Feasibility of 3D Printer to Design an Intracavitary Applicator for the Treatment of Cervical Cancer Patients with a High Dose Rate Brachytherapy System

Abstract Purpose To design Tandem-Ovoid based intracavitary brachytherapy applicator with 3D printer and evaluate its feasibility for the treatment of Cervical Cancer patients with High Dose Rate (HDR) brachytherapy system. Methods SolidWorks, Computer Aided design software was used for the design of the intracavitary brachytherapy applicator. Raise3D Printer and Hewlett-Packard (HP) Jet Fusion 4200 was used for printing different parts of applicators with PLA and PA-12 material. Radiograph and CT images of printed material parts were taken in the air and water medium to see the visualization. Before use in the patient, necessary quality assurance tests were carried out by coupling it with a microSelectron HDR machine. X-ray markers were used to visualize the source path inside the uterine and vaginal tandems. Physical and clinical evaluations were performed with prototype 3D-printed applicator to check its suitability for clinical use. Results Final Applicator design was created from multiple hit and trial methods in SolidWorks. Printed PA-12 of ovoid parts having a mean Hounsfield unit (HU) value of -75 HU. Whereas the mean HU value of the PLA outer layer and inner regions were − 203 HU and − 417 HU respectively. Quality tests on the PA-12 intracavitary applicator performed with the microSelectron HDR brachytherapy machine were passed. Chances of uterine perforation were less due to the semi-rigidity of the PA-12 applicator. The newly designed T-O-based applicator and dummy marker do not produce any artifacts on the CT images. Conclusions Powder-based 3D printing of brachytherapy applicator has more usability as compared to fused deposition-based printer. A low-cost flexible plastic applicator was developed that allowed the user to guide the tandem into the uterus of a patient. The developed PA-12 intracavitary brachytherapy applicator did not produce artifacts on CT images.