Dosimetric Comparison of Superflab and Specially Prepared Bolus Materials Used in Radiotherapy Practice

Serhat Aras; İhsan Oğuz Tanzer; Türkan İkizceli

doi:10.5152/ejbh.2020.5041

Dosimetric Comparison of Superflab and Specially Prepared Bolus Materials Used in Radiotherapy Practice

Eur J Breast Health. 2020 Mar 31;16(3):167-170. doi: 10.5152/ejbh.2020.5041. eCollection 2020 Jul.

Authors

Serhat Aras¹, İhsan Oğuz Tanzer², Türkan İkizceli³

Affiliations

¹ Medical Imaging Programme, University of Health Sciences, İstanbul, Turkey.
² Biomedical Technology Programme, University of Health Sciences, İstanbul, Turkey.
³ Department of Radiology, University of Health Sciences, Haseki Training and Research Hospital, İstanbul, Turkey.

Abstract

Objective: This study compares standard commercial bolus material (Superflab) to custom prepared silicone dental impression material (CDIM) and play dough material (PDM) with respect to dosimetric properties and applicability by using ion chamber measurement and calculated dose values.

Materials and methods: The CDIM bolus was prepared by mixing dental impression silicone material with enough water to maintain a density of about 1.0 g/cm³. The prepared bolus material is applied on an RW3 solid phantom by covering 10x10 cm² area with 0.5-1 cm thickness. Ion chamber measurements were performed separately with and without bolus material application. The setup was scanned in CT and the same procedure was repeated in the TPS using the scan data, in which the Pencil Beam Convolution dose calculation algorithm was used. To compare the effect of bolus material on tissue, the Superflab bolus and CDIM bolus were applied with 1 cm of thickness on postmastectomy scar and dose calculations on TPS were performed.

Results: After comparison of the dosimetric values for Superflab, CDIM and PDM, we obtained statistically meaningful results between superflab and CDIM. For PDM, the results obtained with TPS and ion chamber measurements indicated that, it is not suitable to use in radiotherapy application due to its material properties. For the simulated skin dose values obtained at five random points on the scar tissue, the comparison of Superflab and CDIM TPS calculation results were not statistically significant.

Conclusion: The CDIM is easy to prepare and apply on irregular mastectomy scar tissue and it prevents formation of air gaps in the application surface. Especially for curved anatomical regions such as scar tissue, inclusion of the bolus material in treatment planning protocol will reduce dose uncertainty in application. It is safe to use CDIM as an alternative to Superflab in radiotherapy application, whereas PDM is not useful in clinical practice due to its material properties.

Keywords: Bolus material; dental impression material; play dough; radiotherapy; superflab.