Paper-based 3D printing of anthropomorphic CT phantoms: Feasibility of two construction techniques.

<bold>Objectives: </bold>To develop and evaluate methods for assembling radiopaque printed paper sheets to realistic patient phantoms for CT dose and image quality testing.<bold>Methods: </bold>CT images of two patients were radiopaque printed with aqueous potassium iodide solution (0.6 g/ml) on paper. Two methods were developed for assembling the paper sheets to head and neck phantoms. (1) Printed sheets were fed to a paper-based 3D printer along with corresponding 3D printable STL files. (2) Paper stacks of 5-mm thickness were glued with toner, cut to the patient shape and assembled to a phantom. In a sample application study, both phantoms were examined with five different tube current settings. Images were reconstructed using filtered-back projection (FBP) and iterative reconstruction (AIDR 3D) with three strength levels. Dose length product (DLP), signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNRs) were analysed. Data were analysed using 2-way analysis of variance (ANOVA).<bold>Results: </bold>Both methods achieved anthropomorphic phantoms with detailed patient anatomy. The 3D printer yielded a precise reproduction of the external patient shape, but caused visible glue artefacts. Gluing with toner avoided these artefacts and yielded more flexibility with regard to phantom size. In the sample application study, non-inferior SNR and CNR and up to 83.7% lower DLP were achieved on the phantoms with AIDR 3D compared with FBP.<bold>Conclusions: </bold>Two methods for assembling radiopaque printed paper sheets to phantoms of individual patients are presented. The sample application demonstrates potential for simulation of patient imaging and systematic CT dose and image quality assessment.<bold>Key Points: </bold>• Two methods were developed to create realistic CT phantoms of individual patients from radiopaque printed paper sheets. • Analysis of five tube current and four reconstruction settings on two radiopaque 3D printed patient phantoms yielded non-inferior SNR and CNR and up to 83.7% lower dose with iterative reconstruction in comparison with filtered back projection. • Radiopaque 3D printed phantoms can simulate patients and allow systematic analysis of CT dose and image quality parameters. [ABSTRACT FROM AUTHOR]