Quasi-simultaneous 3D printing of muscle-, lung- and bone-equivalent media: a proof-of-concept study


3D printing is a promising solution for the production of bespoke phantoms and phantom components, for radiotherapy dosimetry and quality assurance (QA) purposes. This proof-of-concept study investigated the use of a dual-head printer to deposit two different filaments (polylactic acid (PLA) and StoneFil PLA-concrete (Formfutura BV, Nijmegen, Netherlands)) at several different in-fill densities, to achieve quasi-simultaneous 3D printing of muscle-, lung- and bone-equivalent media. A Raise 3D Pro 3D printer (Raise 3D Technologies Inc, Irvine, USA) was used to print one thoracic and one cranial phantom slab. Analysis using in-house 3D print QA software showed that the two humanoid phantom slabs geometrically matched the stereolithography (STL) files on which they were based, within 0.3 mm, except in one area of the thoracic slab that was affected by thermal warping by up to 3.4 mm. The 3D printed muscle, lung and bone materials in the two humanoid phantom slabs were approximately radiologically-equivalent to human muscle, lung and bone. In particular, the use of StoneFil with a nominally constant in-fill density of 100% resulted in regions that were approximately inner-bone-equivalent, at kV and MV energies. These regions were bounded by walls that were substantially denser than inner bone, although generally not dense enough to be truly cortical-bone-equivalent. This proof-of-concept study demonstrated a method by which multiple tissue-equivalent materials (eg. muscle-, lung- and bone-equivalent media) can be deposited within one 3D print, allowing complex phantom components to be fabricated efficiently in a clinical setting.

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  1. 1.

    Tino R, Yeo A, Leary M, Brandt M, Kron T (2019) A systematic review on 3D-printed imaging and dosimetry phantoms in radiation therapy. Technol Cancer Res Treat 18:1–14

    Article  Google Scholar 

  2. 2.

    Crowe S (2019) Personalized phantoms through 3D printing. Radiother Oncol 133(S1):s362

    Article  Google Scholar 

  3. 3.

    Tran-Gia J, Schlogl S, Lassmann M (2016) Design and fabrication of kidney phantoms for internal radiation dosimetry using 3D printing technology. J Nucl Med 57(12):1998–2005

    CAS  Article  Google Scholar 

  4. 4.

    Kairn T, Crowe SB, Markwell T (2015) Use of 3D printed materials as tissue equivalent phantoms. IFMBE Proc 51:728–731

    Article  Google Scholar 

  5. 5.

    Dancewicz OL, Sylvander SR, Markwell TS, Crowe SB, Trapp JV (2017) Radiological properties of 3D printed materials in kilovoltage and megavoltage photon beams. Phys Med 38:111–118

    CAS  Article  Google Scholar 

  6. 6.

    Kairn T, Crowe SB (2019) Producing inserts for a commercial motion phantom using 3D printing. Australas Phys Eng Sci Med 42(1):377–378

    Article  Google Scholar 

  7. 7.

    Markovic A (2017) 3d printed bolus with flexible materials: treatment planning accuracy and practical aspects. Int J Radiat Onco Biol Phys 99(2):E696

    Article  Google Scholar 

  8. 8.

    Alssabbagh M, Tajuddin AA, Abdulmanap M, Zainon R (2017) Evaluation of 3D printing materials for fabrication of a novel multifunctional 3D thyroid phantom for medical dosimetry and image quality. Radiat Phys Chem 135:106–112

    CAS  Article  Google Scholar 

  9. 9.

    Van der Walt M, Crabtree T, Albantow C (2019) PLA as a suitable 3D printing thermoplastic for use in external beam radiotherapy. Australas Phys Eng Sci Med 42(4):1165–1176

    Article  Google Scholar 

  10. 10.

    Yea JW, Park JW, Kim SK et al (2017) Feasibility of a 3D printed anthropomorphic patient specific head phantom for patient specific quality assurance of intensity modulated radiotherapy. PLoS ONE 12(7):e0181560

    Article  Google Scholar 

  11. 11.

    Okkalidis N (2018) A novel 3D printing method for accurate anatomy replication in patient-specific phantoms. Med Phys 45(10):4600–4606

    CAS  Article  Google Scholar 

  12. 12.

    Kadoya N, Miyasaka Y, Nakajima Y et al (2017) Evaluation of deformable image registration between external beam radiotherapy and HDR brachytherapy for cervic al cancer with a 3D printed deformable pelvis phantom. Med Phys 44(4):1445–1455

    CAS  Article  Google Scholar 

  13. 13.

    Craft DF, Howell RM (2017) Preparation and fabrication of a full scale, sagittal sliced, 3D printed, patient specific radiotherapy phantom. J Appl Clin Med Phys 18(5):285–292

    Article  Google Scholar 

  14. 14.

    Mayer R, Liacouras P, Thomas A et al (2015) 3D printer generated thorax phantom with mobile tumor for radiation dosimetry. Rev Sci Instrum 86(7):074301

    Article  Google Scholar 

  15. 15.

    Hazelaar C, van Eijnatten M, Dahele M et al (2018) Using 3D printing techniques to create an anthropomorphic thorax phantom for medical imaging purposes. Med Phys 45(1):92–100

    Article  Google Scholar 

  16. 16.

    Pallotta S, Calusi S, Foggi L (2018) ADAM: A breathing phantom for lung SBRT quality assurance. Phys Medica 49:147–155

    Article  Google Scholar 

  17. 17.

    Oh D, Hong C-S, Ju SG (2017) Development of patient specific phantoms for verification of stereotactic body radiation therapy planning in patients with metallic screw fixation. Sci Rep 7:40922

    CAS  Article  Google Scholar 

  18. 18.

