Development and Evaluation of 3D-Printed Homogeneous and Heterogeneous Phantoms for Quality Assurance in Radiation Therapy
Abstract
Background: Affordable and locally manufacturable quality assurance (QA) phantoms are critical for maintaining accuracy in radiation therapy, particularly in low-resource settings. This study evaluates the radiological and dosimetric performance of 3D-printed homogeneous and heterogeneous phantoms against commercial standards.
Methods: Two phantom prototypes were developed: a homogeneous model fabricated from PMMA and a heterogeneous model composed of EVA, PLA, MDI-based foam, and gypsum–chalk composite. Radiological properties were assessed using CT imaging with three reconstruction kernels (Hp38, Bf39, Hr32) at slice thicknesses of 1–3 mm. Hounsfield Units (HU) were compared with reference values from the Easy Slab (IBA) and CatPhan 604. Dosimetric validation was performed with Eclipse TPS (v16.1) using 15 3D-CRT and 15 VMAT plans, delivered on Varian TrueBeam (6 MV, 6 MV FFF, 10 MV, 10 MV FFF) and Halcyon (6 MV FFF) accelerators. Point doses were measured with a calibrated Farmer chamber.
Results: The homogeneous PMMA phantom demonstrated HU stability within ±5 HU of the reference values across all kernels, with standard deviations of less than 3 HU. EVA and gypsum–chalk provided tissue-equivalent and bone-equivalent imaging properties (20 ± 3 HU and 1200 ± 15 HU, respectively), while PLA and MDI foam demonstrated excessive variability (>40 HU kernel dependence). Dosimetrically, the homogeneous phantom achieved agreement with TPS calculations within ±2.5% across all energies and techniques. The heterogeneous phantom exhibited deviations of up to 2.8%, remaining within the ±3% tolerance of AAPM TG-119. Variability was most significant for VMAT plans with FFF beams, particularly on the Halcyon platform.
Conclusion: A 3D-printed homogeneous PMMA phantom demonstrated radiological stability and dosimetric accuracy comparable to that of commercial devices, confirming its feasibility for routine QA. The heterogeneous model exhibited acceptable performance but requires material refinement, particularly substitution of PLA and MDI foam, to improve HU stability. These results highlight the potential of additive manufacturing to provide cost-effective, customizable QA solutions for radiation therapy, especially in resource-limited environments.
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