Reproducibility and air gap pockets of 3D-printed brachytherapy applicator placement in high-dose-rate skin cancer

Background and Purpose: This study aimed to investigate the reproducibility of a novel approach using 3D printed brachytherapy applicators for the treatment of skin cancer. Specifically, we aimed to assess the accuracy of applicator placement and to minimize the existence of air gap pockets between the applicator and the patient's skin. Materials and Methods: A total of 20 patients plans diagnosed with skin cancer were enrolled in this study. All patients underwent high dose rate (HDR) brachytherapy. To ensure precise applicator placement, patient-specific 3D printed applicators were designed based on individual body and tumor topography, utilizing data obtained from computer tomography (CT) scans. All applicators were fabricated using fused deposition modeling technology. Results: The error in applicator placement was measured and found to be less than 1.0 mm on average, with a standard deviation of 0.9 mm. Additionally, the average error in air gap pockets between the applicator and the patient's skin was 0.4 mm (standard deviation was 0.5 mm). The study demonstrated that the personalized approach of 3D printed brachytherapy applicator placement in skin cancer treatment yielded highly accurate results. The average error of less than 1.0 mm in applicator positioning and the minimal air gap pockets demonstrated the reproducibility and precision of this technique. Conclusion: Our study establishes the reproducibility and accuracy of 3D-printed brachytherapy applicator placement in the treatment of skin cancer. This personalized treatment approach offers a highly precise method for delivering radiation therapy, minimizing the risk to adjacent healthy tissues, and enhancing overall patient outcomes.