FAQs

Yes. The OptiBol design software is built in to the “p.d” software, which has a vendor-neutral DICOM interface so it will work with any commercial TPS. Data import and export summaries are as follows:

• The data imported are (1) the DICOM CT (or MR) images and (2) a DICOM RT Structure Set that has (at minimum) the patient external shape and internal target(s) defined.
• The data exported will be a new version of the DICOM RT Structure Set that will transfer the bolus design a new “region of interest” (ROI) defined by a set of axial contours.

OptiBol Pricing is the Same as FlexiBol (and might be less*)

OptiBol prices are determined based on size using the same formulas as conventional, TPS-designed FlexiBol devices. (Note: “Size” here is related to width/length and surface area, not thickness.)

Also, there is no separate software license for p.d users. Once you auto-update to the 6.0.0 version of p.d, you can start designing OptiBols.

(*) OptiBols Might Cost Less Than TPS-Designed FlexiBols

You might find that a subset of your OptiBol devices cost less (per device) than a bolus designed with the conventional tools in your TPS. This is because they are auto-generated based on the underlying target’s shape and volume combined with the user-defined desired buildup.

This automation ensures that OptiBols add bolus material where needed, but only where needed. In some cases, the OptiBols may be smaller in terms of the region covered on the patient surface, and therefore may go down in price level compared to a bolus that is designed in your TPS based on user-estimated surface regions.

The basic differences in workflow are these:

• You will design the bolus based on target volume(s) and external contours, not independent of them.
• Before you create and optimize your treatment plan, you will use the p.d software to generate a bolus as a new region-of-interest (ROI) in a DICOM RT structure set, and export this design from p.d into your TPS.

The bolus design process is as follows:

1. Import data (images and structures) into p.d
2. Enter bolus design parameters
3. Generate your bolus design
4. Export the bolus design back to your TPS.

This process of import, design, and export can be done quickly, requiring only 1-2 minutes in total for typical datasets and target sizes.

Other than the bolus design process, the planning workflow is the same as with a conventional/TPS-designed bolus, including your choice of when to order the bolus relative to generating the treatment plan.

Alignment guides are a design option allowing you to build visible and precise lines into the outer bolus surface. The guides are very shallow and dosimetrically insignificant.

Alignment guides, if selected, are added at user-defined sagittal and/or coronal planes.

• A sagittal plane’s alignment guide will be visible as a precise linear “groove” running inferior-superior in a straight line (e.g., as viewed anteriorly) in the defined sagittal plane.
• The coronal plane’s alignment guide(s) will be visible as grooves running inferior-superior in straight line(s) (e.g., as viewed from the patient’s left or right) at the level of the coronal plane.

An effective and efficient practice is to specify point(s) of interest in the original DICOM RT Structure Set that you import into p.d. A point of interest for alignment might be a setup reference point or other useful position inside or on the patient. If you have a point of interest defined, you can set alignment guides to be at the planes intersecting one of the predefined points. Otherwise, with no points of interest, you can manually adjust alignment guide plane positions in the p.d software.

OptiBols are made of the proprietary silicone composition used by .decimal for all FlexiBol devices.

• The OptiBol material is identical to FlexiBol, so boluses will be just as flexible and comfortable.
• The OptiBol color is identical to FlexiBol, so it will retain the optimized visibility for surface-guided radiation therapy systems.

A variable-thickness OptiBol will essentially “reshape” the irradiated/external surface with bolus material:

• The inner surface of the bolus will be custom-fit to the underlying patient external shape.
• The outer surface is designed so that the minimum depth for all underlying target voxels will be near* or beyond the goal buildup depth specified by the user.

  This means there will be thicker portions near shallower target voxels, and less-thick portions where the target voxels venture deeper, but are still shallower than the user-defined goal buildup.   There will also be variable thickness regions in these regions:  

• The outer bolus margins, where the edges are tapered to avoid steep/square bolus edges
• Alignment guide locations (if the optional alignment guides are used), where very small (and dosimetrically insignificant) “grooves” will be added to the outer bolus surface to form visible alignment guides at user-defined sagittal and coronal planes