Main Session
Sep
28
PQA 01 - Radiation and Cancer Physics, Sarcoma and Cutaneous Tumors
2234 - Digital Uniform Nesting Enclosure (DUNE) for Radiation Therapy in Early-Stage Dupuytren's Disease
Presenter(s)
James Sohn, PhD - University of Chicago, Chicago, IL
E. D. Stolen1, D. Lee1, S. Zheng2, B. H. Kim3, S. Kim4, and J. J. Sohn5; 1University of Chicago, Chicago, IL, 2Department of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, 3Department of Radiation Oncology, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea, Republic of (South), 4Virginia Commonwealth University Health System, Department of Radiation Oncology, Richmond, VA, 5Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL
Purpose/Objective(s):
Dupuytren’s contracture is a progressive fibroproliferative condition that can benefit from low-dose radiation therapy (RT) in its early stages. However, effective RT requires precise and reproducible hand positioning to maximize therapeutic impact and minimize exposure to surrounding tissues. This study introduces a novel 3D-printed patient-specific hand restraint, the DUNE (Dupuytren’s Unique Nesting Enclosure) box, designed to improve positioning accuracy and stability during treatment sessions. By focusing on customization and reproducibility, the DUNE box aims to facilitate more consistent dose delivery, potentially enhancing clinical outcomes for patients undergoing low-dose RT for Dupuytren’s disease.Materials/Methods:
A set of preliminary measurements assessed how different hand and finger positions could influence dose distribution when using standard immobilization techniques. Building on these observations, a customized hand phantom was digitally captured via a 3D hand-held scanner. This digital model then served as the foundation for designing a patient-specific enclosure. The DUNE box was produced on a standard extrusion 3D printer, designed to conform precisely to each patient’s individual hand contours and optimal treatment position. Workflow integration and setup reproducibility were assessed to confirm the feasibility of adopting the DUNE box in a busy clinical environment. Finally, comparisons were made against traditional hand immobilization methods, such as tape or manual positioning, to highlight any differences in setup time and positioning repeatability.Results:
Early testing demonstrated that the DUNE box provides robust immobilization and a high degree of reproducibility, potentially resulting in more uniform dose coverage across the targeted palmar fascia. Clinicians also observed a streamlined setup procedure, facilitated by the box’s ergonomic design. While the 3D printing process introduces additional steps in initial planning and fabrication, these requirements are manageable and can be integrated efficiently into modern radiation oncology workflows.Conclusion:
The DUNE box represents a significant advance in patient-specific immobilization for Dupuytren’s contracture, particularly for low-dose radiation therapy protocols aimed at halting disease progression. By promoting consistent hand positioning and uniform dose distribution, this approach has the potential to improve patient comfort and therapeutic outcomes. Although future prospective trials are warranted to confirm long-term clinical benefits and cost-effectiveness, the DUNE box offers a promising advancement in standardizing RT techniques for Dupuytren’s disease.