Additive Manufacturing of Personalized Lung Shields for TBI: A New Methodology Using Lead Attenuation
DOI:
https://doi.org/10.29384/rbfm.2026.v20.19849001872Keywords:
Radiotherapy, Radiation Protection, Innovation, Dose AttenuationAbstract
This study aimed to develop and physically validate patient-specific lung shielding devices for Total Body Irradiation (TBI) using additive manufacturing (3D printing) and granular lead spheres as the attenuating material. Radiographs of a semi-anthropomorphic phantom were used for three-dimensional modeling of the lung region and fabrication of customized molds. The printed structures were filled with lead spheres equivalent to approximately 0.8 cm thickness and positioned on the phantom to verify geometric adaptation. Dosimetric characterization was performed using a 6 MV linear accelerator beam and solid water phantoms at depths of 5, 10, and 15 cm, representing different equivalent body thicknesses. Ionization readings (nC) were converted to absorbed dose to water (cGy), allowing assessment of attenuation and volumetric uniformity of the device in a homogeneous medium. Mean attenuation ranged from 24.77% to 26.60%, with variation below 2% across depths and a similar response between right and left shields, indicating a homogeneous distribution of the attenuating material and the reproducibility of the manufacturing process. The obtained values are consistent with lung shielding reported in the literature. The results demonstrate that the device provides effective physical attenuation, internal uniformity, and feasible fabrication via additive manufacturing, representing a technically suitable alternative for personalized lung shielding in TBI. Further studies using heterogeneous anthropomorphic phantoms are recommended to validate performance under realistic pulmonary anatomical conditions.
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1. Vogel J, Hui S, Hua C-H, Dusenbery K, Rassiah P, Kalapurakal J, et al. Pulmonary Toxicity After Total Body Irradiation – Critical Review of the Literature and Recommendations for Toxicity Reporting. Front. Oncol. 2021;11:708906.
2. Wong JY, Filippi AR, Dabaja BS, Yahalom J, Specht L. Total body irradiation: guidelines from the international lymphoma radiation oncology group (ILROG). International Journal of Radiation Oncology* Biology* Physics. 2018;101(3):521-529.
3. Furnari L. Controle De Qualidade Em Radioterapia. Revista Brasileira de Física Médica. 2015;3:77-90.
4. Salvajoli JV, Souhami L, Faria SL. Radioterapia em Oncologia. 2nd ed. São Paulo: Atheneu; 2023.
5. Brasil. Ministério da Saúde. Instituto Nacional de Câncer. Curso para técnicos em radioterapia. Rio de Janeiro: INCA; 2000.
6. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Arsenic, Metals, Fibres and Dusts. Lyon (FR): International Agency for Research on Cancer; 2012. (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 100C.) CADMIUM AND CADMIUM COMPOUNDS.
7. Silva HR, Rebello WF, Silva AX, Facure A. Development of a shielding to protect patients against photoneutrons produced by linacs in radiotherapy treatments. Revista Brasileira de Física Médica. 2011;5(2):201-204.
8. Mankovich NJ, Baik H, Baumgartner HA, Hiller JB. Synthetic tomographic image phantom for 3D validation. In Medical Imaging 1993: Image Capture, Formatting, and Display. SPIE. 1993;1897:170-176.
9. Poulin E, Gardi L, Fenster A, Pouliot J, Beaulieu L. Towards real-time 3D ultrasound planning and personalized 3D printing for breast HDR brachytherapy treatment. Radiotherapy and Oncology. 2015;114(3):335-338.
10. Vianna ERL, Schwarz AP. Desenvolvimento e Construção de um Fantoma de Tórax para Uso nos Estudos de Imagens Radiológicas. Trabalho Final de Graduação - Universidade Franciscana; 2020.
11. Nist.gov. [homepage on the Internet]. National Institute of Standards and Technology. X-Ray Mass Attenuation Coefficients – Chapter 2: Introduction to Tables and Graphs. [cited 2025 Mar 23]. Available from: https://physics.nist.gov/PhysRefData/XrayMassCoef/chap2.html.
12. Nist.gov. [homepage on the Internet]. National Institute of Standards and Technology. X-Ray Mass Attenuation Coefficients – Lead (z = 82). [cited 2025 Mar 23]. Available from: https://physics.nist.gov/PhysRefData/XrayMassCoef/ElemTab/z82.html.
13. Van Dyk J, Galvin JM, Glasgow GP, Podgorsak EB. The physical aspects of total and half body photon irradiation. AAPM report. 1986;17:22-24.
14. Nash RA, McSweeney PA, Crofford LJ, Abidi M, Chen CS, Godwin JD, et al. High-dose immunosuppressive therapy and autologous hematopoietic cell transplantation for severe systemic sclerosis: long-term follow-up of the US multicenter pilot study. Blood, The Journal of the American Society of Hematology. 2007;110(4):1388-1396.
15. Yaparpalvi R, Mynampati DK, Fox JL, Tome WA, Kalnicki S. A Simple Technique for Partial Transmission Lung Shielding in Pediatric Patients Undergoing TBI for HSCT. International Journal of Radiation Oncology, Biology, Physics. 2019;105(1):E715.
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Copyright (c) 2026 Luísa Vargas Cassol, Thiago Schmeling Fontana, Tadeu Baumhardt, Stefanie Camile Schwarz, Thiago Victorino Claus
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