This study aims to investigate dose perturbations caused by a metallic biliary stent (MBS) in patients undergoing external beam radiotherapy for cancers in the pancreato-biliary region. Four MBSs with nitinol mesh were examined in the EasyCube® phantom including a custom stent holder fabricated by a 3D printer. For experimental models, three-dimensional conformal radiotherapy plans using a single anterior–posterior (AP) and four-field box (4FB) as well as volumetric modulated arc therapy (VMAT) plan were prepared to deliver the photon beam of 8 Gy to the stent holder. EBT3 film was used to measure dose distributions at four sides surrounding MBS. All MBSs in the AP beam demonstrated mean dose enhancements of 2.3–8.2% at the proximal, left, and right sides. Maximum dose enhancements of 12.3–19.5% appeared at regions surrounding the radiopaque markers. At the location distal to the source, there were mean dose reductions of − 3.6 to − 10.9% and minimum doses of − 11.1 to − 9.5%. The mean and maximum doses with the 4FB plan were in the ranges of − 0.1 to 3.6% and 6.7–14.9%, respectively. The VMAT produced mean doses of − 0.9 to 4.8% and maximum doses of 6.0–15.3%. Dose perturbations were observed with maximum and minimum spots near the stent surface. The use of multiple beams including parallel-opposed pairs reduced dose perturbations caused by the nitinol and radiopaque components within the stent. Special attention is required for patients in whom the radiopaque markers are closely located near critical structures or the target volume.
|Number of pages||12|
|Journal||Australasian Physical and Engineering Sciences in Medicine|
|Publication status||Published - 2019 Sep 15|
Bibliographical noteFunding Information:
This research was supported by a Grant of the Radiation Technology R&D program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (2017M2A2A6A01070330).
All Science Journal Classification (ASJC) codes
- Biomedical Engineering
- Radiology Nuclear Medicine and imaging
- Physics and Astronomy(all)