    Solomon J, Ba A, Bochud F, Samei E (2016) Comparison of low-contrast detectability between two CT reconstruction algorithms using voxel-based 3D printed textured phantoms. Med Phys 43(12):6497–6506

    Article  Google Scholar 

  19. 19.

    Randolph SA (2018) 3D printing: what are the hazards? Workplace Health Saf 66(3):164–164

    Article  Google Scholar 

  20. 20.

    Wojtyła S, Klama P, Baran T (2017) Is 3D printing safe? Analysis of the thermal treatment of thermoplastics: ABS, PLA, PET, and nylon. J Occup Environ Hygiene 14(6):D80–D85

    Article  Google Scholar 

  21. 21.

    Azimi P, Zhao D, Pouzet C et al (2016) Emissions of ultrafine particles and volatile organic compounds from commercially available desktop three-dimensional printers with multiple filaments. Environ Sci Tech 50(3):1260–1268

    CAS  Article  Google Scholar 

  22. 22.

    Fedorov A, Beichel R, Kalpathy-Cramer J et al (2012) 3D slicer as an image computing platform for the quantitative imaging network. Magn Reson Imaging 30(9):1323–1341

    Article  Google Scholar 

  23. 23.

    Clark K, Vendt B, Smith K et al (2013) The cancer imaging archive (TCIA): maintaining and operating a public information repository. J Digital Imaging 26(6):1045–1057

    Article  Google Scholar 

  24. 24.

    Aerts HJWL, Velazquez ER, Leijenaar RTH et al (2014) Decoding tumour phenotype by noninvasive imaging using a quantitative radiomics approach. Nat Commun 5:4006. https://doi.org/10.1038/ncomms5006

    CAS  Article  PubMed Central  Google Scholar 

  25. 25.

    Aerts HJWL, Velazquez ER, Leijenaar RTH et al (2015) Data from NSCLC-radiomics-genomics. Cancer Imaging Arch. https://doi.org/10.7937/K9/TCIA.2015.L4FRET6Z

  26. 26.

    Alsoufi MS, Elsayed AE (2017) Warping deformation of desktop 3D printed parts manufactured by open source fused deposition modeling (FDM) system. Int J Mech Mechatronics Eng 17(4):7–16

    Google Scholar 

  27. 27.

    Charles PH, Kairn T, Crowe SB (2020) Clinical quality assurance of 3D printed patient specific radiotherapy devices. Phys Eng Sci Med 43(1):436–437. https://doi.org/10.1007/s13246-019-00826-6. Correction to: EPSM 2019, Engineering and Physical Sciences in Medicine. Phys Eng Sci Med 43(1):463 (2020). https://doi.org/10.1007/s13246-020-00846-7

  28. 28.

    Sasaki DK, McGeachy P, Aviles JEA et al (2019) A modern mold room: meshing 3D surface scanning, digital design, and 3D printing with bolus fabrication. J Appl Clin Med Phys 20(9):78–85

    Article  Google Scholar 

  29. 29.

    Cignoni P, Callieri M, Corsini M et al (2008) MeshLab: an Open-Source Mesh Processing Tool. Sixth Eurographics Italian Chapter Conference, pp 129–136

  30. 30.

    Cignoni P, Rocchini C, Scopigno R (1998) Metro: measuring error on simplified surfaces. Comput Graphics Forum 17(2):167–174

    Article  Google Scholar 

  31. 31.

    Van Dyk J, Keane TJ, Rider WD (1982) Lung density as measured by computerized tomography: implications for radiotherapy. Int J Radiat Onco Biol Phys 8(8):1363–1372

    Article  Google Scholar 

  32. 32.

    International Commission on Radiation Units and Measurements (1989) ICRU Report 44 Tissue Substitutes in Radiation Dosimetry and Measurement. ICRU publications, Bethseda

  33. 33.

    Gammex, CT Electron Density Phantom https://www.sunnuclear.com/documents/ datasheets/gammex/ct_electron_density_phantom.pdf Accessed January 2020

  34. 34.

    Kairn T, Brown G, Choma K (2020) Design and use of a modular system of 3D printed blocks to model heart and lung tissue in a breast radiotherapy phantom. Phys Eng Sci Med 43(1):455–456. https://doi.org/10.1007/s13246-019-00826-6

    Article  Google Scholar 

  35. 35.

    Tino R, Leary M, Yeo A, Brandt M, Kron T (2019) Gyroid structures for 3D-printed heterogeneous radiotherapy phantoms. Phys Med Biol 64: 21NT05

  36. 36.

    Ceh J, Youd T, Mastrovich Z et al (2017) Bismuth infusion of ABS enables additive manufacturing of complex radiological phantoms and shielding equipment. Sensors 17(3):459

    Article  Google Scholar 

  37. 37.

    Hamedani BA, Melvin A, Vaheesan K et al (2018) Three-dimensional printing CT-derived objects with controllable radiopacity. J Appl Clin Med Phys 19(2):317–328

    Article  Google Scholar 

  38. 38.

    Crowe S, Kairn T, Sylvander S, Lancaster C (2020) Case study: the disappearing skull. Phys Eng Sci Med 43(1):335. https://doi.org/10.1007/s13246-019-00826-6

    Article  Google Scholar 

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Paul Charles and Scott Crowe’s contributions to this work were funded by a Metro North Hospital and Health Service funded Herston Biofabrication Institute program grant (no grant number).

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Correspondence to T. Kairn.

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Kairn, T., Zahrani, M., Cassim, N. et al. Quasi-simultaneous 3D printing of muscle-, lung- and bone-equivalent media: a proof-of-concept study. Phys Eng Sci Med 43, 701–710 (2020). https://doi.org/10.1007/s13246-020-00864-5

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  • Radiation therapy
  • 3D printing
  • Additive manufacture
  • Rapid prototyping