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The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader Mould Room Techniques
Part One The Past the Present amp Future
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Synopsis
bull The evolution of moulds from live source to afterloaded moulds progressing to current Scan amp Plan technique using the Freiburg Flap
The Christie NHS Foundation Trust
1905 Photograph showing the method of strapping on
small tubes of radium to the skin to treat malignancies
Transferred from enwikipedia (Original text Metzenbaum Myron (1905) Radium Its value in the treatment of lupus rodent ulcer and epithelioma with reports of cases International clinics (JB Lippincott) 414 21-31)
The Christie NHS Foundation Trust
1922ndash1923 at the Institut Curie Paris
a) Patient before radium treatment March 1922 b) Patient with radium applicator in the treatment position February 1923 c) Patient follow-up later in 1923 Br J Radiol 1998 Dec71(852)1229-54 The discovery of radium in 1898 by Maria Sklodowska-Curie (1867-1934) and Pierre Curie (1859-1906) with commentary on their life
and times Mould RF
The Christie NHS Foundation Trust
R F Mould ldquoA Century of X-Rays and
Radioactivity in Medicine With Emphasis on Photographic Records of the
Early Yearsrdquo (1993)
The Christie NHS Foundation Trust
Birth of the Mould Room
bull This is where we came from
bull Radium first used in the 1900rsquos
(first used in Manchester 1903)
bull Moulds followed very quickly after that
bull Mould rooms well established by 1920rsquos
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy Moulds at Christie bull Moulds well established pre 1930rsquos bull Ralston Paterson visited Brussels 1932 returning
with ideas for improvements bull 1937 ldquoThe Construction of Superficial Applicators for Radium Therapy ldquo
Paterson amp McVicar British Journal Of Radiology Very detailed description of techniques
bull Radium Cobalt60 Moulds continued until 1991 bull 1991 MicroSelectron Afterloaded moulds bull 2013 Freiburg Flap introduced
The Christie NHS Foundation Trust
Traditional Live Mould (Co60)
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Synopsis
bull The evolution of moulds from live source to afterloaded moulds progressing to current Scan amp Plan technique using the Freiburg Flap
The Christie NHS Foundation Trust
1905 Photograph showing the method of strapping on
small tubes of radium to the skin to treat malignancies
Transferred from enwikipedia (Original text Metzenbaum Myron (1905) Radium Its value in the treatment of lupus rodent ulcer and epithelioma with reports of cases International clinics (JB Lippincott) 414 21-31)
The Christie NHS Foundation Trust
1922ndash1923 at the Institut Curie Paris
a) Patient before radium treatment March 1922 b) Patient with radium applicator in the treatment position February 1923 c) Patient follow-up later in 1923 Br J Radiol 1998 Dec71(852)1229-54 The discovery of radium in 1898 by Maria Sklodowska-Curie (1867-1934) and Pierre Curie (1859-1906) with commentary on their life
and times Mould RF
The Christie NHS Foundation Trust
R F Mould ldquoA Century of X-Rays and
Radioactivity in Medicine With Emphasis on Photographic Records of the
Early Yearsrdquo (1993)
The Christie NHS Foundation Trust
Birth of the Mould Room
bull This is where we came from
bull Radium first used in the 1900rsquos
(first used in Manchester 1903)
bull Moulds followed very quickly after that
bull Mould rooms well established by 1920rsquos
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy Moulds at Christie bull Moulds well established pre 1930rsquos bull Ralston Paterson visited Brussels 1932 returning
with ideas for improvements bull 1937 ldquoThe Construction of Superficial Applicators for Radium Therapy ldquo
Paterson amp McVicar British Journal Of Radiology Very detailed description of techniques
bull Radium Cobalt60 Moulds continued until 1991 bull 1991 MicroSelectron Afterloaded moulds bull 2013 Freiburg Flap introduced
The Christie NHS Foundation Trust
Traditional Live Mould (Co60)
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
1905 Photograph showing the method of strapping on
small tubes of radium to the skin to treat malignancies
Transferred from enwikipedia (Original text Metzenbaum Myron (1905) Radium Its value in the treatment of lupus rodent ulcer and epithelioma with reports of cases International clinics (JB Lippincott) 414 21-31)
The Christie NHS Foundation Trust
1922ndash1923 at the Institut Curie Paris
a) Patient before radium treatment March 1922 b) Patient with radium applicator in the treatment position February 1923 c) Patient follow-up later in 1923 Br J Radiol 1998 Dec71(852)1229-54 The discovery of radium in 1898 by Maria Sklodowska-Curie (1867-1934) and Pierre Curie (1859-1906) with commentary on their life
and times Mould RF
The Christie NHS Foundation Trust
R F Mould ldquoA Century of X-Rays and
Radioactivity in Medicine With Emphasis on Photographic Records of the
Early Yearsrdquo (1993)
The Christie NHS Foundation Trust
Birth of the Mould Room
bull This is where we came from
bull Radium first used in the 1900rsquos
(first used in Manchester 1903)
bull Moulds followed very quickly after that
bull Mould rooms well established by 1920rsquos
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy Moulds at Christie bull Moulds well established pre 1930rsquos bull Ralston Paterson visited Brussels 1932 returning
with ideas for improvements bull 1937 ldquoThe Construction of Superficial Applicators for Radium Therapy ldquo
Paterson amp McVicar British Journal Of Radiology Very detailed description of techniques
bull Radium Cobalt60 Moulds continued until 1991 bull 1991 MicroSelectron Afterloaded moulds bull 2013 Freiburg Flap introduced
The Christie NHS Foundation Trust
Traditional Live Mould (Co60)
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
1922ndash1923 at the Institut Curie Paris
a) Patient before radium treatment March 1922 b) Patient with radium applicator in the treatment position February 1923 c) Patient follow-up later in 1923 Br J Radiol 1998 Dec71(852)1229-54 The discovery of radium in 1898 by Maria Sklodowska-Curie (1867-1934) and Pierre Curie (1859-1906) with commentary on their life
and times Mould RF
The Christie NHS Foundation Trust
R F Mould ldquoA Century of X-Rays and
Radioactivity in Medicine With Emphasis on Photographic Records of the
Early Yearsrdquo (1993)
The Christie NHS Foundation Trust
Birth of the Mould Room
bull This is where we came from
bull Radium first used in the 1900rsquos
(first used in Manchester 1903)
bull Moulds followed very quickly after that
bull Mould rooms well established by 1920rsquos
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy Moulds at Christie bull Moulds well established pre 1930rsquos bull Ralston Paterson visited Brussels 1932 returning
with ideas for improvements bull 1937 ldquoThe Construction of Superficial Applicators for Radium Therapy ldquo
Paterson amp McVicar British Journal Of Radiology Very detailed description of techniques
bull Radium Cobalt60 Moulds continued until 1991 bull 1991 MicroSelectron Afterloaded moulds bull 2013 Freiburg Flap introduced
The Christie NHS Foundation Trust
Traditional Live Mould (Co60)
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
R F Mould ldquoA Century of X-Rays and
Radioactivity in Medicine With Emphasis on Photographic Records of the
Early Yearsrdquo (1993)
The Christie NHS Foundation Trust
Birth of the Mould Room
bull This is where we came from
bull Radium first used in the 1900rsquos
(first used in Manchester 1903)
bull Moulds followed very quickly after that
bull Mould rooms well established by 1920rsquos
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy Moulds at Christie bull Moulds well established pre 1930rsquos bull Ralston Paterson visited Brussels 1932 returning
with ideas for improvements bull 1937 ldquoThe Construction of Superficial Applicators for Radium Therapy ldquo
Paterson amp McVicar British Journal Of Radiology Very detailed description of techniques
bull Radium Cobalt60 Moulds continued until 1991 bull 1991 MicroSelectron Afterloaded moulds bull 2013 Freiburg Flap introduced
The Christie NHS Foundation Trust
Traditional Live Mould (Co60)
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Birth of the Mould Room
bull This is where we came from
bull Radium first used in the 1900rsquos
(first used in Manchester 1903)
bull Moulds followed very quickly after that
bull Mould rooms well established by 1920rsquos
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy Moulds at Christie bull Moulds well established pre 1930rsquos bull Ralston Paterson visited Brussels 1932 returning
with ideas for improvements bull 1937 ldquoThe Construction of Superficial Applicators for Radium Therapy ldquo
Paterson amp McVicar British Journal Of Radiology Very detailed description of techniques
bull Radium Cobalt60 Moulds continued until 1991 bull 1991 MicroSelectron Afterloaded moulds bull 2013 Freiburg Flap introduced
The Christie NHS Foundation Trust
Traditional Live Mould (Co60)
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy Moulds at Christie bull Moulds well established pre 1930rsquos bull Ralston Paterson visited Brussels 1932 returning
with ideas for improvements bull 1937 ldquoThe Construction of Superficial Applicators for Radium Therapy ldquo
Paterson amp McVicar British Journal Of Radiology Very detailed description of techniques
bull Radium Cobalt60 Moulds continued until 1991 bull 1991 MicroSelectron Afterloaded moulds bull 2013 Freiburg Flap introduced
The Christie NHS Foundation Trust
Traditional Live Mould (Co60)
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Brachytherapy Moulds at Christie bull Moulds well established pre 1930rsquos bull Ralston Paterson visited Brussels 1932 returning
with ideas for improvements bull 1937 ldquoThe Construction of Superficial Applicators for Radium Therapy ldquo
Paterson amp McVicar British Journal Of Radiology Very detailed description of techniques
bull Radium Cobalt60 Moulds continued until 1991 bull 1991 MicroSelectron Afterloaded moulds bull 2013 Freiburg Flap introduced
The Christie NHS Foundation Trust
Traditional Live Mould (Co60)
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Traditional Live Mould (Co60)
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Live Radium Cobalt Moulds
bull Long treatment times up to 8hrs per day 8days bull Patient comfort issues bull Mould application and cleaning
bull Radiation safety- Staff other patients
Source security
Most of these issues solved by afterloading technique
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
HDR Microselectron Mould Advantages
bull Afterloaded No radiation hazard whilst fitting
or servicing the mould eg cleaning bull Short treatment time means patient comfort
considerations in mould design less important This may allow patient to tolerate more severe positioning
bull Smaller source size allows tricky source placements
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Drilled post height Platform height
Combined Sourcecatheter diameter 200mm
Traditional Mould ndash Treatment Height
Height and position of sources was critical
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
bull Traditionally Paterson-Parker rules bull Moulds often scanned and planned allowing
some variation in source dwell times
helliphellipbut very little other flexibility in planning and treatment delivery
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Manchester Paterson-Parker system bull Traditional moulds impose fixed geometry as
source position is fixed bull Mould accuracy was crucial as treating distance
determined dose bull Little progression from historical moulds bull Not taking advantage of available technology
scanning planning treatment delivery systems
bull Pre-fixed array arrangement would allow more
flexible planning approach
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Treatment Sites
bull Finger Hand Wrist Forearm bull Leg bull Scalp bull Pinna
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Freiberg Flap
bull Aquaplast Custom Bolus used as spacer material over foundation shell
bull Flexible Catheter array fixed to mould using nylon M4 bolts
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Surface Moulds helliphellipThe Future
bull Further developmentof useage of Thermoplastic
material (pros amp cons) bull Speed up adhesives method
Glue gun thermo setting adhesives
bull 3D Printing is being explored elsewhere
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
3D Printed Patient-specific Surface Mould Applicators for Brachytherapy Treatment of Superficial Lesions
Ian Cumming et al
Laboratory for Percutaneous Surgery School of Computing Queens University KingstonOntario Canada CCSEO Kingston General Hospital and Department of Oncology Queens UniversityKingston Ontario
Canada httpperkcsqueensucasitesperkd7csqueensucafilesCumming2014pdf
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
To Be Continuedhelliphellip Part Two
Practical aspects of Skin Surface Moulds
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Surface Moulds for the HDR MicroSelectron Afterloader
Mould Room Techniques
Part Two Practical Techniques
Tony Stanton Mould Room Manager
The Christie Foundation NHS Trust
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Pre Impression Assessment
bull The mould is literally the foundation on which the treatment is based
bull Correct assessment when planning is crucial bull Scalp amp Legs usually straightforward bull Fingers can be problematic bull Pinna (depends on location)
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Pre-Impression Assessment
bull Assess extent of treatment area bull Consider curvature and how far around cylinder area will extend Remember Freiburg flap Platform will need to extend +10 cm beyond
area
This will determine design of mould- especially fingers hands bull Glove type or Clip down mould
bull Glove type much more difficult to make and fit often difficulties
with shape of finger but if area extends around finger it is required
bull Also may cause difficulties marking area on planning scan bull Finger positions can be crucial
Proximity dose of adjoining fingers Shielding on mould advised
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Impresssion
bull Plaster Bandage usually bull Fingers Lab Putty base with alginate allows
optimal positioning in stressed position bull Hands Lab Putty base often incorporated as
support for hand on a baseplate
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Clip down mould
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Glove type mould
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Flap and platform will have to extend radially +10cm beyond area
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Brachytherapy MicroSelectron Mould patients
bull Preparation ~ Three OP visits
bull Treatment as OP 2 weeks later bull Eight treatments over four days
Mon Weds Tues
Impression Fitting amp Markout RTP CT Scan
am pm
Tues
Weds
Thurs
Frid
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Method (1)
bull Patient selection Ultrasound scan to determine lesion thickness
bull Impression model bull Vac formed Vivak mould bull Fitting bull Doctor defines area traced onto mould bull Required Treatment depth decided will
determine position of Freiburg Flap mounting ie bolus platform layers
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Method (2) bull Apply layers of 48mm Aquaplast RT Custom
Bolustrade bull Decide direction and position of catheters
