Assessing the advantages of CFR-PEEK over titanium spinal stabilization implants in proton therapy - a phantom study.

Assessing the advantages of CFR-PEEK over titanium spinal stabilization implants in proton therapy - a phantom study. Phys Med Biol. 2020 Apr 21;: Authors: Poel R, Belosi MF, Albertini F, Walser M, Gisep A, Lomax AJ, Weber DC Abstract High-density materials as titanium, used for spinal stabilization introduce several critical issues in proton therapy (PT). Artefacts affect both contouring and dose calculation. Subsequently, artefacts need to be corrected which is a time consuming process. Besides, titanium causes proton interactions that are unaccounted for in dose calculation. Result is a suboptimal treatment plan and indeed decreased local controls have been reported for these patients. Carbon fiber reinforced polyetheretherketone (CFR-PEEK) implant material, which is of low-density, potentially solves these issues. For this study, we designed a unique phantom to compare the effects of titanium and CFR-PEEK implants in PT. The phantom contains four interchangeable spinal inserts representing a native spine, and three different spinal stabilizations consisting of; titanium only, CFR-PEEK only and a titanium and CFR-PEEK combination. All phantom scenarios received the standard treatment workup. Two planning approaches were investigated; a single field plan and a multi-field optimized plan with spinal cord sparing. For both plans we analyzed the following aspects: Total volume of artefacts on CT, time required for artefact correction,...
Source: Physics in Medicine and Biology - Category: Physics Authors: Tags: Phys Med Biol Source Type: research