S2741
RTT - Patient preparation, immobilisation, and verification protocols
ESTRO 2026
Italy. 6 Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy. 7 Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy Purpose/Objective: We present a new 3D printed device designed for use in particle therapy for gynecological malignancies. The tool has been developed to enhance setup repeatability and to allow effective useboth during setup and simulation (CT, MRI) and plan delivery with
different particles [1]. Material/Methods:
The device was designed in Blender software (version 4.2) and manufactured in-house employing a multi- material 3D printing approach (printer: WASP 4070 INDUSTRIAL X). The final configuration is shown in Figure 1. In addition to a robust and adjustable applicator holder, radiopaque markers were embedded into the main body of the applicator to provide positional reference during setup refinement procedures (Figure 2). Pre-clinical assessment involved the characterization of constituent materials and the applicator’s physical properties. Principal steps are listed hereafter: Radiological Analysis: mean Hounsfield Unit (HU) value was determined from a standard Computed Tomography (CT) scan of the device wrapped in a tissue-equivalent bolus [2].Water Equivalent Path Length (WEPL) Measurement: proton stopping power was experimentally measured using a monoenergetic proton beam.Dosimetric Impact Study: sensitivity analysis was conducted by generating comparative treatment plans (protons vs carbon-ion beams). The plans were subsequently recalculated by assigning the applicator a water equivalent value to estimate the maximum dosimetric variation.Imaging Compatibility: The visibility of embedded markers and surrogate structures was qualitatively addressed on CT and a 3T MRI modalities.
Conclusion: Inter- and intrafraction variations for OF were comparable to CF and within clinically acceptable variations. These findings support the use of OF in conjunction with SGRT as a safe, patient-friendly alternative for H&N radiotherapy. Keywords: Head-and-neck cancer, SGRT, Immobilisation Digital Poster 3811 Pre-clinical commissioning of a 3D printed device for gynecological patients Ganesh Marchesi 1 , Alessandro Vai 2 , Amelia Barcellini 3,4 , Jessica Franzetti 3 , Viviana Vitolo 3 , Anita Caracciolo 1 , Giulia Sellaro 1 , Arianna Serra 5 , Chiara Paganelli 6 , Mario Ciocca 2 , Guido Baroni 1,6 , Ester Orlandi 3,7 , Andrea Pella 1 1 Bioengineering Unit, Clinical Department, National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy. 2 Medical Physics Unit, Clinical Department, National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy. 3 Radiation Oncology Unit, Clinical Department, National Centre for Oncological Hadrontherapy (CNAO), Pavia, Italy. 4 Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. 5 Quality Department, National Centre for Oncological Hadrontherapy (CNAO), Pavia,
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