Dosimetric characterization of carbon fiber stabilization devices for post-operative particle therapy

E Mastella, S Molinelli, G Magro, A Mirandola, S Russo, A Vai, A Mairani, K Choi, M R Fiore, P Fossati, F Cuzzocrea, A Gasbarrini, F Benazzo, S Boriani, F Valvo, R Orecchia, M Ciocca

Research output: Contribution to journalArticle

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Abstract

PURPOSE: The aim of this study was to evaluate the dosimetric impact caused by recently introduced carbon fiber reinforced polyetheretherketone (CF/PEEK) stabilization devices, in comparison with conventional titanium (Ti) implants, for post-operative particle therapy (PT).

METHODS: As a first step, protons and carbon ions Spread-Out Bragg Peaks (SOBPs) were delivered to CF/PEEK and Ti screws. Transversal dose profiles were acquired with EBT3 films to evaluate beam perturbation. Effects on image quality and reconstruction artifacts were then investigated. CT scans of CF/PEEK and Ti implants were acquired according to our clinical protocol and Hounsfield Unit (HU) mean values were evaluated in three regions of interest. Implants and artifacts were then contoured in the sample CT scans, together with a target volume to simulate a spine tumor. Dose calculation accuracy was assessed by comparing optimized dose distributions with Monte Carlo simulations. In the end, the treatment plans of nine real patients (seven with CF/PEEK and two with Ti stabilization devices) were retrospectively analyzed to evaluate the dosimetric impact potentially occurring if improper management of the spine implant was carried out.

RESULTS: As expected, CF/PEEK screw caused a very slight beam perturbation in comparison with Ti ones, leading to a lower degree of dose degradation in case of contouring and/or set-up uncertainties. Furthermore, CF/PEEK devices did not determine appreciable HU artifacts on CT images thus improving image quality and, as a final result, dose calculation accuracy.

CONCLUSIONS: CF/PEEK spinal fixation devices resulted dosimetrically more suitable than commonly-used Ti implants for post-operative PT.

Original languageEnglish
Pages (from-to)18-25
Number of pages8
JournalPhysica Medica
Volume44
DOIs
Publication statusPublished - Dec 2017

Fingerprint

PEEK
carbon fibers
therapy
stabilization
Titanium
Equipment and Supplies
titanium
dosage
Artifacts
artifacts
spine
screws
Therapeutics
Spine
perturbation
Computer-Assisted Image Processing
carbon fiber
polyetheretherketone
Clinical Protocols
Uncertainty

Keywords

  • Carbon/chemistry
  • Heavy Ion Radiotherapy/instrumentation
  • Humans
  • Ketones/chemistry
  • Neoplasms/radiotherapy
  • Polyethylene Glycols/chemistry
  • Postoperative Period
  • Radiometry
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted

Cite this

Mastella, E., Molinelli, S., Magro, G., Mirandola, A., Russo, S., Vai, A., ... Ciocca, M. (2017). Dosimetric characterization of carbon fiber stabilization devices for post-operative particle therapy. Physica Medica, 44, 18-25. https://doi.org/10.1016/j.ejmp.2017.11.008

Dosimetric characterization of carbon fiber stabilization devices for post-operative particle therapy. / Mastella, E; Molinelli, S; Magro, G; Mirandola, A; Russo, S; Vai, A; Mairani, A; Choi, K; Fiore, M R; Fossati, P; Cuzzocrea, F; Gasbarrini, A; Benazzo, F; Boriani, S; Valvo, F; Orecchia, R; Ciocca, M.

In: Physica Medica, Vol. 44, 12.2017, p. 18-25.

Research output: Contribution to journalArticle

Mastella, E ; Molinelli, S ; Magro, G ; Mirandola, A ; Russo, S ; Vai, A ; Mairani, A ; Choi, K ; Fiore, M R ; Fossati, P ; Cuzzocrea, F ; Gasbarrini, A ; Benazzo, F ; Boriani, S ; Valvo, F ; Orecchia, R ; Ciocca, M. / Dosimetric characterization of carbon fiber stabilization devices for post-operative particle therapy. In: Physica Medica. 2017 ; Vol. 44. pp. 18-25.
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abstract = "PURPOSE: The aim of this study was to evaluate the dosimetric impact caused by recently introduced carbon fiber reinforced polyetheretherketone (CF/PEEK) stabilization devices, in comparison with conventional titanium (Ti) implants, for post-operative particle therapy (PT).METHODS: As a first step, protons and carbon ions Spread-Out Bragg Peaks (SOBPs) were delivered to CF/PEEK and Ti screws. Transversal dose profiles were acquired with EBT3 films to evaluate beam perturbation. Effects on image quality and reconstruction artifacts were then investigated. CT scans of CF/PEEK and Ti implants were acquired according to our clinical protocol and Hounsfield Unit (HU) mean values were evaluated in three regions of interest. Implants and artifacts were then contoured in the sample CT scans, together with a target volume to simulate a spine tumor. Dose calculation accuracy was assessed by comparing optimized dose distributions with Monte Carlo simulations. In the end, the treatment plans of nine real patients (seven with CF/PEEK and two with Ti stabilization devices) were retrospectively analyzed to evaluate the dosimetric impact potentially occurring if improper management of the spine implant was carried out.RESULTS: As expected, CF/PEEK screw caused a very slight beam perturbation in comparison with Ti ones, leading to a lower degree of dose degradation in case of contouring and/or set-up uncertainties. Furthermore, CF/PEEK devices did not determine appreciable HU artifacts on CT images thus improving image quality and, as a final result, dose calculation accuracy.CONCLUSIONS: CF/PEEK spinal fixation devices resulted dosimetrically more suitable than commonly-used Ti implants for post-operative PT.",
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AU - Mastella, E

