Evaluation of Radiological and Dosimetric Characteristics of 3D-Printed High-Impact Polystyrene for Radiotherapy Bolus

F. A. Rizaldi, D. J. D. H. Santjojo, L. A. Abrar, F. K. Hentihu, S. Herwiningsih

Abstract


Post-Mastectomy Radiation Therapy (PMRT) requires optimal dose delivery to the skin surface. However, the skin-sparing effect often leads to superficial underdosage. Although the use of a bolus can increase the surface dose, conventional boluses often have limitations in conforming to irregular surfaces, such as the breast. The Three-Dimensional (3D) printing with High-Impact Polystyrene (HIPS) offers a potential solution for fabricating patient-specific boluses based on Computed Tomography (CT) images. This study aims to evaluate the radiological and dosimetric characteristics of 3D-printed HIPS boluses at different thicknesses and infill densities, and to investigate the conformity of breast-shaped 3D-printed HIPS boluses on mannequin breasts. Plate-shaped 3D-printed HIPS boluses with thicknesses of 6, 8, and 10 mm at 20%, 40%, 60%, and 80% infill densities, as well as breast-shaped boluses with a thickness of 6 mm at 20%, 40%, 60%, and 80% infill densities, were fabricated using a 3D printer with HIPS filament. The material characterizations encompassed Hounsfield Unit (HU), Relative Electron Density (RED), Percentage Surface Dose (PSD), Stopping Power (SP), and Continuous Slowing Down Approximation (CSDA) range. The results indicated HU values of −539 to −248 and RED of 0.56 to 0.75. Surface dose assessment indicated PSD levels of 92% to 97% of the prescribed dose. The total stopping power was observed to vary from 0.143 to 0.167 MeV/mm, while the corresponding CSDA range decreased from 42.8 to 36.7 mm. Increasing infill density resulted in higher HU, RED, and PSD values, and improved bolus homogeneity, but reduced CSDA value. The optimal configuration was identified as an 8 mm thickness at 80% infill density. The breast-shaped boluses on mannequin breast exhibited the air gap volumes ranging from 1.14 to 1.86 cm3. The 3D-printed HIPS boluses show potential to be integrated into the existing clinical workflow.

Keywords


3D-printed bolus; electron beam radiation therapy; dosimetric characterization, high-impact polystyrene; radiological characterization; tissue-equivalent material

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DOI: https://doi.org/10.55981/aij.2026.1813

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