Clinical Applications of Thermoplastic Sheets as Patient-Specific Gonadal Shields During Computed Tomography Simulation

Purpose: Conventional gonadal shields are manufactured in standardized sizes and shapes and do not conform to individual testicular contours, causing discomfort.We developed a novel patientspecific gonadal shield using thermoplastic sheets and tested its feasibility through dosimetric evaluations.Methods: During the computed tomography simulation, custom lead shields were fabricated using thermoplastic sheets that were molded to the testicular shape of the patient.The shielding efficacy was evaluated using optically stimulated luminescent dosimeters (OSLDs) for point dose measurements. Results:The thermoplastic sheet was molded to fit closely to the skin with a minimal air gap of approximately 8.4 cm, providing comfort to the patient during treatment.The patient-specific shield effectively reduced the surface dose from 28 cGy to less than 15 cGy.By combining the OSLDs located in the same row and calculating the mean dose value, a shielding effect was achieved with a maximum dose reduction of 56.1%.Conclusions: Customized gonadal shields were successfully created using thermoplastic sheets to minimize patient discomfort during application.However, further improvements in lead shield fabrication are needed to ensure full conformity.