CN112057750B - Tissue compensator for radiotherapy and preparation method thereof - Google Patents
Tissue compensator for radiotherapy and preparation method thereof Download PDFInfo
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- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
- B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
- B29C39/00—Shaping by casting, i.e. introducing the moulding material into a mould or between confining surfaces without significant moulding pressure; Apparatus therefor
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- B29C39/10—Shaping by casting, i.e. introducing the moulding material into a mould or between confining surfaces without significant moulding pressure; Apparatus therefor for making articles of definite length, i.e. discrete articles incorporating preformed parts or layers, e.g. casting around inserts or for coating articles
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- B—PERFORMING OPERATIONS; TRANSPORTING
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- B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
- B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B29—WORKING OF PLASTICS; WORKING OF SUBSTANCES IN A PLASTIC STATE IN GENERAL
- B29C—SHAPING OR JOINING OF PLASTICS; SHAPING OF MATERIAL IN A PLASTIC STATE, NOT OTHERWISE PROVIDED FOR; AFTER-TREATMENT OF THE SHAPED PRODUCTS, e.g. REPAIRING
- B29C64/00—Additive manufacturing, i.e. manufacturing of three-dimensional [3D] objects by additive deposition, additive agglomeration or additive layering, e.g. by 3D printing, stereolithography or selective laser sintering
- B29C64/30—Auxiliary operations or equipment
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- B33Y10/00—Processes of additive manufacturing
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
- B33Y50/00—Data acquisition or data processing for additive manufacturing
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B33—ADDITIVE MANUFACTURING TECHNOLOGY
- B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
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Abstract
The invention discloses a tissue compensator for radiotherapy and a preparation method thereof, wherein the preparation method comprises the following steps: 1. carrying out CT scanning on the treatment part to obtain image data of the treatment part; 2. drawing the shape and thickness of the tissue compensator according to image data obtained by CT scanning; 3. printing a shell of the tissue compensator by using a CLIP technology, wherein the shell is made of a photosensitive resin material, and the surface roughness of the shell is less than or equal to 3.2; 4. and (3) injecting the silica gel into the shell, wherein the hardness of the cured silica gel is 15-22 degrees, and the tissue compensator is obtained after the silica gel is cured. The preparation method of the invention can meet the requirement of personalized customization, and the tissue compensators of different parts are prepared; in addition, the preparation method has the advantages of easy demoulding, high efficiency, repeatable preparation, smooth surface and proper hardness.
Description
Technical Field
The invention relates to the technical field of radiotherapy tissue compensators, in particular to a tissue compensator for radiotherapy and a preparation method thereof.
Background
Both high-energy X (y) lines and electron lines have dose-building effects, which can lead to insufficient target dose for superficial lesions (such as skin cancer, perineal Paget's disease, etc.). The radiotherapy tissue compensator can effectively increase the skin surface radiation dose, for example, the addition of the effective tissue compensator can increase the 6MV X-ray skin dose from 10-40% to nearly 100%. The most common tissue compensator in clinical practice is a commercial quadrate equivalent tissue compensation membrane with the size of 20cm × 20cm, certain thickness and hardness. However, the human body surface is often uneven or even irregular curved surface, so that an air gap is necessarily formed between the two. The existence of the air gaps can obviously reduce the surface dosage, and when the air gaps are larger than 5mm, the body surface dosage is reduced to about 90 percent; when the air gap is larger than 50mm, the body surface dosage is reduced to about 80%. The air gap is reduced, the dose uniformity of the target area can be improved, and the radiotherapy precision is improved.
Aiming at irregular body surfaces, the self-made tissue compensators such as millet flour bags, paraffin, wet gauze, vaseline (gauze) and the like are generally applied clinically, and the tissue compensators can be made into proper shapes according to requirements, so that the problem of air gaps is partially solved; but has the defects of rough process, poor conformality, poor tissue uniformity, poor repeatability and the like, so that the actual radiotherapy dose of superficial lesions has great uncertainty and the curative effect is influenced. In addition, superficial lesions of some specific sites, such as penile cancer, paget's disease of scrotum, etc., require special devices with positioning and compensation functions to assist.
Disclosure of Invention
The technical problem to be solved by the invention is to provide a tissue compensator for radiotherapy, the inner surface of which is completely matched with the skin of a patient, so that the dose build-up effect is effectively weakened, and the uniform and sufficient irradiation dose is obtained on the surface of the skin of the patient.
