PHYSICAL CHARACTERIZATION OF 3D-PRINTED HIPS BOLUSES AT DIFFERENT THICKNESSES AND INFILL DENSITIES FOR RADIOTHERAPY
DOI:
10.29303/ipr.v9i1.583Downloads
Abstract
In external beam radiation therapy, conventional boluses have limitations in conforming to irregular skin surfaces, leading to the formation of air gaps between the skin surface and the bolus. The fabrication of a three-dimensional printed (3D-printed) bolus using 3D printing improves the bolus’s conformity to the irregular skin surface. This study aims to evaluate the physical characteristics and tissue-equivalent properties of HIPS filament and 3D-printed HIPS boluses at different thicknesses and infill densities. The physical characteristics of HIPS filament, including density, electron density, and Relative Electron Density (RED), were measured. At the same time, Fourier Transform Infrared (FTIR) spectroscopy was performed to determine the mass fraction percentages of polystyrene and polybutadiene. The 3D-printed HIPS boluses were characterized for bulk density, electron density, RED, water absorption percentage, internal pore size, and total pore volume, with bulk density and RED compared to those of adipose tissue. The physical characteristics of the HIPS filament showed a density of 1.01 g/cm3, an electron density of 3.29 × 1023 electrons/cm3, and a RED of 0.98, resembling those of adipose tissue. The physical characteristics of 3D-printed HIPS boluses at different infill densities showed bulk density ranging from 0.61 g/cm3 to 0.81 g/cm3, electron density ranging from 2.00×1023 electrons/cm3 to 2.63×1023 electrons/cm3, RED ranging from 0.59 to 0.79, and water absorption percentage ranging from 2.9% to 7.9%. The evaluation results showed that the 3D-printed HIPS bolus with a thickness of 0.6 cm and 80% infill density was the optimal configuration, exhibiting the lowest water absorption, smallest internal pore size and total pore volume, with bulk density and RED most similar to those of adipose tissue.
Keywords:
High-Impact Polystyrene 3D-Printed Bolus Relative Electron Density RadiotherapyReferences
[1] D. Kong et al., “Effect of bolus materials on dose deposition in deep tissues during electron beam radiotherapy,” J Radiat Res, vol. 65, no. 2, pp. 215–222, Mar. 2024.
[2] X. Wang et al., “3D-printed bolus ensures the precise postmastectomy chest wall radiation therapy for breast cancer,” Front Oncol, vol. 12, Sep. 2022
[3] Y. Zhang et al., “A clinical trial to compare a 3D-printed bolus with a conventional bolus with the aim of reducing cardiopulmonary exposure in postmastectomy patients with volumetric modulated arc therapy,” Cancer Med, vol. 11, no. 4, pp. 1037–1047, Feb. 2022.
[4] S. Herwiningsih et al., “Radiation Therapy (3DCRT) Breast Cancer Treatment Plans,” Indonesian Physical Review, vol. 6, no. 3, pp. 284–293, 2023.
[5] F. Li, W. Hu, H. Li, B. Li, and Y. Wang, “Bolus Use in Postmastectomy Radiation Therapy for Breast Cancer: A Systematic Literature Review,” Technol Cancer Res Treat, vol. 24, Jan. 2025.
[6] A. P. Hariyanto, F. U. Mariyam, L. Almira, E. Endarko, and B. H. Suhartono, “Fabrication and characterization of bolus material using propylene glycol for radiation therapy,” Iranian Journal of Medical Physics, vol. 17, no. 3, pp. 161–169, 2020.
[7] E. Endarko, S. Aisyah, C. C. C. Carina, T. Nazara, G. Sekartaji, and A. Nainggolan, “Evaluation of dosimetric properties of handmade bolus for megavoltage electron and photon radiation therapy,” J Biomed Phys Eng, vol. 11, no. 6, pp. 735–746, Dec. 2021.
[8] J. L. Robar et al., “Intrapatient study comparing 3D printed bolus versus standard vinyl gel sheet bolus for postmastectomy chest wall radiation therapy,” Pract Radiat Oncol, vol. 8, no. 4, pp. 221–229, Jul. 2018.
[9] L. Dilson et al., “Estimation of Surface Dose in the Presence of Unwanted Air Gaps under the Bolus in Postmastectomy Radiation Therapy: A Phantom Dosimetric Study,” Asian Pacific Journal of Cancer Prevention, vol. 23, no. 9, pp. 2973–2981, 2022.
[10] D. Lobo, C. Srinivas, S. Banerjee, M. S. Athiyamaan, K. Johan Sunny, and A. Krishna, “Estimation of surface doses in the presence of an air gap under a bolus for a 6 MV clinical photon beam - a phantom study,” Radiat Environ Biophys, vol. 64, no. 1, pp. 77–83, Mar. 2025.
[11] S. G. Gugliandolo et al., “3D-printed boluses for radiotherapy: influence of geometrical and printing parameters on dosimetric characterization and air gap evaluation,” Radiol Phys Technol, vol. 17, no. 2, pp. 347–359, Jun. 2024.
[12] D. Basaula et al., “Additive manufacturing of patient specific bolus for radiotherapy: large scale production and quality assurance,” Phys Eng Sci Med, vol. 47, no. 2, pp. 551–561, Jun. 2024.
[13] C. Albantow, C. Hargrave, A. Brown, and C. Halsall, “Comparison of 3D printed nose bolus to traditional wax bolus for cost-effectiveness, volumetric accuracy and dosimetric effect,” J Med Radiat Sci, vol. 67, no. 1, pp. 54–63, Mar. 2020.
[14] B. Ananthi, K. Bhuvana, R. Faith, G. Selvaluxmy, N. Vivekanandan, and I. Priya, “Conformal electron beam radiotherapy using custom-made step bolus for postmastectomy chest wall irradiation: An institutional experience,” J Cancer Res Ther, vol. 15, no. 5, pp. 999–1004, Jul. 2019.
[15] X. Ma, M. Figl, E. Unger, M. Buschmann, and P. Homolka, “X-ray attenuation of bone, soft and adipose tissue in CT from 70 to 140 kV and comparison with 3D printable additive manufacturing materials,” Sci Rep, vol. 12, no. 1, Dec. 2022.
[16] M. Bento et al., “Characterisation of 3D-printable thermoplastics to be used as tissue-equivalent materials in photon and proton beam radiotherapy end-to-end quality assurance devices,” Biomed Phys Eng Express, vol. 10, no. 6, Nov. 2024.
[17] K. H. Jung, D. H. Han, K. Y. Lee, J. O. Kim, W. S. Ahn, and C. H. Baek, “Evaluating the performance of thermoplastic 3D bolus used in radiation therapy,” Applied Radiation and Isotopes, vol. 209, Jul. 2024.
[18] D. H. Han et al., “Dosimetric Characteristics of a 3D-printed Bolus Fabricated using Different Filament Materials for Radiation Therapy,” New Physics: Sae Mulli, vol. 72, no. 10, pp. 806–811, Oct. 2022.
[19] R. Ricotti et al., “Dosimetric characterization of 3D printed bolus at different infill percentage for external photon beam radiotherapy,” Physica Medica, vol. 39, pp. 25–32, Jul. 2017.
[20] E. Dąbrowska-Szewczyk et al., “Low-density 3D-printed boluses with honeycomb infill 3D-printed boluses in radiotherapy,” Physica Medica, vol. 110, Jun. 2023.
[21] A. Yuliandari, S. Oktamuliani, Harmadi, and F. Diyona, “Dosimetric Characterization of 3D Printed Bolus with Polylactic Acid (PLA) in Breast Cancer External Beam Radiotherapy,” Iranian Journal of Medical Physics, vol. 21, no. 3, pp. 211–216, 2024.
[22] B. Ergene, Y. E. İnci, B. Çetintaş, and B. Daysal, “An experimental study on the wear performance of 3D printed polylactic acid and carbon fiber reinforced polylactic acid parts: Effect of infill rate and water absorption time,” Polym Compos, vol. 46, no. 1, pp. 372–386, Jan. 2025.
[23] M. Boopathi, D. Khanna, P. Venkatraman, R. Varshini, C. S. Sureka, and S. Pooja, “Fabrication and Dosimetric Characteristics of Silicon Elastomer-Based Bolus Using External Beam Radiotherapy,” Asian Pacific Journal of Cancer Prevention, vol. 24, no. 1, pp. 141–147, 2023.
[24] N. S. Giakoumakis et al., “Total revalorization of high impact polystyrene (HIPS): enhancing styrene recovery and upcycling of the rubber phase,” Green Chemistry, vol. 26, no. 1, pp. 340–352, Nov. 2023.
[25] ASTM, “ASTM D570-22 : Standard Test Method for Water Absorption of Plastics,” ASTM International, West Conshohocken, PA, Sep. 2022.
[26] I. Buj-Corral, A. Bagheri, A. Dominguez-Fernandez, and R. Casado-Lopez, “Influence of infill and nozzle diameter on porosity of FDM printed part with rectilinear grid pattern,” Procedia Manuf, vol. 41, pp. 288–5, 2019.
[27] PNNL, “Data Mining Analysis and Modeling Cell Compendium of Material Composition Data for Radiation Transport Modeling,” Washington, 2021.
[28] O. Rusoke-Dierich, “Composition of The Normal Air,” in Diving Medicine, Cham: Springer, 2018, ch. 6, pp. 41–42.
[29] K. Usui, K. Ogawa, and K. Sasai, “Analysis of Dose Calculation Accuracy in Cone Beam Computed Tomography with Various Amount of Scattered Photon Contamination,” Int J Med Phys Clin Eng Radiat Oncol, vol. 06, no. 03, pp. 233–251, 2017.
[30] F. M. Khan, “Dose Distribution and Scatter Analysis,” in The Physics of Radiation Therapy, 3rd ed., Philadelphia: Lippincott Williams & Wilkins, 2003, ch. 9, pp. 159–177.
[31] M. Q. dos Reis, R. J. C. Carbas, E. A. S. Marques, and L. F. M. da Silva, “Effect of the Infill Density on 3D-Printed Geometrically Graded Impact Attenuators,” Polymers (Basel), vol. 16, no. 22, Nov. 2024.
[32] J. Madamesila, P. McGeachy, J. E. Villarreal Barajas, and R. Khan, “Characterizing 3D printing in the fabrication of variable density phantoms for quality assurance of radiotherapy,” Physica Medica, vol. 32, no. 1, pp. 242–247, Jan. 2016.
[33] H. Bakhtiari, M. Nikzad, and M. Tolouei-Rad, “Influence of Three-Dimensional Printing Parameters on Compressive Properties and Surface Smoothness of Polylactic Acid Specimens,” Polymers (Basel), vol. 15, no. 18, Sep. 2023.
License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with Indonesian Physical Review Journal, agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International Licence (CC BY SA-4.0). This license allows authors to use all articles, data sets, graphics, and appendices in data mining applications, search engines, web sites, blogs, and other platforms by providing an appropriate reference. The journal allows the author(s) to hold the copyright without restrictions and will retain publishing rights without restrictions.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Indonesian Physical Review Journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).

