Jurgita Laurikaitiene

Background and Objectives: Early-stage glottic cancer requires highly precise radiotherapy due to laryngeal motion and the proximity of critical structures. Magnetic resonance-guided radiotherapy (MRgRT) enables real-time visualization and motion management, potentially improving dose conformity while reducing treatment margins. This pilot comparative planning study compared the dosimetric characteristics of MR-guided intensity-modulated radiotherapy (IMRT) delivered on the Unity MR-linac with volumetric modulated arc therapy (VMAT) plans generated for the TrueBeam STx and Halcyon systems. Materials and Methods: Ten patients with T1–T2N0 glottic squamous cell carcinoma were included. For each patient, treatment plans prescribing 42.5 Gy in five fractions were generated using all three systems. Planning target volume (PTV) coverage, conformity index (CI), homogeneity index (HI), organ-at-risk (OAR) doses, monitor units, and beam-on times were compared using Friedman and post hoc Wilcoxon signed-rank tests. Results: Unity achieved superior dose conformity (CI 0.97 ± 0.01 vs. 0.78 ± 0.15 for TrueBeam STx and 0.58 ± 0.19 for Halcyon; p < 0.001) and the highest mean dose, while PTV coverage (D95% and D98%) was comparable to TrueBeam STx and higher than Halcyon. Reduced treatment margins resulted in significantly smaller PTV volumes (11.09 ± 3.87 cm³ vs. 17.43 ± 4.75 cm³; p = 0.0001). Halcyon demonstrated the most homogeneous dose distribution (HI 7.88 ± 3.14), whereas TrueBeam STx showed intermediate homogeneity (HI 12.81 ± 3.90). Most OAR dose metrics were comparable among techniques, although selected laryngeal structures and the esophagus differed significantly. Beam-on time was longest for Unity. Conclusions: MR-guided IMRT provided superior dose conformity while maintaining target coverage comparable to TrueBeam STx with clinically acceptable OAR sparing. Prospective clinical studies are required to determine whether these dosimetric advantages translate into improved patient outcomes.

The growing use of radiation technologies has increased the need for shielding materials that are lightweight, safe, and adaptable to complex geometries. While lead remains highly effective, its toxicity and weight limit its suitability, driving interest in alternative materials. The process of 3D printing enables the rapid fabrication of customized shielding geometries; however, only limited research has focused on 3D-printed polymer composites formulated specifically for mixed photon–neutron fields. In this study, we developed a series of 3D-printable ABS-based composites incorporating tungsten (W), bismuth oxide (Bi₂O₃), gadolinium oxide (Gd₂O₃), and boron nitride (BN). Composite filaments were produced using a controlled extrusion process, and all materials were 3D printed under identical conditions to enable consistent comparison across formulations. Photon attenuation at 120 kVp and neutron attenuation using a broad-spectrum Pu–Be source (activity 4.5 × 10⁷ n/s), providing a mixed neutron field with a central flux of ~7 × 10⁴ n·cm⁻²·s⁻¹ (predominantly thermal with epithermal and fast components), were evaluated for both individual composite samples and layered (sandwich) configurations. Among single-material prints, the 30 wt% Bi₂O₃ composite achieved a mass attenuation coefficient of 2.30 cm²/g, approximately 68% of that of lead. Layered structures combining high-Z and neutron-absorbing fillers further improved performance, achieving up to ~95% attenuation of diagnostic X-rays and ~40% attenuation of neutrons. The developed materials provided a promising balance between 3D-printability and dual-field shielding effectiveness, highlighting their potential as lightweight, lead-free shielding components for diverse applications.

The exponential growth of plastic production in the healthcare sector and the limited capacity of conventional recycling systems have created a global environmental challenge. Latest 3D printing technologies have the potential to solve this problem by enabling on-demand, localized manufacturing. This study aimed to investigate the mechanical properties of 3D-printed ABS composites with Bi₂O₃ fillers after multiple recycling and irradiation cycles to assess their suitability for creating robust, reusable supporting devices for radiotherapy. Filaments of PLA, ABS, and ABS composites enriched with 5 wt% and 10 wt% Bi₂O₃ were extruded, repeatedly recycled through shredding and re-extrusion up to ten times and irradiated to 70 Gy using a 6 MeV photon beam to simulate clinical radiotherapy conditions. In contrast to PLA, ABS demonstrated better recyclability; however, after ten recycling cycles, its tensile strength declined from 25.1 MPa to 20.9 MPa, and its Young’s modulus decreased from 2503.5 MPa to 1410.4 MPa. Incorporation of 5 wt% Bi₂O₃ into ABS significantly improved recyclability and mechanical retention. After ten recycling rounds, an ABS composite containing 5 wt% Bi₂O₃ retained tensile strength of 22.2 MPa, modulus of 1553.9 MPa, and strain at break of 14.4%. In contrast, the composite enforced with 10 wt% Bi₂O₃ showed slightly lower performance, likely due to filler agglomeration. Under irradiation, the ABS–5 wt% Bi₂O₃ composite exhibited minimal additional degradation, maintaining mechanical integrity superior to other materials. These results indicate that ABS–5 wt% Bi₂O₃ is a promising, recyclable material for durable, patient-specific devices in radiotherapy, supporting sustainability in medical manufacturing.