The technical problem to be solved by the invention is to provide a method for preparing a tissue compensator for radiotherapy, and the prepared tissue compensator has high precision, easy demoulding and high efficiency.
In order to solve the technical problem, the invention provides a preparation method of a tissue compensator for radiotherapy, which comprises the following steps:
1. carrying out CT scanning on the treatment part to obtain image data of the treatment part;
2. drawing the shape and thickness of the tissue compensator according to image data obtained by CT scanning;
3. printing a shell of the tissue compensator by using a CLIP technology, wherein the shell is made of a photosensitive resin material, and the surface roughness of the shell is less than or equal to 3.2;
4. and (3) injecting the silica gel into the shell, wherein the hardness of the cured silica gel is 15-22 degrees, and the tissue compensator is obtained after the silica gel is cured.
As an improvement of the scheme, the photosensitive resin material comprises a photosensitive prepolymer, an active diluent, a photoinitiator and a photosensitizer, the photosensitive prepolymer comprises one or more of acrylic acid esterified epoxy resin, unsaturated polyester, polyurethane and polythiol/polyene photocuring resin, and the molecular weight of the photosensitive prepolymer is 6600-8000.
As an improvement of the above scheme, the reactive diluent comprises one or more of styrene, vinyl pyrrolidone, vinyl acetate, butyl acrylate, isooctyl acrylate, 1, 6-hexanediol diacrylate, tripropylene glycol diacrylate, neopentyl glycol diacrylate, trimethylolpropane triacrylate, acryloxy, methacryloxy, vinyl and allyl;
the photoinitiator comprises one or more of benzoin and derivatives thereof, acetophenone derivatives and triarylsulfur salts;
the photosensitizer comprises one or more of benzophenone, michaelis-son, thioxanthone and benzil.
As an improvement of the scheme, the thickness of the shell is 0.5-3 mm.
As an improvement of the proposal, the impact strength of the shell is 6-8 KJ/m 2 Tensile strength of 55-77 MPa and notch impact strength of 10-14J/m 2 。
As an improvement of the above, the housing comprises an outer housing and an inner housing, the outer housing has a shape of an outer surface of the tissue compensator, and the inner housing has a shape of an inner surface of the tissue compensator;
and fixing the inner shell and the outer shell on the bottom plate, wherein the inner shell, the outer shell and the bottom plate enclose to form a cavity, and the size and the shape of the cavity are consistent with those of the tissue compensator.
As an improvement of the above scheme, before injecting the silica gel into the shell, the method further comprises the following steps: and coating a layer of release agent on the inner surface of the shell, wherein the release agent is glycerol.
As an improvement of the above scheme, the shore hardness of the cured silica gel is 18 to 21 degrees.
Correspondingly, the invention also provides a tissue compensator for radiotherapy, which is prepared by adopting the preparation method.
The implementation of the invention has the following beneficial effects:
1. the preparation method of the invention delineates the shape and the thickness of the tissue compensator through CT image data, then prints a shell with high precision, smooth surface and easy demoulding by matching with photosensitive resin materials through CLIP technology, and finally prepares the silica gel tissue compensator with proper hardness by adopting the shell. The preparation method of the invention can meet the requirement of personalized customization, and the tissue compensators of different parts are prepared; in addition, the preparation method is easy to demould, high in efficiency, capable of repeatedly preparing, smooth in surface and suitable in hardness.
2. The tissue compensator prepared by the invention has high precision, is consistent with the shape and thickness of the tissue compensator outlined by a TPS system, can effectively weaken the dose build-up effect, and enables the skin surface of a patient to obtain uniform and sufficient irradiation dose.
3. The tissue compensator has good adhesiveness and good ductility, can be in seamless contact with the epidermis of a human body, effectively improves the dose uniformity of a target area, and improves the accuracy of radiotherapy.
Drawings
Fig. 1 is a schematic structural view of the housing of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention will be described in further detail with reference to the accompanying drawings.
The invention provides a preparation method of a tissue compensator for radiotherapy, which comprises the following steps:
1. carrying out CT scanning on the treatment part to obtain image data of the treatment part;
2. drawing the shape and thickness of the tissue compensator according to image data obtained by CT scanning;
specifically, after the CT scanning is finished, the image data are transmitted to a TPS system to make a radiotherapy plan, the CT image data are imported into 3D modeling software, the outline of the tissue compensator is sketched, and the thickness of the manufactured compensator is calculated.
