Uniform Thickness Bolus

Can a Simple Bolus be created to treat a patient with their breast still intact?

Yes. Our bolus incorporates all contours and shapes of the treatment area, including breast tissue.

How accurate is the 3D Simple Bolus?

In a recent study where a standard simple bolus and 3D printed simple bolus were fitted to the chest wall, the occurrence of air gaps were reduced from 30% to 13% and the average maximum air gap dimension diminished from 0.5 +/− 0.3 mm to 0.3 +/− 0.3 mm. Surface dosage was within 3% for both standard sheet and 3D printed bolus.

Source: Robar et al – Intrapatient study comparing 3D printed bolus versus standard vinyl gel sheet bolus for postmastectomy chest wall radiation therapy.

How does the custom-fit bolus compare to other traditional materials such as moulding wax or jelly-based materials such as Superflab?

Boluses designed using our software use the patient’s exact measurements and can be previewed before printing. Our software offers smoothing and cropping functions to ensure that the device is not only the best fit, but that it also has no air gaps, completely eliminating the need for additional bolus.

How does the Simple Bolus module differ from a conventional STL conversion?

Post-production modifications such as cropping and smoothing functions were added for a better fit and patient experience. Adaptiiv also allows the user to add a printable ID tag directly to the bolus. We are continually investing in new features, such as vivo dosimetry and the ability to print bolus in multiple pieces for larger or hard-to-fit areas, like the skull.

Modulated Electron Bolus

Couldn’t we simply contour our bolus accordingly in the TPS and then export for printing?

In a recent business case, a leading cancer center developed a modulated bolus using Eclipse software. The therapist had to adjust the bolus slice by slice to ensure that the bolus thickness aligned with the PTV. It took a total of 32 hours.

In comparison, when using Adaptiiv’s methods, it took only minutes to render the same design. You can even import the model back into the planning system to be reviewed prior to printing.

The uniform thickness of a Simple Bolus cannot conform to the PTV (Planning Target Volume), resulting in dispersed dosages that overexposed the underlying tissues, compromising the effectiveness of treatments. Modulated boluses custom created using moulding wax offer slightly better results but face the same set of dosage issues with the added downside of being extra fragile and labour intensive.

How do adjustments or modifications occur to the bolus design using Adaptiiv software?

Adaptiiv software algorithms generate a custom bolus structure based on the DICOM information imported from the TPS. No manual alterations are required.

If I am able to achieve acceptable dosimetry using wax bolus, then what is the value of using 3D Bolus software?

Our software will save you time, and create more effective treatments. Our creation process takes mere minutes instead of hours or days, and creates durable, custom-fit boluses that go beyond achieving acceptable dosimetry to deliver exact dosages.

Brachytherapy Applicator

Can Adaptiiv software create intra-cavitary brachytherapy applicators?

Not at this time however we are always interested in collaborating with centers to create new features and modules that can be added to our application.

Does the user have the ability to import the applicator back into the Brachytherapy TPS in order to re-evaluate the dose distribution?

Yes. Our HDR Surface Brachytherapy module allows the user to export the object back to the TPS for evaluation prior to printing.

In the case of smaller lesions that would be primarily treated using a Valencia applicator, how would Adaptiiv applicators compare in terms of treatment effectiveness?

Unlike general flat-surfaced Valencia applicators, our devices are tailored to the individual patient for more consistent placement over both small and large areas—no matter how complex.

Software & Hardware

How does Adaptiiv integrate with existing systems?

Our software links seamlessly with your center’s Treatment Planning System to produce a patient-specific bolus design based on CT scan data. The structure is then exported as an STL file which can be printed in a matter of hours.

What type of materials are used?

3D boluses are printed using durable, tissue-equivalent materials that hold their shape and do not degrade during treatments. Patients typically use the same 3D printed bolus for the duration of their treatment, reducing the risk of infection.