Radiotherapy Immobilization Mask Molding Through the Use of 3D-Printed Head Models.

PURPOSE: To evaluate the feasibility of a workflow free of a simulation appointment using three-dimensional-printed heads and custom immobilization devices. MATERIALS AND METHODS: Simulation computed tomography scans of 11 patients who received radiotherapy for brain tumors were used to create three-dimensional printable models of the patients' heads and neck rests. The models were three-dimensional-printed using fused deposition modeling and reassembled. Then, thermoplastic immobilization masks were molded onto them. These setups were then computed tomography-scanned and compared against the volumes from the original patient computed tomography-scans. Following translational +/- rotational coregistrations of the volumes from three-dimensional-printed models and the patients, the similarities and accuracies of the setups were evaluated using Dice similarity coefficients, Hausdorff distances, differences in centroid positions, and angular deviations. Potential dosimetric differences secondary to inaccuracies in the rotational positioning of patients were calculated. RESULTS: Mean angular deviation of the 3D-printout from the original volume for the Pitch, Yaw, and Roll were 1.1° (standard deviation = 0.77°), 0.59° (standard deviation = 0.41°), and 0.79° (standard deviation = 0.86°), respectively. Following translational + rotational shifts, the mean Dice similarity coefficients of the three-dimensional-printed and original volumes was 0.985 (standard deviation = 0.002) while the mean Hausdorff distance was 0.9 mm (standard error of the mean: 0.1 mm). The mean centroid vector displacement was 0.5 mm (standard deviation: 0.3 mm). Compared to plans that were coregistered using translational + rotational shifts, the D95 of the brain from three-dimensional-printed heads adjusted for TR shifts only differed by -0.1% (standard deviation = 0.2%). CONCLUSIONS: Patient head volumes and positions at simulation computed tomography scans can be accurately reproduced using three-dimensional-printed models, which can be used to mold radiotherapy immobilization masks onto. This strategy, if applied on diagnostic computed tomography scans, may allow symptomatic and frail patients to avoid a computed tomography-simulation and mask molding session in preparation for palliative whole brain radiotherapy.

Developmental expression of spontaneous activity in the spinal cord of postnatal opossums, Monodelphis domestica: an anatomical study.

Using Sulforhodamine-101 (SR101) labeling and calcium imaging on in vitro preparations, we investigated the development of spontaneous activity in the spinal enlargements of a marsupial born more immature than eutherian mammals, the opossum Monodelphis domestica. Following the retrograde transport of Calcium Green dye from the limb nerves, we observed the occurrence of spontaneous calcium waves activating the motor columns of the cervical enlargement of opossums aged from P3 to P15 (day of birth: P0) and of the lumbar enlargement from at least P6 to P12. In other preparations, SR101 was added to the bath to identify the active cells. In P1 opossums, only a few SR101-labeled cells were observed in the cervical enlargement and none in the lumbar enlargement. At P5, their number increased cervically and they appeared in the lumbar enlargement. Motoneurons were the major cell type labeled by SR101 but dye leakage made their quantification inaccurate. SR101-labeled cells also occurred elsewhere in the ventral and dorsal grey. Their number increased until P12-14 in both enlargements and then decreased to disappear by P21, the last age examined. Thus in contrast to eutherian mammals, in which spontaneous activity is mostly prenatal, spontaneous activity occurs predominantly postnatally in opossums. It increases at the time when connections from the brain begin to impinge on spinal neurons and when the limbs, especially the hindlimbs, start moving and then decreases as the systems mature.