CT was used to obtain the effective atomic number (Z eff) and relative electron density (RED) for thirty-one different materials including different colours of the same filament from the same manufacturer and the same type of filament from different manufacturers. In addition, a custom bone equivalent filament was developed and evaluated since a high-density filament with a composition similar to bone is not commercially available. Printing settings such as infill density, infill pattern, layer height and nozzle size were also evaluated. Main results. Large differences were observed for HU (288), RED (>10%) and Z eff (>50%) for different colours of the same filament due to the colour pigment. Results show a wide HU variation (−714 to 1104), RED (0.277 to 1.480) and Z eff (5.22 to 12.39) between the printed samples with some materials being comparable to commercial tissue-mimicking materials and good substitutes to a range of materials from lung to bone. Printer settings can result in directional dependency and significantly affect the homogeneity of the samples. Significance. The use of DECT to extract RED, and Z eff allows for quantitative imaging and dosimetry using 3D printed materials equivalent to certified tissue-mimicking tissues.

[1]  G. Brix,et al.  Tissue equivalence of 3D printing materials with respect to attenuation and absorption of X-rays used for diagnostic and interventional imaging. , 2022, Medical physics.

[2]  M. Figl,et al.  X-ray attenuation of bone, soft and adipose tissue in CT from 70 to 140 kV and comparison with 3D printable additive manufacturing materials , 2022, Scientific Reports.

[3]  Xiangjie Ma,et al.  Classification of X-Ray Attenuation Properties of Additive Manufacturing and 3D Printing Materials Using Computed Tomography From 70 to 140 kVp , 2021, Frontiers in Bioengineering and Biotechnology.

[4]  M. Leary,et al.  A customizable anthropomorphic phantom for dosimetric verification of 3D-printed lung, tissue, and bone density materials. , 2021, Medical physics.

[5]  W. Newhauser,et al.  Personalized 3D-printed anthropomorphic phantoms for dosimetry in charged particle fields , 2021, Physics in medicine and biology.

[6]  F. Verhaegen,et al.  Time-resolved QA and brachytherapy applicator commissioning: Towards the clinical implementation. , 2021, Brachytherapy.

[7]  P. Barry,et al.  A novel use of 3D-printed template in vaginal HDR brachytherapy. , 2021, Brachytherapy.

[8]  K. Mei,et al.  Three-dimensional printing of patient-specific lung phantoms for CT imaging: emulating lung tissue with accurate attenuation profiles and textures , 2021, medRxiv.

[9]  O. Rodrigues,et al.  Study on attenuation of 3D printing commercial filaments on standard X-ray beams for dosimetry and tissue equivalence , 2021, Radiation Physics and Chemistry.

[10]  P. Fearns,et al.  Evaluating 3D-Printed Bolus Compared to Conventional Bolus Types Used in External Beam Radiation Therapy. , 2021, Current medical imaging.

[11]  Choonsik Lee,et al.  Fabrication of a pediatric torso phantom with multiple tissues represented using a dual nozzle thermoplastic 3D printer , 2020, Journal of applied clinical medical physics.

[12]  M.P.A. Potiens,et al.  Commercial filament testing for use in 3D printed phantoms , 2020 .

[13]  E. Ehler,et al.  3D printed copper-plastic composite material for use as a radiotherapy bolus. , 2020, Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics.

[14]  So-yeon Park,et al.  Radiological Characteristics of Materials Used in 3-Dimensional Printing with Various Infill Densities , 2019, Progress in Medical Physics.

[15]  Christine Albantow,et al.  PLA as a suitable 3D printing thermoplastic for use in external beam radiotherapy , 2019, Australasian Physical & Engineering Sciences in Medicine.

[16]  Tomas Kron,et al.  Gyroid structures for 3D-printed heterogeneous radiotherapy phantoms , 2019, Physics in medicine and biology.

[17]  J. Solc,et al.  Tissue-equivalence of 3D-printed plastics for medical phantoms in radiology , 2018, Journal of Instrumentation.

[18]  Nikiforos Okkalidis,et al.  A novel 3D printing method for accurate anatomy replication in patient‐specific phantoms , 2018, Medical physics.

[19]  Peter Balter,et al.  Material matters: Analysis of density uncertainty in 3D printing and its consequences for radiation oncology , 2018, Medical physics.

[20]  et al. Alssabbagh Evaluation of nine 3D printing materials as tissue equivalent materials in terms of mass attenuation coefficient and mass density , 2017 .

[21]  Shota Sagara,et al.  Simplified derivation of stopping power ratio in the human body from dual‐energy CT data , 2017, Medical physics.

[22]  Frank Verhaegen,et al.  Dual energy CT in radiotherapy: Current applications and future outlook. , 2016, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[23]  Joao Seco,et al.  Tissue decomposition from dual energy CT data for MC based dose calculation in particle therapy. , 2014, Medical physics.

[24]  Mitchell M Goodsitt,et al.  Accuracies of the synthesized monochromatic CT numbers and effective atomic numbers obtained with a rapid kVp switching dual energy CT scanner. , 2011, Medical physics.

[25]  R. Mohan,et al.  Theoretical variance analysis of single- and dual-energy computed tomography methods for calculating proton stopping power ratios of biological tissues , 2010, Physics in medicine and biology.

[26]  P. Deluca,et al.  Realistic reference phantoms: An ICRP/ICRU joint effort , 2009, Annals of the ICRP.

[27]  F. Verhaegen,et al.  Dual-energy CT-based material extraction for tissue segmentation in Monte Carlo dose calculations , 2008, Physics in medicine and biology.

[28]  Geert J. Streekstra,et al.  Development of a 3D printed anthropomorphic lung phantom for image quality assessment in CT. , 2019, Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics.

[29]  Katia Parodi,et al.  Dual‐energy CT quantitative imaging: a comparison study between twin‐beam and dual‐source CT scanners , 2017, Medical physics.

[30]  Rao Khan,et al.  Characterizing 3D printing in the fabrication of variable density phantoms for quality assurance of radiotherapy. , 2016, Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics.