Journal of applied clinical medical physics · 2026
Evaluation of testicular shielding effectiveness for surface and internal photon dose using a 3D-printed scrotal phantom.
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Speth Joseph, Kilian-Meneghin Josh, Jabbour Salma K, Zhang Yin, Wang Xiao, Xiong Zhenyu, Nie Ke, Yue Ning J, Zhang Xinxin
Аннотация
BACKGROUND: Testicular shielding has long been used to reduce testicular dose during radiation treatment. However, quantitative evaluations of the effectiveness of such shielding in the literature vary substantially.
PURPOSE: In this study, the dose reduction expected at both the testicular skin surface and the inside of the testes was evaluated under different irradiation conditions, to enable informed clinical decision-making.
METHODS: A 3D printed scrotal phantom was designed to simulate patient testes and was composed of three layers to enable dose measurement inside the phantom. Gafchromic EBT3 film was used for dose measurements. The scrotal phantom was attached to a RANDO anthropomorphic phantom for computed tomography scanning and measurements. A commercial testicular shield with a lead wall thickness of 1.27 cm and a diameter of 6 cm was used for shielded measurements. The measured absolute dose was normalized to the delivered MU for each measurement to obtain a dose-to-MU value (cGy/MU). Both dose-to-MU values and shielding effectiveness were evaluated with a stationary anterior-posterior beam at different distances from field edge to scrotal phantom. In addition, the energy dependence of shielding effectiveness was assessed using two volumetric modulated arc therapy (VMAT) plans with identical parameters and modulation but using 6 and 15 MV energies.
RESULTS: The shielded and unshielded dose-to-MU values generally decreased with increasing field-to-phantom distance for both surface and internal dose measurements. However, the shielding ratio remained relatively constant across distances, with a reduction factor of approximately 3.3 for surface dose and 2.7 for internal dose. Minimal energy dependence was observed in both internal and surface dose measurements, as well as in shielding effectiveness, across the two VMAT plans. The overall shielding ratio was approximately 2.3 for both plans.
CONCLUSIONS: Testicular shielding reduced both surface and internal testicular dose by approximately a factor of 2 to 3, demonstrating consistent effectiveness across different irradiation geometries and photon energies.
PURPOSE: In this study, the dose reduction expected at both the testicular skin surface and the inside of the testes was evaluated under different irradiation conditions, to enable informed clinical decision-making.
METHODS: A 3D printed scrotal phantom was designed to simulate patient testes and was composed of three layers to enable dose measurement inside the phantom. Gafchromic EBT3 film was used for dose measurements. The scrotal phantom was attached to a RANDO anthropomorphic phantom for computed tomography scanning and measurements. A commercial testicular shield with a lead wall thickness of 1.27 cm and a diameter of 6 cm was used for shielded measurements. The measured absolute dose was normalized to the delivered MU for each measurement to obtain a dose-to-MU value (cGy/MU). Both dose-to-MU values and shielding effectiveness were evaluated with a stationary anterior-posterior beam at different distances from field edge to scrotal phantom. In addition, the energy dependence of shielding effectiveness was assessed using two volumetric modulated arc therapy (VMAT) plans with identical parameters and modulation but using 6 and 15 MV energies.
RESULTS: The shielded and unshielded dose-to-MU values generally decreased with increasing field-to-phantom distance for both surface and internal dose measurements. However, the shielding ratio remained relatively constant across distances, with a reduction factor of approximately 3.3 for surface dose and 2.7 for internal dose. Minimal energy dependence was observed in both internal and surface dose measurements, as well as in shielding effectiveness, across the two VMAT plans. The overall shielding ratio was approximately 2.3 for both plans.
CONCLUSIONS: Testicular shielding reduced both surface and internal testicular dose by approximately a factor of 2 to 3, demonstrating consistent effectiveness across different irradiation geometries and photon energies.