Skip to main content Accessibility help

Towards the production of radiotherapy treatment shells on 3D printers using data derived from DICOM CT and MRI: preclinical feasibility studies

  • S. D. Laycock (a1), M. Hulse (a2), C. D. Scrase (a3), M. D. Tam (a4) (a5), S. Isherwood (a3), D. B. Mortimore (a6), D. Emmens (a3), J. Patman (a2), S. C. Short (a7) and G. D. Bell (a1) (a8)...



Immobilisation for patients undergoing brain or head and neck radiotherapy is achieved using perspex or thermoplastic devices that require direct moulding to patient anatomy. The mould room visit can be distressing for patients and the shells do not always fit perfectly. In addition the mould room process can be time consuming. With recent developments in three-dimensional (3D) printing technologies comes the potential to generate a treatment shell directly from a computer model of a patient. Typically, a patient requiring radiotherapy treatment will have had a computed tomography (CT) scan and if a computer model of a shell could be obtained directly from the CT data it would reduce patient distress, reduce visits, obtain a close fitting shell and possibly enable the patient to start their radiotherapy treatment more quickly.


This paper focuses on the first stage of generating the front part of the shell and investigates the dosimetric properties of the materials to show the feasibility of 3D printer materials for the production of a radiotherapy treatment shell.

Materials and methods:

Computer algorithms are used to segment the surface of the patient’s head from CT and MRI datasets. After segmentation approaches are used to construct a 3D model suitable for printing on a 3D printer. To ensure that 3D printing is feasible the properties of a set of 3D printing materials are tested.


The majority of the possible candidate 3D printing materials tested result in very similar attenuation of a therapeutic radiotherapy beam as the Orfit soft-drape masks currently in use in many UK radiotherapy centres. The costs involved in 3D printing are reducing and the applications to medicine are becoming more widely adopted. In this paper we show that 3D printing of bespoke radiotherapy masks is feasible and warrants further investigation.


Corresponding author

Correspondence to: Stephen D. Laycock, School of Computing Sciences, University of East Anglia, Norwich, NR4 7TJ, UK. Tel: +44(0)1603 593795; E-mail:


Hide All
1.Devereux, C, Grundy, G, Littman, P. Plastic moulds for patient immobilisation. Int J Radiat Oncol Biol Phys 1976; 1: 553557.
2.Gilbeau, L, Octave-Prignot, M, Loncol, T, Ranard, L, Gregoire, V. Comparison of setup accuracy of three different thermoplastic masks for the treatment of brain and head and neck tumours. Radiother Oncol 2001; 58: 155162.
3.Hess, C F, Kortmann, R D, Jany, A, Hamberger, M. Accuracy of field alignment in radiotherapy of head and neck cancer utilizing individualized face mask immobilisation: a retrospective analysis of clinical practice. Radiother Oncol 1995; 34: 6972.
4.Schulte, R W, Fargo, R A, Meinass, H J, Slater, J D, Slater, J M. Analysis of head motion prior to and during proton beam therapy. Int J Radiat Oncol Biol Phys 2000; 47: 11051110.
5.Sharp, L, Lewin, F, Johansson, H, Payne, D, Gerhardsson, A, Rutqvist, L E. Randomized trial on two types of thermoplastic masks for patient immobilization during radiation therapy for head and neck cancer. Int J Radiat Oncol Biol Phys 2005; 61: 250256.
6.McCloskey, T, Moore, P. Making a radiotherapy mask, Macmillan Cancer Support. Accessed 12 August 2014.
7.Tam, M D, Laycock, S, Bell, G D, Chojnowski, A. 3D printout of a DICOM to aid surgical planning in a 6 year old patient with a large scapular osteochondroma complicating congenital diaphyseal aclasia. J Radiol Case Rep 2012; 6 (1): 3137.
8.Laycock, S D, Bell, G D, Mortimore, D, Greco, M K, Corps, N, Finkle, I. Combining X-ray micro-CT technology and 3D printing for the digital preservation and study of a 19th century Cantonese Chess piece with intricate internal structures. J Comput Cult Herit 2013; 5 (4): 17.
9.Esses, S J, Berman, P, Bloom, A I, Sosna, J. Clinical applications of physical 3D models derived from MDCT data and created by rapid prototyping. AJR Am J Roentgenol 2011; 196: W683W688.
10.Sanghera, B, Amis, A, McGurk, M. Preliminary study of the potential for rapid prototype and surfaced scanned radiotherapy facemask production technique. J Med Eng Technol 2002; 26: 1621.
11.McKernan, B, Bydder, S, Deans, T, Nixon, M A, Joseph, D J. Surface laser scanning to routinely produce casts for patient immobilization during radiotherapy. Australas Radiol 2007; 51 (2): 150153.
12.Hulse, M, Isherwood, S, Scrase, C, Laycock, S, Bell, G D. 3D CT-aided modelling of treatment shells for use in radiotherapy. Presented at the National Cancer Research Institute (NCRI) Clinical and Translational Radiotherapy Research Working Group (CTRad) Clinical Trials Workshop, 27th February 2012, Leeds.
13.Zou, W, Fisher, T, Swann, Bet al. MO-H-19A-03: patient specific bolus with 3D printing technology for electron radiotherapy. Med Phys 2014; 41: 443.
14.Kim, H, Park, Y-K, Ki, I H, Ye, S-J. Development of an optical-based image guidance system: technique detecting external markers behind a full mask. Med Phys 2011; 38: 30063012.
15.Rotondo, R L, Sultanem, K, Lavoie, I, Skelly, J, Raymond, L. Comparison of repositioning accuracy of two commercially available immobilization systems for treatment of head-and-neck tumors using simulation computed tomography imaging. Int J Radiat Oncol Biol Phys 2008; 70 (5): 13891396.
16.Kang, H, Lovelock, D M, Yorke, E D, Kriminski, S, Lee, N, Amols, H I. Accurate positioning for head and neck cancer patients using 2D and 3D image guidance. J Appl Clin Med Phys 2010; 12 (1): 8696.


Towards the production of radiotherapy treatment shells on 3D printers using data derived from DICOM CT and MRI: preclinical feasibility studies

  • S. D. Laycock (a1), M. Hulse (a2), C. D. Scrase (a3), M. D. Tam (a4) (a5), S. Isherwood (a3), D. B. Mortimore (a6), D. Emmens (a3), J. Patman (a2), S. C. Short (a7) and G. D. Bell (a1) (a8)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed