Alexander Markovic noticed a problem with radiation treatment.
It’s difficult for doctors to make sure patients were getting the appropriate amount of radiation. The device used to direct that dosage is called a bolas.
It works best when there’s no air gap between the skin and the bolus. The traditional material is square and flexible, so air gaps are a common problem.
When doctors prescribe a dose, Markovic said, they expect results based off that dose. With the traditional bolus, patients could get too much or too little radiation.
Markovic is the medical physics program director at the North Colorado Medical Center cancer institute. He read about how some practices were using 3D printers to create custom boluses.
Since he works at McKee Medical Center twice a week, he stopped by Aleph Objects, Inc. a 3D printer shop in Loveland for a tour. He convinced NCMC to pay for the $3,000 machine, called a LulzBot TAZ 6.
He figured if something went wrong with the printer as he tinkered with the settings, it’d be good to have the shop close by.
It took a while for Markovic to find the right temperature and speed settings – he wanted to make sure the material worked well too – but he found the right combination. Markovic can take a patient’s CT scan and build a custom-molded bolus for that patient that’s flexible and comfortable. There’s no known allergy to the material either.
“What we’re planning in the computer is what patients get,” Markovic said. “Before, we’d get as close as we could.”
Not every cancer patient is a candidate for the new bolus or needs that kind of treatment, Markovic said. It would help patients with cancer close to the surface of the skin.
Markovic got the printer and began perfecting the 3D printed bolus in December. He subjected it to months of tests before it was ready.
He started using the bolus clinically three weeks ago and already has treated four patients with it. Once he gets to 10 patients, Banner likely will buy a 3D printer at McKee Medical Center, too.
There’s a learning curve, Markovic said. It’s still a new technique and it takes a while to train doctors how to use it. He had to learn through YouTube and experimentation, but he hopes he can make that process smoother.
Jeffery Albert, a doctor at the NCMC cancer institute, said he thinks the 3D printed bolus is much more sophisticated and precise than the traditional model.
Before, patients could spend a couple grand for a separate company to make a custom fit bolus, he said. Now it costs a couple bucks.
Markovic is still working out a way to follow up with patients and measure the effectiveness of the new bolus. For now, he plans to measure the anticipated dose against the actual dose of radiation.
Markovic anticipates the idea will take off elsewhere. He gave a talk Wednesday on how to use the printer and its application to radiation treatment to his department and NCMC’s counterpart in Arizona.
“It feels good to bring something innovative to the patient that will help treatment,” Markovic said. “I’ve always found the traditional bolus to be annoying.”
– Kelly Ragan writes features and covers health for The Greeley Tribune. Have a tip? Want to share your story? Call (970) 392-4424, email kragan@greeleytribune.com or connect on Twitter @kelly_raygun.
