Design and evaluation of 3D printable patient‐specific applicators for gynecologic HDR brachytherapy
Bibliographic record
Abstract
PURPOSE: The purpose of this study is to improve dose distribution and organ-at-risk sparing during gynecologic HDR brachytherapy with patient-specific applicators. The majority of applicators used today are generic in design and do not allow for dose modulation for patient-specific shaping of dose distributions. Their performance might be adjusted with commercially available wedge shields; however, this provides dose modulation in the orthogonal plane only and does not allow for variation along the length of the applicator. Generic applicators are available only in standard sizes and geometries, and provide suboptimal patient fit with limited dose modulation. METHODS: In this paper we use Monte Carlo modeling for comprehensive characterization of radiologic properties of various 3D printable biocompatible and sterilizable materials with comparison to water. Based on these results, we choose the optimal set of materials for a patient-specific applicator. We develop a novel method to design the patient-specific applicator without incurring a significant increase in treatment time or changes to clinical workflow. Finally, using an example of two selected vaginal cancers, we compare the performance of patient-specific and water-equivalent applicators in terms of target coverage and rectum sparing. RESULTS: In the energy range from 1 MeV to 4 MeV, all materials have similar attenuation coefficients. In the range from ~2 keV to 1 MeV and above 4 MeV, tungsten-polylactic acid composite (WPLA) was seen to have the highest attenuation coefficient. The dose distribution of the water-equivalent applicator was found to be symmetric about its central axis. At the same time patient-specific shielded applicators exhibit well-modulated dose distributions. Their isodose lines are seen to spread radially into the patient, while merging close to the applicator surface, where WPLA shielding has been applied. CONCLUSIONS: The patient-specific cylinders provide comparable dose to the target, while offering advanced healthy tissue sparing, not achievable with the generic design.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".