Ramotar, M. (Matthew)

Filtering

20231

Settings

Author search.filters.isAuthorOfPublication.309cca44-b3e0-49a6-8993-65fc2326adc7

Search Results

Now showing 1 - 1 of 1
  • Thumbnail Image
    A total inverse planning paradigm: Prospective clinical trial evaluating the performance of a novel MR-based 3D-printed head immobilization device
    (2023) Santiago, A. (Ana) de; Ramotar, M. (Matthew); Badzynski, A. (Adam); Conrad, T. (Tatiana); Chan, H. H. L. (Harley H. L.); Shultz, D. (David); Jablonska, P.A. (Paola Anna); Irish, J. C. (Jonathan C.); Tsang, D.S. (Derek S.); Tadic, T. (Tony); Millar, B.A. (Barbara-Ann); Filleti, M. (Matthew); Berlin, A. (Alejandro); Laperriere, N. (Normand); Braganza, M. (Maria); Cho, Y.B. (Young-Bin); Parent, A. (Amy); La-Macchia, N. (Nancy)
    Background and purpose: Brain radiotherapy (cnsRT) requires reproducible positioning and immobilization, attained through redundant dedicated imaging studies and a bespoke moulding session to create a thermoplastic mask (T-mask). Innovative approaches may improve the value of care. We prospectively deployed and assessed the performance of a patient-specific 3D-printed mask (3Dp-mask), generated solely from MR imaging, to replicate a reproducible positioning and tolerable immobilization for patients undergoing cnsRT.Material and methods: Patients undergoing LINAC-based cnsRT (primary tumors or resected metastases) were enrolled into two arms: control (T-mask) and investigational (3Dp-mask). For the latter, an in-house designed 3Dp-mask was generated from MR images to recreate the head positioning during MR acquisition and allow coupling with the LINAC tabletop. Differences in inter-fraction motion were compared between both arms. Tolerability was assessed using patient-reported questionnaires at various time points.Results: Between January 2020 -July 2022, forty patients were enrolled (20 per arm). All participants completed the prescribed cnsRT and study evaluations. Average 3Dp-mask design and printing completion time was 36 h:50 min (range 12 h:56 min -42 h:01 min). Inter-fraction motion analyses showed three-axis displacements comparable to the acceptable tolerance for the current standard-of-care. No differences in patient-reported tolerability were seen at baseline. During the last week of cnsRT, 3Dp-mask resulted in significantly lower facial and cervical discomfort and patients subjectively reported less pressure and confinement sensation when compared to the T-mask. No adverse events were observed.Conclusion: The proposed total inverse planning paradigm using a 3D-printed immobilization device is feasible and renders comparable inter-fraction performance while offering a better patient experience, potentially improving cnsRT workflows and its cost-effectiveness.