The TPS system is a radiation treatment planning system that simulates the radiation treatment planned for delivery by modeling the radiation source and the patient. The system uses one or more algorithms to calculate the distribution of absorbed dose in the patient, and the results are used by the radiation therapy planner. Existing TPS systems include Pinnacle3, eclipse, modernTPS or Xio.
3. Printing out a shell of the tissue compensator by using a CLIP technology;
compared with the FDM technology (fused deposition technology), the CLIP technology (Continuous Liquid Interface Production) adopted in the invention has the advantages of faster printing speed, more perfect printed product details (high precision and smooth surface) and difficult blockage of the spray head.
The fused deposition technology (FDM) adopts polylactic acid (PLA) as a printing material, a spray head extrusion mode is adopted, the diameter of the spray head determines the printing precision, the method and the material are matched with the printing speed to be slow, the surface of a printed shell is rough, silica gel is easy to adhere to the surface, and the surface and the shape of the silica gel are easy to damage. In addition, polylactic acid materials have high toughness and are difficult to break and take out tissue compensators; it is therefore not desirable to print the tissue compensator shells using FDM techniques.
The invention can directly print out a hollow shell, and then inject silica gel into the shell to form a tissue compensator; however, this method requires breaking the shell to print out the tissue compensator.
The invention can also print out the components of the shell, and then can be disassembled and assembled so as to be convenient for taking out the tissue compensator, thereby ensuring that the shell can be repeatedly used and the manufactured tissue compensator has less error.
Referring to fig. 1, the housing includes an outer housing 1 and an inner housing 2, the outer housing 1 having a shape of an outer surface of the tissue compensator, and the inner housing 2 having a shape of an inner surface of the tissue compensator.
Specifically, fix interior casing 2, shell body 1 on bottom plate 3, interior casing 2 and shell body 1 accessible glue bond are on bottom plate 3, and the tip between interior casing 2 and the shell body 1 forms sealing connection through end plate 4 to make interior casing 2, shell body 1 and bottom plate 3 enclose and close formation cavity 5.
The bottom plate is an acrylic plate, a wood plate, a plastic plate or a glass plate. For better fit with the housing, preferably the bottom plate is an acrylic plate.
Preferably, the surface roughness (Ra) of the shell is less than or equal to 3.2. If the surface roughness of the case is greater than 3.2, the silicone gel is easily adhered to the surface of the case, and the surface and shape of the silicone gel are damaged.
The material of the shell plays an important role in the preparation of the tissue compensator. First, the material of the housing is readily available, inexpensive, non-toxic, harmless, and easily breakable. After the silica gel in the shell is cured, the shell needs to be broken into pieces to take out the tissue compensator. To facilitate removal of the tissue compensator from the housing, it is preferred that the housing be made of a brittle, light-sensitive resin material.
The photosensitive resin material comprises a photosensitive prepolymer, an active diluent, a photoinitiator and a photosensitizer, wherein the photosensitive prepolymer comprises one or more of acrylated epoxy resin, unsaturated polyester, polyurethane and polythiol/polyene photocuring resin, and the molecular weight of the photosensitive prepolymer is 6600-8000;
the active diluent comprises one or more of styrene, vinyl pyrrolidone, vinyl acetate, butyl acrylate, isooctyl acrylate, 1, 6-hexanediol diacrylate, tripropylene glycol diacrylate, neopentyl glycol diacrylate, trimethylolpropane triacrylate, acryloxy, methacryloxy, vinyl and allyl;
the photoinitiator comprises one or more of benzoin and derivatives thereof, acetophenone derivatives and triarylsulfur salts;
the photosensitizer comprises one or more of benzophenone, mikrobile ketone, thioxanthone and benzil.
In the invention, the photosensitive prepolymer is a low-molecular-weight prepolymer capable of being subjected to photocuring, if the molecular weight of the photosensitive prepolymer is less than 6600, the brittleness of the shell is reduced, so that the shell is not easy to break, and if the molecular weight of the photosensitive prepolymer is more than 8000, the shell is easy to crack and is not easy to print and form; the reactive diluent is used for participating in the curing reaction of the epoxy resin and becomes a part of a cross-linked network structure of a cured epoxy resin; the photoinitiator and photosensitizer act to promote initiation of polymerization during polymerization.
Specifically, the impact strength of the shell is 6-8 KJ/m 2 The tensile strength is 55-77 MPa, and the notch impact strength is 10-14J/m 2 。
The invention adopts the CLIP technology and the photosensitive resin material to be matched to manufacture the shell, thereby forming the shell which has high precision, low cost, safety and reliability and is easy to break.
It should be noted that the thickness of the shell also plays an important role in the preparation of the tissue compensator; if the thickness of the shell is too thin, the shell is deformed, so that the solidification of silica gel is not facilitated, and the precision of the tissue compensator is influenced; if the thickness of the shell is too thick, the shell is not easy to break, the printing speed is slow, and materials are wasted. Preferably, the thickness of the shell is 0.5 to 3mm. More preferably, the thickness of the shell is 1.5-2.5 mm.
Before silica gel is injected into the shell, the method also comprises the following steps: a layer of release agent is applied to the inner surface of the shell to further increase the smoothness of the shell surface. Preferably, the release agent is glycerol.
4. Injecting silica gel into the shell, and curing the silica gel to obtain a tissue compensator;
it should be noted that the silica gel is in a liquid state before being injected into the housing, and the silica gel is solidified after a predetermined time. In order to accelerate the curing speed of the silica gel, the silica gel is heated at the temperature of 60-80 ℃.
It should be noted that the hardness of the cured silicone gel has an important influence on the use effect of the tissue compensator, and if the hardness of the cured silicone gel is too high, the oppressive feeling of the treatment site of the patient is increased, and the pain of the patient is caused. If the hardness of the cured silicone is too low, the silicone is easily adhered to the housing, and is not easily taken out, and the surface and shape of the silicone are easily damaged.
Preferably, the shore hardness of the cured silica gel is 15-22 degrees.
More preferably, the Shore hardness of the cured silica gel is 18-21 degrees.
More preferably, the Shore hardness of the cured silica gel is 20-21 degrees.
Correspondingly, the invention also provides a tissue compensator for radiotherapy, which is prepared by the preparation method. The tissue compensator is made of silica gel, is an amorphous substance, is a high-activity adsorption material, has good toughness and elasticity, does not deform under the action of external force, is nontoxic, tasteless and colorless, does not harm human bodies, can be effectively stuck on the epidermis of human bodies, reduces gaps between the epidermis of human bodies and improves the treatment effect.
The tissue compensator prepared by the preparation method has uniform texture and thickness, can be tightly attached to the skin of a human body, effectively improves the dosimetry parameters of a superficial tumor target area, and reduces the dosage.
In addition, the tissue compensator of the invention can be customized according to different patients and different parts, and the precision of the tissue compensator is high.
The invention will be further developed by means of the following specific examples
Carrying out CT scanning on a breast cancer patient 1 to obtain image data of a treatment part; drawing the shape and thickness of the tissue compensator according to image data obtained by CT scanning;
example 1
Printing a shell of a tissue compensator by using a CLIP technology, wherein the shell is made of a photosensitive resin material and comprises a photosensitive prepolymer, an active diluent, a photoinitiator and a photosensitizer, and the molecular weight of the photosensitive prepolymer is 7500;
the roughness of the shell is 1.5, the thickness is 1mm, and the impact strength is 7KJ/m 2 Tensile strength of 60MPa and notch impact strength of 12J/m 2 (ii) a The printing time of the shell is 1.3h;
injecting silica gel into the shell, wherein the injection time of the silica gel is 5min, and the hardness of the cured silica gel is 20 degrees;
the shell is broken up and the tissue compensator is completely removed.
Example 2
Printing a shell of the tissue compensator by using a CLIP technology, wherein the shell is made of a photosensitive resin material and comprises a photosensitive prepolymer, an active diluent, a photoinitiator and a photosensitizer, and the molecular weight of the photosensitive prepolymer is 7000;
the shell comprises an outer shell and an inner shell, the outer shell is in the shape of the outer surface of the tissue compensator, the inner shell is in the shape of the inner surface of the tissue compensator, the inner shell and the outer shell are fixed on the bottom plate, and the inner shell, the outer shell and the bottom plate enclose to form a cavity;
the roughness of the shell is 1.5, the thickness of the shell is 1mm, and the impact strength of the shell is 8KJ/m 2 Tensile strength of 70MPa and notch impact strength of 14J/m 2 (ii) a The printing time of the shell is 1.5h;
injecting silica gel into the cavity of the shell, wherein the injection time of the silica gel is 5min, and the hardness of the cured silica gel is 18 degrees;
the inner and outer housings are opened and the tissue compensator is removed intact.
Comparative example 1
Printing a shell of the tissue compensator by adopting FDM technology, wherein the shell is made of polylactic acid material, and the roughness of the shell12.5, 1mm in thickness and 18-25 KJ/m in impact strength 2 The notch impact strength is 30-40J/m 2 (ii) a The printing time of the shell is 4.5h;
injecting silica gel into the shell, wherein the injection time of the silica gel is 30min, and the hardness of the cured silica gel is 8 degrees;
the shell is difficult to break, the silica gel is adhered to the surface of the shell, and the tissue compensator cannot be completely taken out.
The consistency of the shape and the thickness of the tissue compensator prepared in the embodiment 1 and the embodiment 2 and the tissue compensator sketched by the TPS system reaches more than 95%, and the consistency of the shape and the thickness of the tissue compensator prepared in the comparative example 1 and the tissue compensator sketched by the TPS system only reaches 80% -85%.
While the invention has been described in connection with what is presently considered to be the most practical and preferred embodiment, it is to be understood that the invention is not to be limited to the disclosed embodiment, but on the contrary, is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims.
Claims (8)
1. A method of preparing a tissue compensator for radiotherapy comprising the steps of:
1. carrying out CT scanning on the treatment part to obtain image data of the treatment part;
2. drawing the shape and thickness of the tissue compensator according to image data obtained by CT scanning;
3. printing a shell of the tissue compensator by using a CLIP technology, wherein the shell is made of a photosensitive resin material, and the surface roughness of the shell is less than or equal to 3.2;
4. injecting silica gel into the shell, wherein the hardness of the cured silica gel is 15-22 degrees, and the tissue compensator is obtained after the silica gel is cured;
the photosensitive resin material comprises a photosensitive prepolymer, an active diluent, a photoinitiator and a photosensitizer, wherein the photosensitive prepolymer comprises one or more of acrylated epoxy resin, unsaturated polyester, polyurethane and a polythiol/polyene photocuring resin body, and the molecular weight of the photosensitive prepolymer is 6600-8000.
2. The method of claim 1, wherein the reactive diluent comprises one or more of styrene, vinyl pyrrolidone, vinyl acetate, butyl acrylate, isooctyl acrylate, 1, 6-hexanediol diacrylate, tripropylene glycol diacrylate, neopentyl glycol diacrylate, trimethylolpropane triacrylate, acryloxy, methacryloxy, vinyl and allyl groups;
the photoinitiator comprises one or more of benzoin and derivatives thereof, acetophenone derivatives and triarylsulfur salts;
the photosensitizer comprises one or more of benzophenone, mikrobile ketone, thioxanthone and benzil.
3. The method of claim 1, wherein the thickness of the shell is 0.5-3 mm.
4. The method for preparing the tissue compensator for radiotherapy as set forth in claim 1, wherein the impact strength of the shell is 6 to 8KJ/m 2 The tensile strength is 55 to 77MPa, and the notch impact strength is 10 to 14J/m 2 。
5. The method of preparing a tissue compensator for radiation therapy as claimed in claim 1, wherein the housing comprises an outer housing and an inner housing, the outer housing having a shape that is the shape of the outer surface of the tissue compensator and the inner housing having a shape that is the shape of the inner surface of the tissue compensator;
and fixing the inner shell and the outer shell on the bottom plate, wherein the inner shell, the outer shell and the bottom plate enclose to form a cavity, and the size and the shape of the cavity are consistent with those of the tissue compensator.
6. The method of preparing a tissue compensator for radiation therapy as claimed in claim 1, wherein before injecting the silicone gel into the housing, further comprising the steps of: and coating a layer of release agent on the inner surface of the shell, wherein the release agent is glycerol.
7. The method of claim 1, wherein the cured silicone gel has a shore hardness of between 18 ° and 21 °.
8. A tissue compensator for radiotherapy, which is prepared by the preparation method of the tissue compensator for radiotherapy as claimed in any one of claims 1 to 7.
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| CN113679958B (en) * | 2021-08-02 | 2023-03-24 | 无锡恒成医疗科技股份有限公司 | Equivalent tissue compensator and preparation method thereof |
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| JP2004204051A (en) * | 2002-12-25 | 2004-07-22 | Mitsubishi Engineering Plastics Corp | Molded product of polyacetal-based resin having specific corner part |
| CN107868443A (en) * | 2017-12-01 | 2018-04-03 | 惠州市优恒科三维材料有限公司 | A kind of photosensitive resin material of 3D printing |
| WO2019167895A1 (en) * | 2018-03-01 | 2019-09-06 | コニカミノルタ株式会社 | Resin composition and production method for three dimensional shaped object using same, and three dimensional shaped object |
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