Comparing multichannel cylinder and 3D-printed applicators for vaginal cuff brachytherapy with preliminary exploration of post-hysterectomy vaginal morphology
Junfang Yan, Xuejun Qin, Fuquan Zhang, Xiaorong Hou, Lang Yu, Jie Qiu
Abstract
PURPOSE: To compare dosimetric parameters of multichannel cylinder (MCC) and 3-dimensional (3D)-printed plans for high-dose-rate vaginal cuff brachytherapy (VBT) and to explore vaginal morphologies after hysterectomy. MATERIAL AND METHODS: to mould vaginal anatomy. 3D digital model of vaginal gauze was then generated and subsequently converted into a prototype 3D-printed applicator, and optimized source catheters were placed in the applicator. Post-hysterectomy vaginal configurations were classified via morphometric analysis of 3D-printed applicators. RESULTS: < 0.001). 3D-printed applicators demonstrated superiority over MCC in terms of bladder and rectum protection. However, it would cause higher undesired doses to sigmoid. Post-hysterectomy vaginal configurations were classified into five different types, including dome-column, Gothic arch-column, two dog ears-column, one dog ear-column, and 'up wide and low narrow'. CONCLUSIONS: Compared with MCC, 3D-printed applicators delivered a higher dose and larger volume, and offered more homogeneous and conformal target coverage. Further research on vaginal morphology will be valuable to help screen out patients who need 3D-printed applicators, and to provide guidance for designing new applicators.