Introduction. This study evaluates the secondary cancer risks associated with low-dose ionizing radiation from pelvic cone beam computed tomography (CBCT) imaging protocols in the context of image-guided radiotherapy (IGRT). Methods. The research identifies that effective dose varies significantly with protocol choice and field size; larger fields result in higher doses, emphasizing the need for optimization to balance diagnostic accuracy with safety. Results. Protocols such as Pelvis Fast, characterized by reduced default mAs and shorter scan times, demonstrate substantially lower effective doses compared to alternatives like Pelvis Large, translating to a decreased excess absolute risk (EAR) for secondary cancer development. Utilizing the BEIR VII model for risk assessment, the study underscores the importance of selecting imaging protocols with lower EAR values to mitigate secondary cancer risks effectively. Conclutions. These findings highlight the critical role of protocol selection in reducing radiation exposure while maintaining high image quality, providing valuable guidance for enhancing patient safety in medical imaging practices.

The essential component of modern radiation therapy is the application of steep dose gradients during patient treatment in order to maximize the radiation dose to the target volume and protect neighboring heathy tissues. However, volumetric dose distribution in an irradiated target is still a bottleneck of dose verification in modern radiotherapy. Dose gels are almost the only known dosimetry tool which allows for the evaluation of dose distribution in the irradiated volume due to gel’s polymerization upon irradiation. The accuracy of dose gel dosimetry has its own obstacle, which is related to the continuation of the gel’s polymerization after the radiation treatment procedure is finished. In this article, a method to monitor the polymerization dynamics of dose gels in real-time is proposed using a modified optical spectrometry system. Using the proposed method, the changes of the optical characteristics of irradiated nMAG dose gels in situ were assessed. The investigation revealed that the detectable polymerization in dose gel proceeds up to 6 h after irradiation. This time is significantly shorter compared with a commonly recommended 24 h waiting time allocated for polymer gel to settle. It was also found that dose rate significantly influences the temporal response of the nMAG dosimeter. By increasing the irradiation dose rate by a factor of 2, the time needed for the polymerization process to settle was increased by 22%. Identification of the gel’s post-irradiation polymerization time interval and its dependence on irradiation parameters will contribute to more accurate dose verification using dose gel dosimetry.

Tooth whitening is one of the most conservative procedures for increasing the aesthetics of patients, but the effect of bleaching on ceramic restorations has not been extensively studied. In this study, the bleaching effect on three dental restoration materials (polished/glazed lithium disilicate glass ceramic, leucite reinforced glass ceramic and zirconium dioxide ceramic) has been investigated in terms of surface roughness changes of the exposed samples. Philips Zoom NiteWhite 16% carbamide peroxide, Philips Zoom 6% hydrogen peroxide with following LED illumination and Pola Office 6% hydrogen peroxide have been used for ceramic bleaching. The experimental investigation and performed statistical analysis revealed that the highest surface roughness changes of all investigated ceramics were caused by the hydrogen peroxide and the lowest by carbamide peroxide. These findings correlated well with the colour changes observed in the same bleached dental ceramic samples indicating potential of carbamide peroxide as the most prospective bleaching agent.

Polymer gels and films, due to their near equivalence to biological tissue, are amongst the most promising future dosimetry tools for medical applications. The application of polymer dose gels is limited by the sensitivity of dose readout methods and dose gel properties. It is a challenge to find suitable dosimeters for registration of doses delivered to the target by orthovoltage therapy units. The application of metal-particle-enriched polymer composites for dose registration in X-ray therapy might be an elegant solution, especially if recent dose-reading technologies exploring advantages of different physical phenomena are involved. In this work, X-rays from the orthovoltage therapy range were used for the irradiation of experimental samples. In addition, radiation-induced processes of formation of silver nanoparticles in AgNO₃–PVA gels and in free standing AgNO₃PVA films, also containing some additional solvents, namely glycerol, ethanol, and isopropanol, have been investigated, with the aim to apply the developed composites for medical dosimetry purposes. A simple and environmentally friendly method for the formation of free-standing AgPVA films at room temperature was proposed and realized for preparing AgPVA films for investigation. Radiation-induced synthesis of silver nanoparticles in AgPVA composites was investigated, analyzing LPSR-based UV-VIS spectral changes to the irradiated films with respect to irradiation doses, and dose-related tendencies were also evaluated. It was shown that AgPVA films were more sensitive for detection of doses from the interval 0–1.0 Gy, thus indicating potential application of AgPVA films for dosimetry purposes.

In radiation therapy, a bolus is used to improve dose distribution in superficial tumors; however, commercial boluses lack conformity to patient surface leading to the formation of an air gap between the bolus and patient surface and suboptimal tumor control. The aim of this study was to explore 3D-printing technology for the development of patient-specific conformal 3D-printed devices, which can be used for the radiation treatment of superficial head and neck cancer (HNC). Two 3D boluses (0.5 and 1.0 cm thick) for surface dose build-up and patient-specific 3D phantom were printed based on reconstruction of computed tomography (CT) images of a patient with HNC. The 3D-printed patient-specific phantom indicated good tissue equivalency (HU = −32) and geometric accuracy (DSC = 0.957). Both boluses indicated high conformity to the irregular skin surface with minimal air gaps (0.4–2.1 mm for 0.5 cm bolus and 0.6–2.2 mm for 1.0 cm bolus). The performed dose assessment showed that boluses of both thicknesses have comparable effectiveness, increasing the dose that covers 99% of the target volume by 52% and 26% for single field and intensity modulated fields, respectively, when compared with no bolus case. The performed investigation showed the potential of 3D printing in development of cost effective, patient specific and patient friendly conformal devices for dose verification in radiotherapy.