Transit dose Curvature amp contours
bull Mount Freiburg Flap on mould using M4 bolts bull CT RTP Scan bull Dosimetry and programming of MicroSelectron
machine bull Treatment
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Catheter Source transit direction
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Bolus Platform
bull Bolus added in 48mm layers bull Aquaplast bolus will adhere to mould
(Holes drilled later will act as reference) Cyanoacrylate adhesive (Superglue) may also be used
bull Area traced through by layer useful when positioning Freiburg flap
(Bolus is translucent when warm) bull Allowed to cool completely
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
bull Bolus platform is threaded using M4 Tap
bull helliphelliphelliphellipSlowly Tap generates friction=heat
which will melt low temperature material if rushed (Thread spoiled)
bull Typically 5 mins per hole (maybe x25) bull Fixed with countersunk nylon M4 bolts
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
M4 Threaded Tap amp Bolts
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Holes between beads of Freiburg Flap fit countersunk M4 bolt head
Allow adjustmentremoval of flap during preparation
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
bullFreiburg Flap
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Treatment height d
Mould thickness
Added Platform height in 48mm
layers
Freiburg Flap thickness
80 depth dose level
Freiburg Flap ndash Treatment Height
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Pb shielding incorporated into mould
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
bull No bolus layers required
bull Unable to tap amp bolt Freiburg flap
bull Catheters superglued directly to plastic platform
Short Treatment distance
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Conclusion
bull The Freiburg Flap can be successfully mounted onto surface moulds using thermoplastic bolus material as a spacer material
bull M4 countersunk bolts allow the flap to be reversibly attached to the mould allowing adjustment and removal during the preparatory phase
bull Brachytherapy skin moulds remain an effective and efficient method of treating skin cancer
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Thank You
(Materials amp Suppliers details attached) TonyStantonChristienhsuk
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
The End
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Coltene Lab Putty ITEM Product Code
Lab Putty 75 Kg Hospital Pack 8815
Lab Putty Activator 8840
Coltene Adhesive 10ml 4410
httpwwwcoltenecomenproducts47details206searchresult-article-206html
Supplier
Coltene Whaledent UK The President Suite C
Kendal House
Victoria Way Burgess Hill Sussex
RH15 9NF Tel 01444 235486
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
Aquaplast RT Custom Bolustrade UK Supplier Oncology Imaging Systems Units 7-8 The Paddocks Carriers Way East Hoathly East Sussex BN8 6AG Tel +44 (0)1825 840 633 Fax +44 (0)1825 841 496 Email salesoncologyimagingcom httpwwwoncologyimagingcom
httpqfixcomqfix-productsaids-and-accessoriesaspCID=10ampPLID=51
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
-
The Christie NHS Foundation Trust
M4 Nylon Countersunk Screws
Nylon amp Alloys Ltd Unit 1500 145 - 147 Boston Road Hanwell London W7 3SA Tel +44 (0)20 8579 5166 Fax +44 (0)20 8579 6986 Email nanylonalloyscouk
httpwwwnylonalloyscouk httpwwwnylonalloyscoukcgi-binshopnylon-alloys-productsplNYLON|METRIC|SCREWS|countersunk|countersunkslotted
096304010 M4 10mm 096304012 M4 12mm 096304016 M4 16mm 096304020 M4 20mm
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part One The Past the Present amp Future
- Synopsis
- 1905 Photograph showing the method of strapping on small tubes of radium to the skin to treat malignancies
- 1922ndash1923 at the Institut Curie Paris
- Slide Number 5
- Birth of the Mould Room
- Slide Number 7
- Brachytherapy Moulds at Christie
- Traditional Live Mould (Co60)
- Slide Number 10
- Live Radium Cobalt Moulds
- HDR Microselectron MouldAdvantages
- Slide Number 13
- Slide Number 14
- Slide Number 15
- Slide Number 16
- Slide Number 17
- Slide Number 18
- Manchester Paterson-Parker system
- Treatment Sites
- Freiberg Flap
- Surface Moulds helliphellipThe Future
- 3D Printed Patient-specific Surface Mould Applicators forBrachytherapy Treatment of Superficial Lesions
- Slide Number 24
- Surface Moulds for the HDR MicroSelectron AfterloaderMould Room Techniques Part Two Practical Techniques
- Pre Impression Assessment
- Pre-Impression Assessment
- Impresssion
- Clip down mould
- Glove type mould
- Slide Number 31
- Slide Number 32
- Slide Number 33
- Brachytherapy MicroSelectron Mould patients
- Method (1)
- Method (2)
- Catheter Source transit direction
- Slide Number 38
- Bolus Platform
- Slide Number 40
- Slide Number 41
- M4 Threaded Tap amp Bolts
- Slide Number 43
- Slide Number 44
- Slide Number 45
- Slide Number 46
- Slide Number 47
- Slide Number 48
- Pb shielding incorporated into mould
- Slide Number 50
- Conclusion
- Thank You
- The End
- Coltene Lab Putty
- Aquaplast RT Custom Bolustrade
- M4 Nylon Countersunk Screws
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