A review of 3D printed patient specific immobilisation devices in radiotherapy.

BACKGROUND AND PURPOSE: Radiotherapy is one of the most effective cancer treatment techniques, however, delivering the optimal radiation dosage is challenging due to movements of the patient during treatment. Immobilisation devices are typically used to minimise motion. This paper reviews published research investigating the use of 3D printing (additive manufacturing) to produce patient-specific immobilisation devices, and compares these to traditional devices. MATERIALS AND METHODS: A systematic review was conducted across thirty-eight databases, with results limited to those published between January 2000 and January 2019. A total of eighteen papers suitably detailed the use of 3D printing to manufacture and test immobilisers, and were included in this review. This included ten journal papers, five posters, two conference papers and one thesis. RESULTS: 61% of relevant studies featured human subjects, 22% focussed on animal subjects, 11% used phantoms, and one study utilised experimental test methods. Advantages of 3D printed immobilisers reported in literature included improved patient experience and comfort over traditional methods, as well as high levels of accuracy between immobiliser and patient, repeatable setup, and similar beam attenuation properties to thermoformed immobilisers. Disadvantages included the slow 3D printing process and the potential for inaccuracies in the digitisation of patient geometry. CONCLUSION: It was found that a lack of technical knowledge, combined with disparate studies with small patient samples, required further research in order to validate claims supporting the benefits of 3D printing to improve patient comfort or treatment accuracy.

Planar lens integrated capillary action microfluidic immunoassay device for the optical detection of troponin I.

Optical based analysis in microfluidic and lab-on-a-chip systems are currently considered the gold standard methodology for the determination of end point reactions for various chemical and biological reaction processes. Typically, assays are performed using bulky ancillary apparatus such as microscopes and complex optical excitation and detection systems. Such instrumentation negates many of the advantages offered by device miniaturisation, particularly with respect to overall portability. In this article, we present a CO2 laser ablation technique for rapidly prototyping on-chip planar lenses, in conjunction with capillary action based autonomous microfluidics, to create a miniaturised and fully integrated optical biosensing platform. The presented self-aligned on-chip optical components offer an efficient means to direct excitation light within microfluidics and to directly couple light from a LED source. The device has been used in conjunction with a miniaturised and bespoke fluorescence detection platform to create a complete, palm sized system (≈60 × 80 × 60 mm) capable of performing fluoro-immunoassays. The system has been applied to the detection of cardiac Troponin I, one of the gold standard biomarkers for the diagnosis of acute myocardial infarction, achieving a lower detection limit of 0.08 ng/ml, which is at the threshold of clinically applicable concentrations. The portable nature of the complete system and the biomarker detection capabilities demonstrate the potential of the devised instrumentation for use as a medical diagnostics device at the point of care.

A miniaturised integrated biophotonic point-of-care genotyping system.

This paper reports the development of a novel genotyping device specifically designed for point-of-care applications. As the results of the human genome project are applied to clinical practice there is an increasing requirement for simple to operate high-speed, potentially low-cost genotyping devices for use in the clinic. The aim of such devices is not to specifically detect a full gene sequence but to monitor the presence of specific Single Nucleotide Polymorphisms (SNPs). The instrument is designed to fulfil this specific clinical requirement. Using a FRET-based assay the instrument completes a full PCR process and then performs a melting point test to determine the exact SNPs present in the sample. Results are presented in which the instrument produces results within 18 min based upon saliva samples provided by the patient. The paper also reports successful results both with purified DNA samples and saliva-based samples which were taken from subjects after experiments deliberately aimed at confusing the instrument.

Lab-on-a-chip based immunosensor principles and technologies for the detection of cardiac biomarkers: a review.

This review examines the current state of the art lab-on-a-chip and microfluidic based biosensor technologies used in the detection of cardiac biomarkers. The determination and quantification of blood based, cardiac biomarkers are crucial in the triage and management of a range of cardiac related conditions, where time delay has a major impact on short and longer-term outcomes of a patient. The design and manufacturing of biomarker detection systems are multi-disciplinary in nature and require researchers to have knowledge of both life sciences and engineering for the full potential of this field to be realised. This review will therefore provide a comprehensive overview of chip based immunosensing technology as applied to cardiac biomarker detection, while discussing the potential suitability and limitations of each configuration for incorporation within a clinical diagnostics device suitable for point-of-care applications.