AU - Molinelli, S

AU - Magro, G

AU - Mirandola, A

AU - Russo, S

AU - Vai, A

AU - Mairani, A

AU - Choi, K

AU - Fiore, M R

AU - Fossati, P

AU - Cuzzocrea, F

AU - Gasbarrini, A

AU - Benazzo, F

AU - Boriani, S

AU - Valvo, F

AU - Orecchia, R

AU - Ciocca, M

N1 - Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

PY - 2017/12

Y1 - 2017/12

N2 - PURPOSE: The aim of this study was to evaluate the dosimetric impact caused by recently introduced carbon fiber reinforced polyetheretherketone (CF/PEEK) stabilization devices, in comparison with conventional titanium (Ti) implants, for post-operative particle therapy (PT).METHODS: As a first step, protons and carbon ions Spread-Out Bragg Peaks (SOBPs) were delivered to CF/PEEK and Ti screws. Transversal dose profiles were acquired with EBT3 films to evaluate beam perturbation. Effects on image quality and reconstruction artifacts were then investigated. CT scans of CF/PEEK and Ti implants were acquired according to our clinical protocol and Hounsfield Unit (HU) mean values were evaluated in three regions of interest. Implants and artifacts were then contoured in the sample CT scans, together with a target volume to simulate a spine tumor. Dose calculation accuracy was assessed by comparing optimized dose distributions with Monte Carlo simulations. In the end, the treatment plans of nine real patients (seven with CF/PEEK and two with Ti stabilization devices) were retrospectively analyzed to evaluate the dosimetric impact potentially occurring if improper management of the spine implant was carried out.RESULTS: As expected, CF/PEEK screw caused a very slight beam perturbation in comparison with Ti ones, leading to a lower degree of dose degradation in case of contouring and/or set-up uncertainties. Furthermore, CF/PEEK devices did not determine appreciable HU artifacts on CT images thus improving image quality and, as a final result, dose calculation accuracy.CONCLUSIONS: CF/PEEK spinal fixation devices resulted dosimetrically more suitable than commonly-used Ti implants for post-operative PT.

AB - PURPOSE: The aim of this study was to evaluate the dosimetric impact caused by recently introduced carbon fiber reinforced polyetheretherketone (CF/PEEK) stabilization devices, in comparison with conventional titanium (Ti) implants, for post-operative particle therapy (PT).METHODS: As a first step, protons and carbon ions Spread-Out Bragg Peaks (SOBPs) were delivered to CF/PEEK and Ti screws. Transversal dose profiles were acquired with EBT3 films to evaluate beam perturbation. Effects on image quality and reconstruction artifacts were then investigated. CT scans of CF/PEEK and Ti implants were acquired according to our clinical protocol and Hounsfield Unit (HU) mean values were evaluated in three regions of interest. Implants and artifacts were then contoured in the sample CT scans, together with a target volume to simulate a spine tumor. Dose calculation accuracy was assessed by comparing optimized dose distributions with Monte Carlo simulations. In the end, the treatment plans of nine real patients (seven with CF/PEEK and two with Ti stabilization devices) were retrospectively analyzed to evaluate the dosimetric impact potentially occurring if improper management of the spine implant was carried out.RESULTS: As expected, CF/PEEK screw caused a very slight beam perturbation in comparison with Ti ones, leading to a lower degree of dose degradation in case of contouring and/or set-up uncertainties. Furthermore, CF/PEEK devices did not determine appreciable HU artifacts on CT images thus improving image quality and, as a final result, dose calculation accuracy.CONCLUSIONS: CF/PEEK spinal fixation devices resulted dosimetrically more suitable than commonly-used Ti implants for post-operative PT.

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KW - Heavy Ion Radiotherapy/instrumentation

KW - Humans

KW - Ketones/chemistry

KW - Neoplasms/radiotherapy

KW - Polyethylene Glycols/chemistry

KW - Postoperative Period

KW - Radiometry

KW - Radiotherapy Dosage

KW - Radiotherapy Planning, Computer-Assisted

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DO - 10.1016/j.ejmp.2017.11.008

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SN - 1120-1797

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