Validation of spine SBRT using a 3D printed Anthropomorphic phantom

Abstract A segment of a spine was 3D-printed based on real patient anatomy, using metal-doped high density plastic to radiographically mimic bone. This spine was submerged in a water tank to create an anthropomorphic phantom. The spine print incorporated a slot for Gafchromic EBT3 film dosimeters and fiducials for alignment of measured and calculated dose distributions. Spine SBRT treatment plans were generated for both 6 MV and 10FFF energies based on oncologist-drawn contours transferred from real anatomy. Plans were delivered under image guidance using our clinical procedures, to evaluate the dosimetric accuracy of our planning system in high density inhomogeneities and the geometric accuracy of delivery. Results show that the Acuros XB algorithm (dose-to-water) agrees well with film measurements throughout the measured region, including within the bone substitute material. Alignment of the steep dose gradients in planned and measured doses was within 0.5 mm in the ANT-POST direction and within 0.9 mm in the SUP-INF direction, both within machine tolerances. Our results give us confidence in our ability to plan and accurately deliver spinal SBRT treatments.